The role of Euphemisms in Nzema Language and Culture

This paper examines the role of euphemisms in the context of Nzema. It however discusses the Nzema examples alongside Akan, a sister language. Euphemisms can be linked to bone marrow in the sense that they are inseparable from language just as marrow is with bone. That is to say, it is highly impossible for bones not to have marrow as they are already embedded or built into the bones for varying purposes. Inasmuch as a body without breath is lifeless, a language that has no euphemistic expressions can also be said to be inadequate with respect to its functional and stylistic aspects. We use language to communicate and euphemism is a proper language style that people pursue in social communication in order to reach an ideal communication effect. Euphemisms are used in place of some sensitive, unpleasant, disturbing and taboo topics. The Nzema data indicate that in this language (Nzema), these expressions (euphemisms) can be dichotomised into two categories based on the communicative function they hold. In the first place, euphemisms are motivated by issues relating to taboos and are mainly used to avoid affronting both speaker’s and the hearer’s face. Secondly, they function as a stylistic marker so that their use is not as a response to taboo topics, rather, are subtle means of expressing one’s thought which fit in the context of use

Consonant mutation in Nzema and Esahie

This study examines consonant mutation particularly in Esahie[1] and Nzema. The reason for the study arises from the mutuality in the two languages. Again, previous studies have superficially treated this subject in the separate languages. However, the subject of consonant mutation is common in the above languages, yet the prevailing characteristics of the phenomenon are similar and dissimilar in the languages. Thus, this study compares and contrast consonant mutation in the two related languages to establish a correlation. In this vein, it discusses the mutational pattern, directionalities and voicing. Data for this study are assembled from four native speakers of each of the languages and literature of the respective languages. The data are analysed within the purview of Distinctive Feature Theory. The study identifies evidence to the relational effect that, the phonological environments in which the various realizations of mutation occurs also results in a harmony system. However, they differ in their mutational domains. The featural agreement normally forges between the vowel-consonant. Again, it is observed in Nzema and Esahie that, the common feature responsible for mutation in the alternant pairs, [k/x] and [k/g] is [dorsal]; [d/l] and [d/n] is [coronal]; [ʨ/ɕ] is [+strident] and [b/m] is [labial]. In both languages, harmonic assimilation is bidirectional. [1] Esahie is also known as Sefwi, Sehwi, or Asahyue. In Ghana, the language is classified as part of the linguistic Akan group of the larger Akan dialects, even though it shares very close intelligibility with Nzema (a solely ethnographic Akan) than Twi and Mfantse (which are both linguistic and ethnographic Akan). Therefore, in this paper, we shall refer to both variants as separate languages

Nzema Idiomatic Expressions as Indirection Strategy: A Politeness Theoretical Perspective

The paper explores Nzema idiomatic expressions used as indirection strategy. Figurative devices such as proverbs and euphemisms have received quite an appreciable amount of study in connection with verbal indirection in Nzema. Little or no attention however has been given to idioms, particularly as indirection devices in the language. This paper therefore focuses on idioms which incorporate body parts such as head/brain, eyes, nose, mouth, teeth, hands, legs, heart/chest, stomach and body/skin that are used to avoid any straightforward language that seeks to undermine and threaten the face of an addressee. Data were gathered from both primary and secondary sources. The primary data comprise recordings of traditional ceremonies such as marriage contraction and arbitration, where the use of idioms as indirect expressions was pervasive. Authors’ native speaker intuition was also brought to bear on the analysis of data. Interviews with competent indigenous speakers of Nzema were conducted for useful information and clarification on the data gathered. The secondary data were sourced from two Nzema literary texts. The paper finds that, these culturally constructed body parts related idioms are deliberately employed as both face saving and as politeness devices in the language

HEALER2: a framework for secure data lake towards healthcare digital transformation efforts in low and middle-income countries.

Low and middle-income countries are vigorously digitizing their operations in the healthcare sector as steps in the digital transformation journey. However, some of the basic principles in information security are being skipped. This has a tendency to introduce fundamental vulnerabilities in the core foundation of their healthcare IT infrastructure. This paper, therefore, assessed e-health strategies in Africa and proposed a data lake framework for healthcare IT infrastructure which is deemed secure, privacy-preserving and economically efficient

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The Impact of Intensifying Prostate Cancer Screening in Black Men: A Model-Based Analysis

Background: Black men in the United States have markedly higher rates of prostate cancer than the general population. National guidelines for prostate-specific antigen (PSA) screening do not provide clear guidance for this high-risk population. The purpose of this study is to estimate the benefit and harm of intensified PSA screening in Black men. Methods: Two microsimulation models of prostate cancer calibrated to incidence from the Surveillance, Epidemiology, and End Results program among Black men project the impact of different screening strategies (varying screening intervals, starting and stopping ages, and biopsy utilization following an abnormal PSA) on disease-specific mortality and overdiagnosis. Each strategy induces a mean lead time (MLT) for detected cases. A longer MLT reduces mortality according to estimates combining the US and European prostate cancer screening trials but increases overdiagnosis. Results: Under historical population screening, Black men had similar MLT to men of all races and similar mortality reduction (range between models = 21%-24% vs 20%-24%) but a higher frequency of overdiagnosis (75-86 vs 58-60 per 1000 men). Screening Black men aged 40-84 years annually would increase both mortality reduction (29%-31%) and overdiagnosis (112-129 per 1000). Restricting screening to ages 45-69 years would still achieve substantial mortality reduction (26%-29%) with lower overdiagnosis (51-61 per 1000). Increasing biopsy utilization to 100% of abnormal tests would further reduce mortality but substantially increase overdiagnosis. Conclusions: Annual screening in Black men is expected to reduce mortality more than that estimated under historical screening. Limiting screening to men younger than 70 years is expected to help reduce overdiagnosis

Perceptions of Ghanaian traditional health practitioners, primary health care workers, service users and caregivers regarding collaboration for mental health care

Background: In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods: The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results: The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion: Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships