The Role of Permissive and Neglectful Parenting Style in Determining the Academic Performance of Adolescents in the Senior High Schools in the Birim Municipality

The purpose of the study was to examine the impact of parenting styles on the academic performance of adolescents in the senior high school of Birim Central Municipality in Ghana. To accomplish this, a descriptive survey research design procedure using a quantitative approach was employed. A sample size of 317 respondents were used for the study. Questionnaire was used to obtain data from the respondents. The data was analysed using inferential statistics (multiple regression and Pearson Product Moment Correlation). The study revealed that generally, the academic performance of adolescents in the third year in the Senior High School of Birim Central Municipality in Ghana was greatly influenced by the type of parenting style the parents adopt. However, the findings from study suggest that differences in academic performances of students in the study area were as a result of the variations in parenting styles used by parents.  Overall, authoritarian parenting style was found to have a more significant effect on students’ academic performance than other parenting style. Additionally, students from authoritarian homes were found to perform better than the others from other parenting homes. It was therefore, recommended that there should be awareness of parenting styles and their dimensions of parenting by the Municipal Assembly, Ghana Education Service, the Parent Teacher Associations within the Senior High Schools, the Clergy and the Media within the Birim Central Municipality in Ghana. This will help parents to adopt the right parenting style and it dimensions. Keywords: Parenting, Permissive, Neglectful, Parents, Adolescen

Effects of Global Warming on Work-Rest Routines for Crop Workers in Appalachia

Background: Workers in outdoor occupations are expected to be at high risk of increased morbidity and mortality, and diminished productivity, as a result of global warming in the 21st century. A previous modelling study of geographic variations in heat-related mortality risk in projected U.S. populations mid-century showed the states of Tennessee, Kentucky and North Carolina to be highly vulnerable. Methods: Under both the RCP4.5 and RCP8.5 emissions scenarios of IPCC AR5, we evaluate the effect of future warming on estimated Wet Bulb Globe Thermometer (WBGT) temperatures using model-simulated future climate variables that were dynamically downscaled by a regional meteorology model for years 2049-2052. Select Appalachian counties in the three states that are presently dependent upon agricultural crop production are the focus of this analysis. Results: Using predicted WBGT temperatures, together with estimated work loads for hand harvesting of crops, alterations in work-rest routines under heat stress prevention guidelines are presented. Conclusions: Assumptions needed to translate these altered work-rest routines into measures of productivity and economic loss are discussed. Issues in extending the modelling to heat-related morbidity and mortality in outdoor worker populations are considered in terms of data gaps and major sources of uncertainty

Using Holt Winter’s Multiplicative Model to Forecast Assisted Childbirths at the Teaching Hospital in Ashanti Region, Ghana

The use of maternal healthcare facilities is an important indicator of the impact of the free maternal healthcare policy aimed at improving health status of pregnant women in Ghana. This study investigated the pattern of quarterly assisted deliveries at Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana from 2000 to 2011. The Holt Winters multiplicative and additive forecasting models were considered. The Multiplicative model reported a Root Mean Square Error of Prediction (RMSEP) of 31.10, Root Mean Square Error (RMSE) of 188.080, Mean Absolute Percentage Error (MAPE) of 6.2951 and Mean Absolute Scaled Error (MASE) of 0.7086 while the additive model reported RMSEP, RMSE, MAPE and MASE of 49.59 201.83, 6.3098 and 0.7106 respectively .The multiplicative model further passed the Shapiro-Wilks test (p-value 0.07358). Results identified the second and fourth quarters as peak seasons and the first quarters as deep seasons for assisted childbirths in the hospital.  The negative binomial regression confirmed this by identifying April, May, October and November as peaks months with May being the most significant month. Keywords: Holt Winter’s multiplicative and addictive models, Forecasting, Seasonal, Negative binomial model

Assessing Heat-Related Mortality Risks among Rural Populations: A Systematic Review and Meta-Analysis of Epidemiological Evidence

Most epidemiological studies of high temperature effects on mortality have focused on urban settings, while heat-related health risks in rural areas remain underexplored. To date there has been no meta-analysis of epidemiologic literature concerning heat-related mortality in rural settings. This study aims to systematically review the current literature for assessing heat-related mortality risk among rural populations. We conducted a comprehensive literature search using PubMed, Web of Science, and Google Scholar to identify articles published up to April 2018. Key selection criteria included study location, health endpoints, and study design. Fourteen studies conducted in rural areas in seven countries on four continents met the selection criteria, and eleven were included in the meta-analysis. Using the random effects model, the pooled estimates of relative risks (RRs) for all-cause and cardiovascular mortality were 1.030 (95% CI: 1.013, 1.048) and 1.111 (95% CI: 1.045, 1.181) per 1 °C increase in daily mean temperature, respectively. We found excess risks in rural settings not to be smaller than risks in urban settings. Our results suggest that rural populations, like urban populations, are also vulnerable to heat-related mortality. Further evaluation of heat-related mortality among rural populations is warranted to develop public health interventions in rural communities

