Possible Health Risk due to the Environmental Exposure of High Levels of Lead in Exhaust Soot of Automobiles in Parts of Accra, Ghana

Internal combustion engines produce soot as a result of incomplete gasoline and diesel combustion.  Leaded exhaust soot emitted into the atmosphere has serious health and environmental concerns. Lead has been outlawed as an automotive gasoline additive in most countries including Ghana because of its cumulative toxicity in humans especially children and damaging effect on catalytic converters in automobiles. Nevertheless, leaded fuels are apparently being produced, imported and used illegally in some countries as octane rating booster because of its profitability. Refined gasoline and diesel are imported into Ghana through bulk oil distribution firms. This preliminary study assessed the level of lead in automotive exhaust soot from randomly selected automobiles in parts of Accra. Exhaust soot samples obtained from ten diesel and ten gasoline automobiles were collected for analysis of its lead concentration using atomic absorption spectrophotometry. The results showed the presence of lead in 4(40%) and 10(100%) of the randomly selected diesel and gasoline vehicular exhaust soot respectively. The concentration of lead in the exhaust soot of diesel-powered automobiles ranged from 0.060mg/kg to 0.435mg/kg and that of the gasoline-powered vehicles recorded values ranging from 0.195mg/kg to 2.055mg/kg. With this rather high level of lead in the vehicular soot, it could be concluded that the exhaust soot can be a significant source of lead in the atmosphere in parts of Accra. Lead exposure is known to cause debilitating developmental and neurological effects in children and cardiovascular effects in adults. The high levels of lead in the exhaust soot may be attributed to the possibility of lead additives in the gasoline and diesel used by those automobiles. Regulators of the petroleum downstream industry such as the National Petroleum Authority must routinely test for lead in imported refined petroleum products and enforce the ban on the importation, sale and usage of the outlawed leaded fuel in Ghana. Further studies should be conducted on the levels of lead in air and blood lead levels in fuel dispensers, fuel tanker drivers and fuel loading workers of bulk oil distribution firms. Keywords: Lead, Exhaust, Soot, Gasoline, Automobil

The Effects of Cash Flow Management on the Financial Performance of Listed Manufacturing Firms in Ghana

The study investigated the effect of cash flow management on financial performance of listed manufacturing firms in Ghana. Specifically, the study examined the effect of operating cash flows, investing cash flows, financing cash flows and free cash flows on financial performance. The study used a panel data of 10 conveniently selected firms over a 7-year period from 2012 to 2018. Pooled Ordinary Least Squares, Fixed Effect and Random Effect Models to analyze the data. The results indicates that operating cash flows has a negative and statistically significant impact on financial performance, investing cash flows does not have any significant effect on financial performance while financing cash flows has a direct and significant effect on financial performance. Lastly, free cash flow was found to have a positive and significant effect on financial performance of listed manufacturing firms in Ghana. The study concludes that policies by investors or equity holders should not focus entirely on investment cash flows but rather, operating cash flows, financing cash flows and free cash flows as they are found to significantly affect financial performance. Keywords:Cash Flow management, financial performance, operating cash flow, investing cash flow, financing cash flow, free cash flow DOI: 10.7176/RJFA/14-16-05 Publication date:August 31st 2023

The potential for technology and knowledge transfers between foreign and local firms: a study of the construction industry in Ghana

Multinational corporations (MNCs) and other foreign firms can be conduits for technology and knowledge (T&K) transfer to host countries in the developing world. Most of the existing research focuses on T&K transfers through FDI and are drawn from Asia not Sub-Saharan Africa (SSA), although SSA is increasingly receiving foreign investment. There is a paucity of research that gives insights into project-level T&K transfer issues in SSA countries. Using the Ghanaian construction industry as an empirical focus, this article explores T&K transfer potential. The findings reveal significant weaknesses in T&K transfer across industry subsectors and between foreign and local firms. This arises from the potentially complementary but dissimilar resource and knowledge bases. The weaknesses are compounded by the absence of coherent government T&K development policie

COVID-19 in Ghana: Knowledge, perception and practice among health trainees

Objective: This study assessed the knowledge, perceptions and practices among health trainees in Ghana regarding COVID-19. Understanding the knowledge, perception and practices among health trainees can provide important information for policy formulations and proper planning.Method: The survey was conducted through a Google form link shared on students’ social media networks mainly through Facebook, and WhatsApp platforms. Responses received were imported to SPSS version 24 for cleaning and analysis. Output measures were demonstrated in simple frequency and percentages, using tables and charts. Fisher’s exact test was used to assess the effect of potential covariate on practice of preventive measures with their corresponding p-values.  Results: Twenty-five percent (25%) of respondents had good knowledge, 69% had moderate knowledge and 6% had poor knowledge on COVID-19. Regarding perception of health students on COVID-19, 8.47% indicated that drinking alcohol could protect them from the virus. More than 90% of participants’ practice the general preventive measures. Gender and level of program of study was found to be significantly associated with practice of preventive measure. Male students (54.64%) were engaged in good preventive practices compared to female students (43.75%).Conclusion: Majority of the health trainees had basic information and proactive practice towards COVID-19. Most trainees had good perception on the disease, however, a few still believe that drinking alcohol will prevent them from being infected with the disease. Gender and level of trainees are significant predictors of proactive practices towards COVID-19

Treatment of Malaria Infection and Drug Resistance

Malaria is a public health challenge that requires prompt treatment for those infected to make a full recovery. Treatment of malaria infection is to be started as soon as a diagnosis is confirmed. Antimalarial medications are administered to prevent and also to treat malaria. The type of medication used and the duration of therapy is dependent on the type of malaria-causing plasmodium species, the severity of the symptoms, geographical area where malaria infection occurred and the medication used to prevent malaria and whether there is pregnancy. Treatment of malaria from public health perspective is to reduce transmission of the infection to others, by reducing the infectious reservoir and to prevent the emergence and spread of resistance to antimalarial medicines. Medications used in the treatment of malaria infection come from the following five groups of chemical compounds: quinolines and aryl amino alcohols, antifolate, artemisinin derivatives, hydroxynaphthoquinones and antibacterial agents. The treatment of malaria is not initiated until the diagnosis has been established through laboratory testing. Artemisinin-based Combination Therapy (ACTs) has been used for the treatment of uncomplicated malaria. ACTs are also to enhance treatment and protect against the development of drug resistance. IV artesunate is used in the treatment of severe malaria, regardless of infecting species

Nexus between constructs of social cognitive theory model and diabetes self-management among Ghanaian diabetic patients: A mediation modelling approach

The promotion of Diabetes Self-Management (DSM) practices, education, and support is vital to improving the care and wellbeing of diabetic patients. Identifying factors that affect DSM behaviours may be useful to promote healthy living among these patients. The study assessed the determinants of DSM practices among Type 2 diabetes mellitus (T2DM) patients using a model-based social cognitive theory (SCT). This cross-sectional study comprised 420 (T2DM) patients who visited the Diabetic Clinic of the Komfo Anokye Teaching Hospital (KATH), Kumasi-Ghana. Data was collected using self-structured questionnaires to obtain socio-demographic characteristics, T2DM-related knowledge, DSM practices, SCT constructs; beliefs in treatment effectiveness, level of self-efficacy, perceived family support, and healthcare provider-patient communication. Path analysis was used to determine direct and indirect effects of T2DM-related knowledge, perceived family support, and healthcare provider service on DSM practices with level of self-efficacy mediating the relationships, and beliefs in treatment effectiveness as moderators. The mean age of the participants was 53.1(SD = 11.4) years and the average disease duration of T2DM was 10 years. Most of the participants (65.5 %) had high ( \u3e 6.1mmol/L) fasting blood glucose (FBG) with an average of 6.93 (SD = 2.41). The path analysis model revealed that age (p = 0.176), gender (p = 0.901), and duration of T2DM (p = 0.119) did not confound the relationships between the SCT constructs and DSM specified in the model. A significant direct positive effect of family and friends’ support (Critical ratio (CR) = 5.279, p \u3c 0.001) on DSM was observed. Self-efficacy was a significant mediator in this relationship (CR = 4.833, p \u3c 0.001). There were significant conditional indirect effects (CIE) for knowledge of T2DM and family and friends’ support at medium and high levels of belief in treatment effectiveness (p \u3c 0.05) via level of self-efficacy on DSM practices. However, no evidence of moderated-mediation was observed for the exogenous variables on DSM. Diabetes-related knowledge of T2DM, family and friends’ support, level of self-efficacy, and belief in treatment effectiveness are crucial in DSM practices among Ghanaian T2DM patients. It is incumbent to consider these factors when designing interventions to improve DSM adherence

Commonalities and differences in injured patient experiences of accessing and receiving quality injury care: a qualitative study in three sub-Saharan African countries

Objectives: To understand commonalities and differences in injured patient experiences of accessing and receiving quality injury care across three lower-income and middle-income countries. Design: A qualitative interview study. The interviews were audiorecorded, transcribed and thematically analysed. Setting: Urban and rural settings in Ghana, South Africa and Rwanda. Participants: 59 patients with musculoskeletal injuries. Results: We found five common barriers and six common facilitators to injured patient experiences of accessing and receiving high-quality injury care. The barriers encompassed issues such as service and treatment availability, transportation challenges, apathetic care, individual financial scarcity and inadequate health insurance coverage, alongside low health literacy and information provision. Facilitators included effective information giving and informed consent practices, access to health insurance, improved health literacy, empathetic and responsive care, comprehensive multidisciplinary management and discharge planning, as well as both informal and formal transportation options including ambulance services. These barriers and facilitators were prevalent and shared across at least two countries but demonstrated intercountry and intracountry (between urbanity and rurality) variation in thematic frequency. Conclusion: There are universal factors influencing patient experiences of accessing and receiving care, independent of the context or healthcare system. It is important to recognise and understand these barriers and facilitators to inform policy decisions and develop transferable interventions aimed at enhancing the quality of injury care in sub-Saharan African nations

