Uncredited. Diseño gráfico y títulos de crédito. Gemma Solana y Antonio Boneu. Barcelona, Index Book, 2007. 313 páginas

Obra ressenyada: Gemma Solana y Antonio Boneu, Uncredited. Diseño gráfico y títulos de crédito. Barcelona, Index Book, 200

Perception of pregnant women on barriers to male involvement in antenatal care in Sekondi, Ghana

Getting men to be actively involved in Antenatal Care (ANC) has been acknowledged by the World Health Organisation as a key indicator for better maternal health outcomes. We investigated the perception of women about barriers to male involvement in ANC in Sekondi, Ghana. Dwelling on cross-sectional design, we used a sample of 300 pregnant women (adolescents excluded) who had ever attended ANC in five fishing communities in Sekondi. The study was underpinned by a conceptual framework adapted from Doe's conceptual framework of male partner involvement in maternity care. We used questionnaire for the data collection. Both descriptive-frequencies and percentages; and inferential-binary logistic regression analyses were carried out. Seven out of ten (70%) participants indicated high male involvement in ANC. Respondents whose partners were aged 50–59 were less likely to report high male involvement in ANC compared to those whose partners were aged 20–29 years (OR = 0.47, 95% CI = [0.35–0.86], p = 0.03). Those living together with their partners were about two times more likely to report high male involvement in ANC compared to those who did not live with their partners (OR = 1.63, 95% CI = [1.18–3.19], p = 0.01). Participants who identified long waiting time at the health facility as a determinant of male involvement in ANC were less likely to report high male involvement in ANC compared to those who disagreed (OR = 0.57, 95% CI = [0.38–0.85], p = 0.01). The outcome of our study calls for male partner friendly policy driven environment at the various ANC visit points that would make men more comfortable to accompany their partners in accessing ANC services

Export competitiveness in Bolivia

In comparison with other countries, Bolivia seems to face a gap in its capacity to take advantage of international market opportunities. Addressing the shortcomings in Bolivia’s export performance is a major challenge and requires attention to the incentives that actual and potential exporters face, the efficiency of service providers in the economy, and the effectiveness of trade support institutions that help private sector firms to discover and exploit international market opportunities. These three elements of export competitiveness are discussed in turn in this paper

Examining Pregnancy Related Socio-Cultural Factors Among Adolescent Girls in the Komenda-Edina-Eguafo-Abrem Municipality in the Central Region of Ghana: A Case-Control Study

Ahinkorah BO, Hagan Jr. JE, Seidu A-A, et al. Examining Pregnancy Related Socio-Cultural Factors Among Adolescent Girls in the Komenda-Edina-Eguafo-Abrem Municipality in the Central Region of Ghana: A Case-Control Study. Frontiers in Public Health. 2019;7: 93.Background and Purpose: Given that Ghana continues to record higher rates of adolescent pregnancy among rural dwellers, notably, those living in the Brong Ahafo, Central and Volta regions, it is surprising that scholarly information related to socio-cultural determinants of this sequel in these mentioned areas of the country is limited. This study sought to examine the socio-cultural factors associated with pregnancy among adolescent girls in Komenda-Edina-Eguafo-Abrem (KEEA) Municipality in the Central Region of Ghana. Methods and results: Using a matched case-control design with a 1:1 ratio, a facility-based sampling approach was used to select 400 adolescent females aged between 15 and 19 years. Chi-square analyses on the strictness level of rules and regulations in family [χ2(1) = 62.010, p < 0.05], freedom within the family to discuss issues related to sexuality [χ2(1) = 9.600, p < 0.05], religious support of sex before marriage [χ2(1) = 4.312, p < 0.05], peer influence to engage in sexual intercourse [χ2(1) = 7.793, p < 0.05], reaction of parents toward pregnancy [χ2(1) = 70.064, p < 0.05], and reaction of siblings toward pregnancy [χ2(1) = 66.702, p < 0.05] were significantly related to adolescents' pregnancy status. Additionally, binary logistic regression analysis also showed that non-pregnant adolescents were seven times more likely to belong to families with strict rules and regulations compared to pregnant adolescents [OR = 0.14, 95% CI = (0.07–0.25), p ≤ 0.01]. Non-pregnant adolescents were 3 times more likely to have freedom within the family to discuss issues related to sexuality compared to pregnant adolescents [OR = 0.33, 95% CI = (0.18–0.59), p ≤ 0.01]. However, pregnant adolescents were 3 times more likely to be influenced by their peers to engage in sexual intercourse [OR = 2.63, 95% CI = (1.46–4.74), p ≤ 0.001] and 3 times more likely to have parents with positive reaction toward adolescent pregnancy compared to non-pregnant adolescents [OR = 2.97, 95% CI = (1.15–7.70), p ≤ 0.05]. Additionally, these pregnant adolescents were eight times more likely to have siblings with positive reaction toward adolescent pregnancy [OR = 7.74, 95% CI = (2.59–21.4), p ≤ 0.001] compared to their non-pregnant counterparts. Conclusion: Adolescent pregnancy heightens the risk of negating birth outcomes that is independent of recognized confounding variables. Therefore, adolescent girls in the KEEA Municipality are likely to experience continuous exposure to the risk of pregnancy with the existence of negative socio-cultural norms. Specific strategies need to involve multifaceted interventions that include education, competency-based skill training and support for young people, especially pregnant adolescents. Further research ought to determine which other factors would help us better understand circumstances that may lead to adolescent pregnancies in other areas of the region and perhaps among other subgroups

Africans Who Arrive in the United States before 20 Years of Age Maintain Both Cardiometabolic Health and Cultural Identity: Insight from the Africans in America Study

The overall consensus is that foreign-born adults who come to America age \u3c 20 y achieve economic success but develop adverse behaviors (smoking and drinking) that lead to worse cardiometabolic health than immigrants who arrive age ≥ 20 y. Whether age of immigration affects the health of African-born Blacks living in America is unknown. Our goals were to examine cultural identity, behavior, and socioeconomic factors and determine if differences exist in the cardiometabolic health of Africans who immigrated to America before and after age 20 y. Of the 482 enrollees (age: 38 ± 1 (mean ± SE), range: 20–65 y) in the Africans in America cohort, 23% (111/482) arrived age \u3c 20 y, and 77% (371/482) arrived age ≥ 20 y. Independent of francophone status or African region of origin, Africans who immigrated age \u3c 20 y had similar or better cardiometabolic health than Africans who immigrated age ≥ 20 y. The majority of Africans who immigrated age \u3c 20 y identified as African, had African-born spouses, exercised, did not adopt adverse health behaviors, and actualized early life migration advantages, such as an American university education. Due to maintenance of cultural identity and actualization of opportunities in America, cardiometabolic health may be protected in Africans who immigrate before age 20. In short, immigrant health research must be cognizant of the diversity within the foreign-born community and age of immigration

Stress Measured by Allostatic Load Varies by Reason for Immigration, Age at Immigration, and Number of Children: The Africans in America Study

Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 ± 10 y (mean ± Standard Deviation (SD)), range 22–65 y). ALS was calculated with High-ALS defined as ALS ≥ 3.0 and Low-ALS defined as ALS \u3c 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-α, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 ± 1.2 vs. 1.3 ± 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-α levels: 15 ± 9 vs. 11 ± 6 pg/mL, respectively (all p ≤ 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, p = 0.013), their age at immigration was ≥30 y (OR 3.28, p \u3c 0.001), their duration of residence in United States was ≥10 y (OR 3.16, p = 0.001), or their number of children was ≥3 (OR 2.67, p = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children

Sleep and Economic Status are Linked to Daily Life Stress in African-born Blacks Living in America.

To identify determinants of daily life stress in Africans in America, 156 African-born Blacks (Age: 40 ± 10 years (mean ± SD), range 22-65 years) who came to the United States as adults (age ≥ 18 years) were asked about stress, sleep, behavior and socioeconomic status. Daily life stress and sleep quality were assessed with the Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. High-stress was defined by the threshold of the upper quartile of population distribution of PSS (≥16) and low-stress as PSS \u3c 16. Poor sleep quality required PSQI \u3e 5. Low income was defined as groups, PSS were: 21 ± 4 versus 9 ± 4, p \u3c 0.001 and PSQI were: 6 ± 3 versus 4 ± 3, p \u3c 0.001, respectively. PSS and PSQI were correlated (r = 0.38, p \u3c 0.001). The odds of high-stress were higher among those with poor sleep quality (OR 5.11, 95% CI: 2.07, 12.62), low income (OR 5.03, 95% CI: 1.75, 14.47), and no health insurance (OR 3.01, 95% CI: 1.19, 8.56). Overall, in African-born Blacks living in America, daily life stress appears to be linked to poor quality sleep and exacerbated by low income and lack of health insurance

Dietary intake and its associated factors among in-school adolescents in Ghana.