Supporting a review of the benefits package of the National Health Insurance Scheme in Ghana

BACKGROUND: Although Ghana is lauded for its National Health Insurance Scheme (NHIS), concerns exist about the scheme’s functioning and sustainability. An often-cited issue—contributing to the scheme’s decreasing membership, long-standing financial deficit, and frequent out-of-pocket payments among members—is the large benefits package (BP). While, on paper, the BP covers over 95% of the conditions occurring in Ghana, its design was not informed by any budget analysis, nor any systematic prioritization of interventions. This paper aims to provide evidence-based input into ongoing discussions regarding a review of the NHIS benefits package. METHODS: An existing analytic framework is used to calculate net health benefit (NHB) for a range of interventions in order to assess their cost-effectiveness and enable the prioritization of ‘best buys’. The framework is expanded upon by incorporating concerns for financial protection, and practical feasibility, as well as the political economy challenges of disinvesting in currently funded activities. Five different options for the benefits package, each based on policy discourse in Ghana’s health sector, are presented and evaluated. RESULTS: Implementing all interventions for which data was available to 100% of the population in need was estimated to cost GH₵4323 million (US$994 million), while the available NHIS budget was only GH₵970 million (US$223 million). Options for the benefits package that focussed on cost-effectiveness and primary care provision achieved the best health outcomes, while options reflecting the status quo and allowing for co-payments included a higher number of healthcare interventions. Apart from the package option focussing on primary care, all packages were faced with physician shortages. CONCLUSIONS: Current funding to the NHIS is insufficient to provide the historical benefits package, which promises to cover over 95% of disease conditions occurring in Ghana, to the total population. Shifting the NHIS focus from intervention coverage to population coverage is likely to lead to better health outcomes. A primary care package may be most feasible in the short-term, though additional physicians should be trained to provide higher-level care that is highly cost-effective, such as emergency neonatal care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12962-022-00365-0

Multi-block data integration analysis for identifying and validating targeted N-glycans as biomarkers for type II diabetes mellitus

Plasma N-glycan profiles have been shown to be defective in type II diabetes Mellitus (T2DM) and holds a promise to discovering biomarkers. The study comprised 232 T2DM patients and 219 healthy individuals. N-glycans were analysed by high-performance liquid chromatography. The multivariate integrative framework, DIABLO was employed for the statistical analysis. N-glycan groups (GPs 34, 32, 26, 31, 36 and 30) were significantly expressed in T2DM in component 1 and GPs 38 and 20 were related to T2DM in component 2. Four clusters were observed based on the correlation of the expressive signatures of the 39 N-glycans across T2DM and controls. Cluster A, B, C and D had 16, 16, 4 and 3 N-glycans respectively, of which 11, 8, 1 and 1 were found to express differently between controls and T2DM in a univariate analysis (p\u3c 0.05). Multi-block analysis revealed that trigalactosylated (G3), triantennary (TRIA), high branching (HB) and trisialylated (S3) expressed significantly highly in T2DM than healthy controls. A bipartite relevance network revealed that HB, monogalactosylated (G1) and G3 were central in the network and observed more connections, highlighting their importance in discriminating between T2DM and healthy controls. Investigation of these N-glycans can enhance the understanding of T2DM

Colorectal cancer survival rates in Ghana: A retrospective hospital-based study

BACKGROUND: Colorectal cancer (CRC) is one of the commonest cancers associated with diverse prognosis times in different parts of the world. Despite medical interventions, the overall clinical outcomes and survival remains very poor for most patients in developing countries. This study therefore investigated the survival rate of colorectal cancer and its prognostic factors among patients at Komfo Anokye Teaching Hospital, Ghana. METHODOLOGY: In this retrospective cohort study, a total of 221 patients diagnosed with CRC from 2009 to 2015 at the Surgical and Oncological units of Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana were employed. The survival graphs were obtained using the Kaplan-Meier method and compared by the Log-rank test. Cox regression analysis was used to assess prognostic factors. All analyses were performed by SPSS version 22. RESULTS: The median survival time was 15 months 95% CI (11.79-18.21). The overall survival rate for CRC over the 5 years period was 16.0%. The survival rates at the 1st, 2nd, 3rd, 4th and 5th years were 64% 95% CI (56.2-71.1), 40% 95% CI (32.2-50.1), 21% 95% CI (11.4-30.6) 16% 95% CI (8.9-26.9) and 16% 95% CI (7.3-24.9). There was a significant difference in the survival rate of colorectal cancer according to the different stages (p = 0.0001). Family history [HR = (3.44), p = 0.029)], Chemotherapy [HR = (0.23), p = CONCLUSION: The study has clearly demonstrated that survival rate for CRC patients at KATH, Ghana is very low in a 5 years period. This is influenced by significant number of clinical and pathological prognostic factors. Identification of prognostic factors would be a primary basis for early prediction and treatment of patients with colorectal cancer

Interplay of adipokines in the pathogenesis of essential hypertension: A comparative cross-sectional in Ghana

Background: The renin-angiotensin-system (RAS), endothelial dysfunction and sympathetic nervous system are mechanistic risk factors of hypertension. The study sought to elucidate the interplay of adipokines in the pathogenesis of essential hypertension.Methodology: This comparative cross-sectional study recruited 200 confirmed hypertensive patients from the KATH and 50 age-matched normotensives. Participants’ blood pressures, anthropometric and socio-demographic information were voluntarily obtained. Serum levels of adiponectin, leptin and resistin of the participants were quantified using the ELISA. Renal function, lipid profile and glycemic status of all subjects were also analyzed.Results: Hypertensive patients showed a significantly higher anthropometric indices of adiposity compared to normotensives, CI (p < 0.0001), BAI (p < 0.0001) and AVI (p = 0.002). Adiponectin levels (p < 0.0001) were significantly lower in the hypertensive relative to the normotensives. Furthermore, significantly higher concentrations of serum leptin (p = 0.016) and the leptin-adiponectin ratio (p = 0.001) were observed among the hypertensive compared to the normotensives. The study further observed a direct association between serum leptin and weight (r = 0.111, p = 0.022), BMI (r = 0.129, p = 0.009) and WHtR (r = 0.098, p = 0.045) but inverse relationship with height (r = -0.134, p = 0.006) among the hypertensive. Serum leptin has a significant negative correlation with HDL-C among the hypertensive (r = -0.174, p = 0.013). The fully aOR for hypertension as predicted by resistin and adiponectin were 1.12 (95% Cl, 1.02–1.25); p = 0.019) and 0.93 (95% Cl, 0.91–0.95); p = 0.0001) respectively.Conclusion: We found that elevations in serum levels of leptin and resistin, and low levels of adiponectin may play a role in the pathogenesis of essential hypertension. Therefore, adipokines may offer themselves as potential indices for early and accurate detection of high blood pressure. At the same time our presentresults also confirm the conclusions with respect to correlation of leptin and obesity. Further longitudinal studies in a larger population are warranted to investigate the physiological and pathological functions of adipokines in hypertension.Keywords: Adipokines, Hypertension, Leptin, Adiponectin, Resisti

Applying Latent Class Analysis on Cancer Registry Data to Identify and Compare Health Disparity Profiles in Colorectal Cancer Surgical Treatment Delay

Context: Colorectal cancer (CRC) surgical treatment delay (TD) has been associated with mortality and morbidity; however, disparities by TD profiles are unknown. Objectives: This study aimed to identify CRC patient profiles of surgical TD while accounting for differences in sociodemographic, health insurance, and geographic characteristics. Design: We used latent class analysis (LCA) on 2005-2015 Tennessee Cancer Registry data of CRC patients and observed indicators that included sex/gender, age at diagnosis, marital status (single/married/divorced/widowed), race (White/Black/other), health insurance type, and geographic residence (non-Appalachian/Appalachian). Setting: The state of Tennessee in the United States that included both Appalachian and non-Appalachian counties. Participants: Adult (18 years or older) CRC patients (N = 35 412) who were diagnosed and surgically treated for in situ (n = 1286) and malignant CRC (n = 34 126). Main Outcome Measure: The distal outcome of TD was categorized as 30 days or less and more than 30 days from diagnosis to surgical treatment. Results: Our LCA identified a 4-class solution and a 3-class solution for in situ and malignant profiles, respectively. The highest in situ CRC patient risk profile was female, White, aged 75 to 84 years, widowed, and used public health insurance when compared with respective profiles. The highest malignant CRC patient risk profile was male, Black, both single/never married and divorced/separated, resided in non-Appalachian county, and used public health insurance when compared with respective profiles. The highest risk profiles of in situ and malignant patients had a TD likelihood of 19.3% and 29.4%, respectively. Conclusions: While our findings are not meant for diagnostic purposes, we found that Blacks had lower TD with in situ CRC. The opposite was found in the malignant profiles where Blacks had the highest TD. Although TD is not a definitive marker of survival, we observed that non-Appalachian underserved/underrepresented groups were overrepresented in the highest TD profiles. The observed disparities could be indicative of intervenable risk