Demand-led approaches to drive post-harvest innovation and nutritious RTB products

Roots, Tubers and Bananas (RTB) Strategy Development Workshop Report

Surgically correctable adrenal-dependent hypertension: a report of five cases

Although endocrine causes of secondary hypertension are relatively uncommon, medical practitioners must maintain a high index of suspicion for them in certain categories of patients. Such patientsinclude young individuals, those with difficult- to-treat hypertension and those presenting with symptoms, clinical signs and/or laboratoryparameters well-known to be associated with Cushing’s syndrome, Conn’s syndrome or phaeochromocytoma. This paper reports on 5 patients identified over a 2-year period with various hormonally-activeadrenal adenomas causing hypertension in an environment where, hitherto, the occurrence of these conditions was generally thought to be rare. Aspects of the patients’ histories, examination and laboratory findings that drew attention to the possibility of the diagnosis in each case are highlighted, as are the confirmatory investigationsand management methods used by a multidisciplinary team of medical practitioners. The clinical outcome with appropriate treatment of adrenalrelated hypertension is good and can result in significantcost savings in the long term

Insulin signalling and the regulation of glucose and lipid metabolism

The epidemic of type 2 diabetes and impaired glucose tolerance is one of the main causes of morbidity and mortality worldwide. In both disorders, tissues such as muscle, fat and liver become less responsive or resistant to insulin. This state is also linked to other common health problems, such as obesity, polycystic ovarian disease, hyperlipidaemia, hypertension and atherosclerosis. The pathophysiology of insulin resistance involves a complex network of signalling pathways, activated by the insulin receptor, which regulates intermediary metabolism and its organization in cells. But recent studies have shown that numerous other hormones and signalling events attenuate insulin action, and are important in type 2 diabetes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62568/1/414799a.pd

The Metabolic Syndrome Among Patients With Cardiovascular Disease in Accra, Ghana

Background: There is evidence linking the Metabolic Syndrome with an increased risk of developing cardio-vascular disease, previously thought to be rare in Af-rica but now a major public health concern.Objectives: To determine the frequency of occurrence of the Metabolic Syndrome among patients presenting with cardiovascular disease at the Korle Bu Teaching Hospital, Ghana.Methods: This was a case-control study of 100 con-secutive cardiovascular disease patients and 100 age- and sex- matched controls who underwent an interview and physical examination. Anthropometric measure-ments and fasting blood samples for plasma glucose and lipids were taken. The National Cholesterol Educa-tion Programme: Adult Treatment Panel III criteria were used for the diagnosis of the Metabolic Syn-drome.Results: The prevalence of Metabolic Syndrome among cases and controls was 54% and 18% respec-tively, with the prevalence increasing with advancing age. Hypertension and central obesity were the two components with the highest frequency among indi-viduals with Metabolic Syndrome. The Metabolic Syn-drome was associated with the development of cardio-vascular disease (OR = 5.35, 95% CI: 2.81 – 10.18, p= 0.0001), with the odds ratio increasing with the number of components present.Conclusion: The Metabolic Syndrome is prevalent among cardiovascular disease patients attending the Korle Bu Teaching Hospital, with a significant associa-tion between the number of components of the Meta-bolic Syndrome present and the probability of develop-ing a cardiovascular disease. A policy to institute rou-tine screening in clinical practice and provision of ap-propriate interventions for Metabolic Syndrome com-ponents among Ghanaian adults is needed

Do leadership styles influence productivity?

Background: Leadership and productivity in nursing and midwifery have become topical issues for discussion. This is possibly due to nurses constituting the largest group of the healthcare workforce. Nurses and midwives have been held accountable for low productivity and inappropriate leadership in the past. However, there has been limited consensus in the nursing literature about the impact of nurse managers' leadership styles on nurses' and midwives' productivity levels. Method: Two hundred and seventy five nurses and midwives (response rate of 99.2%) were asked to take part in a cross-sectional survey from five hospitals in the eastern region of Ghana, to examine the impact of nurse managers' leadership styles on self-reported productivity levels. Descriptive summaries, Pearson's correlations and linear regressions are presented. Results: Findings show for every hour of lost productive time, four hours of unpaid overtime in the course of the month was accrued due to staff shortages. Nurse managers' most frequently exercised a supportive leadership style, and a directive leadership style the least. Within the last one month of work experience prior to the study, nurses' self-perception of productivity levels were high (8.39 on a 10-point scale), 10% more productive than their peers in the same unit. Nurses believed their own productivity improved by about 1.8% over the preceding six months. Leadership styles explained only 6.9% (95% CI: 4.6-9.3%) of the variance in nurses' perceived level of productivity. Achievement-oriented leadership style most significantly improved productivity by 18.4% (95% CI: 13.0-24.0%). Implications for management and policy: There is a need to strengthen supervision and establish performance benchmarks within nursing and midwifery to measure staff performance, addressing health worker productivity more seriously through research and policy. Health institutions should invest in leadership development programmes for nurses and midwives to maximise productivity

Ghana’s burden of chronic non-communicable diseases: Future directions in research, practice and policy

The prevalence of major chronic non-communicable diseases and their risk factors has increased over timeand contributes significantly to the Ghana’s disease burden. Conditions like hypertension, stroke anddiabetes affect young and old, urban and rural, and wealthy and poor communities. The high cost of caredrives the poor further into poverty. Lay awareness and knowledge are limited, health systems (biomedical,ethnomedical and complementary) are weak, and there are no chronic disease policies. These factorscontribute to increasing risk, morbidity and mortality. As a result chronic diseases constitute a public healthand a developmental problem that should be of urgent concern not only for the Ministry of Health, but alsofor the Government of Ghana. New directions in research, practice and policy are urgently needed. Theyshould be supported by active partnerships between researchers, policymakers, industry, patient groups,civil society, government and development partners.Keywords: chronic non-communicable diseases, health systems, policy, research, Ghan

Ghana's burden of chronic non-communicable diseases:future directions in research, practice and policy

The prevalence of major chronic non-communicable diseases and their risk factors has increased over time and contributes significantly to the Ghana's disease burden. Conditions like hypertension, stroke and diabetes affect young and old, urban and rural, and wealthy and poor communities. The high cost of care drives the poor further into poverty. Lay awareness and knowledge are limited, health systems (biomedical, ethnomedical and complementary) are weak, and there are no chronic disease policies. These factors contribute to increasing risk, morbidity and mortality. As a result chronic diseases constitute a public health and a developmental problem that should be of urgent concern not only for the Ministry of Health, but also for the Government of Ghana. New directions in research, practice and policy are urgently needed. They should be supported by active partnerships between researchers, policymakers, industry, patient groups, civil society, government and development partners