Commonalities and differences in injured patient experiences of accessing and receiving quality injury care:a qualitative study in three sub-Saharan African countries

Objectives: To understand commonalities and differences in injured patient experiences of accessing and receiving quality injury care across three lower-income and middle-income countries. Design: A qualitative interview study. The interviews were audiorecorded, transcribed and thematically analysed. Setting: Urban and rural settings in Ghana, South Africa and Rwanda. Participants: 59 patients with musculoskeletal injuries. Results: We found five common barriers and six common facilitators to injured patient experiences of accessing and receiving high-quality injury care. The barriers encompassed issues such as service and treatment availability, transportation challenges, apathetic care, individual financial scarcity and inadequate health insurance coverage, alongside low health literacy and information provision. Facilitators included effective information giving and informed consent practices, access to health insurance, improved health literacy, empathetic and responsive care, comprehensive multidisciplinary management and discharge planning, as well as both informal and formal transportation options including ambulance services. These barriers and facilitators were prevalent and shared across at least two countries but demonstrated intercountry and intracountry (between urbanity and rurality) variation in thematic frequency. Conclusion: There are universal factors influencing patient experiences of accessing and receiving care, independent of the context or healthcare system. It is important to recognise and understand these barriers and facilitators to inform policy decisions and develop transferable interventions aimed at enhancing the quality of injury care in sub-Saharan African nations

Commonalities and differences in injured patient experiences of accessing and receiving quality injury care:a qualitative study in three sub-Saharan African countries

Objectives: To understand commonalities and differences in injured patient experiences of accessing and receiving quality injury care across three lower-income and middle-income countries. Design: A qualitative interview study. The interviews were audiorecorded, transcribed and thematically analysed. Setting: Urban and rural settings in Ghana, South Africa and Rwanda. Participants: 59 patients with musculoskeletal injuries. Results: We found five common barriers and six common facilitators to injured patient experiences of accessing and receiving high-quality injury care. The barriers encompassed issues such as service and treatment availability, transportation challenges, apathetic care, individual financial scarcity and inadequate health insurance coverage, alongside low health literacy and information provision. Facilitators included effective information giving and informed consent practices, access to health insurance, improved health literacy, empathetic and responsive care, comprehensive multidisciplinary management and discharge planning, as well as both informal and formal transportation options including ambulance services. These barriers and facilitators were prevalent and shared across at least two countries but demonstrated intercountry and intracountry (between urbanity and rurality) variation in thematic frequency. Conclusion: There are universal factors influencing patient experiences of accessing and receiving care, independent of the context or healthcare system. It is important to recognise and understand these barriers and facilitators to inform policy decisions and develop transferable interventions aimed at enhancing the quality of injury care in sub-Saharan African nations

Intrauterine exposure to mild analgesics is a risk factor for development of male reproductive disorders in human and rat

International audienceBACKGROUND: More than half of pregnant women in the Western world report intake of mild analgesics, and some of these drugs have been associated with anti-androgenic effects in animal experiments. Intrauterine exposure to anti-androgens is suspected to contribute to the recent increase in male reproductive problems, and many of the anti-androgenic compounds are like the mild analgesics potent inhibitors of prostaglandin synthesis. Therefore, it appears imperative to further investigate the potential endocrine disrupting properties of mild analgesics. METHODS: In a prospective birth cohort study, 2297 Danish and Finnish pregnant women completed a questionnaire and 491 of the Danish mothers participated in a telephone interview, reporting on their use of mild analgesics during pregnancy. The testicular position of newborns was assessed by trained paediatricians. In rats, the impact of mild analgesics on anogenital distance (AGD) after intrauterine exposure was examined together with the effect on ex vivo gestational day 14.5 testes. RESULTS: In the Danish birth cohort, the use of mild analgesics was dose-dependently associated with congenital cryptorchidism. In particular, use during the second trimester increased the risk. This risk was further increased after the simultaneous use of different analgesics. The association was not found in the Finnish birth cohort. Intrauterine exposure of rats to paracetamol led to a reduction in the AGD and mild analgesics accordingly reduced testosterone production in ex vivo fetal rat testes. CONCLUSION: There was an association between the timing and the duration of mild analgesic use during pregnancy and the risk of cryptorchidism. These findings were supported by anti-androgenic effects in rat models leading to impaired masculinization. Our results suggest that intrauterine exposure to mild analgesics is a risk factor for development of male reproductive disorders