IntroductionEarly-life nutrition related experiences may fuel the emergence of obesity and type 2 diabetes in adolescence. The adoption of unhealthy dietary practices early in life is an indicator of adverse cardiometabolic health in adulthood. In-school adolescents' dietary practices in Ghana have not been explored extensively despite increasing levels of obesity in adolescents. This study sought to examine dietary practices, socio-demographic disparities and the factors influencing dietary choices among in-school adolescents in Ghana.MethodsA school-based, cross-sectional study was conducted in the Central region of Ghana in 2017. Using multistage sampling procedures, a total of 1,311 in-school adolescents were selected for the study. A modified version of the generic Global School Health Survey questionnaire on dietary practices was adapted and used for data collection. Percentage and frequency counts were used to report on the dietary practices, while Chi-square was used to determine socio-demographic variations in the dietary practices. Binary logistic regression was used to compute the influence of socio-demographic characteristics of respondents on the prevalence of healthy dietary behavior among in-school adolescents.ResultsThe study revealed the prevalence of healthy dietary practices (49.9%, n = 654) among in-school adolescents in the region. The study also found increased frequency in consumption of soft drinks (93%, n = 1220) and toffees/sweets (90%, n = 1183) among in-school adolescents. However, low intake of breakfast (57%, n = 749) was observed among the adolescents. Significant disparities were observed in relation to gender, age, parental communication, academic performance and geographical location in the dietary practices of in-school adolescents. Furthermore, gender (OR = 1.36, P = 0.007), academic performance (OR = 2.19, P = 0.001) and geographical location (OR = 1.79, P = 0.001) were found to be significantly associated with dietary practices among in-school adolescents in the region.ConclusionsThere was low consumption of fruits and vegetables among adolescents. Fruits and vegetables consumption was associated with gender, academic performance and geographical location, and these may be a reflection that knowledge on healthy food choices and availability are important factors influencing dietary choices among in-school adolescents. School health policy interventions aimed at improving nutritional status among adolescents and enhanced fruit and vegetable consumption in the country should take into account the potential benefit of increasing availability of fruits and vegetables in schools, while reducing access to sweets and soft drinks in the schools and communities

Stress Measured by Allostatic Load Varies by Reason for Immigration, Age at Immigration, and Number of Children: The Africans in America Study

Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 &plusmn; 10 y (mean &plusmn; Standard Deviation (SD)), range 22&ndash;65 y). ALS was calculated with High-ALS defined as ALS &ge; 3.0 and Low-ALS defined as ALS &lt; 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-&alpha;, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 &plusmn; 1.2 vs. 1.3 &plusmn; 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-&alpha; levels: 15 &plusmn; 9 vs. 11 &plusmn; 6 pg/mL, respectively (all p &le; 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, p = 0.013), their age at immigration was &ge;30 y (OR 3.28, p &lt; 0.001), their duration of residence in United States was &ge;10 y (OR 3.16, p = 0.001), or their number of children was &ge;3 (OR 2.67, p = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children

Factors influencing teenage pregnancy in Komenda, Edina, Eguafo Abirem Municipality: Factors influencing teenage pregnancy in Komenda, Edina, Eguafo Abirem Municipality

Adolescents are the most important sexually active population in our societies, and given their size and characteristics, majority are exposed to early unplanned and unprotected sexual intercourse leading to unwanted pregnancy and sometimes unsafe abortions. Teenage pregnancy has become very common in the Ghanaian society, especially among adolescents at the Primary and Junior High School (JHS) levels of education. The purpose of this study was to assess the prevalence of teenage pregnancy in the Komenda, Edina, Eguafo Abrem Municipality in the Central Region of Ghana from 2012-2016. The study employed descriptive survey design to purposively sample teenage mothers and pregnant teenagers seeking antenatal and postnatal care at the Elmina Urban Health Centre and Ankaful Leprosy/General Hospital. Questionnaire and secondary data was collected and analyzed using simple frequencies and percentages. The finding revealed 25% prevalence of teenage pregnancy among the adolescents between 2012 and 2016. Poverty, peer pressure, and the influence of the media (electronic and social) were found to be the major risk factors to influence teenage pregnancy among the participants. Birth complications and school dropouts were the major consequences of teenage pregnancy among the participants. It was concluded that the high prevalence of teenage in the municipality could also lead to high presence of sexually transmitted infections. It was therefore recommended that municipal assemblies establish trade schools as well as use successful indigenes as role models to increase students’ ambition for the future and decrease their engagement in the sexual activities. Also, condom usage should be highlighted in the schools to help those who cannot abstain to use protection