Shopping malls as catalyst for sub-urban development in Ghana

The concentration of population in major cities is usually the consequence of the concentration of employment opportunities, goods and services in such cities. These goods and services act as pull factors to the regional population, especially from the suburban or rural areas, to densely populated cities. The resulting migration creates congestion of all kinds in the cities. Suburban communities are, thus, rendered unattractive for living. This situation is prevalent in Ghana where 75% of migrants into major cities are from suburban areas and the rate of urbanization is 4.1%. Decentralizing amenities to suburban areas would initiate re-distribution of population and thus development. This study investigated the possibility of using the Shopping Mall concept as catalyst to both help develop the suburbia and decongest cities in Ghana. The West Hills Mall at Dunkonah, a suburb near Accra was selected for the study. A mixed research method including  questionnaires, interviews, and observations was used for data collection. Out of a total of 1,642 house owners 328 were sampled and interviewed with questionnaire that delved into their origins, whether they are migrants, and the reasons behind their movement. The study concluded that shopping malls could act as catalysts for development.Keywords: Shopping Malls, Catalyst, Decongestion, Suburbanization, Amenitie

Antibiotic stewardship and its impact on antibiotic use at the child health directorate of a teaching hospital in Ghana

Purpose: The study was intended to ascertain the existence of an antibiotic stewardship programme at the Child Health Directorate of Komfo Anokye Teaching Hospital (KATH) and assess the knowledge of health professionals about the importance of the antimicrobial stewardship programme. Again, it sort to assess the experience of participants with pharmacotherapy of infections and patient outcomes with generic and innovative brands of antibiotics. The third was to assess reporting on adverse reactions and storage conditions of the antibiotics.Design/Methodology/ Approach: This was a cross-sectional study involving health professionals who participated in the provision of infectious disease management services. Eighty-eight (88) professionals were involved in the study, comprising nurses (n=51), medical doctors (n=21), pharmacists (n=8), biomedical scientists (n=5) and public health officers (n=3).Findings: The majority (75 %, n=66) reported treatment failure with generic brands of antibiotics compared to innovator brands. Thirty-four percent of the participants reported adverse drug reactions (ADRs) on antibiotic therapy to superiors instead of filling out ADR forms.Research Limitations: The study was done in one Directorate in the hospital and thus cannot be generalized to reflect the situation in all teaching hospitals in Ghana.Practical implication: The evidence obtained highlighted the need for pragmatic antimicrobial stewardship (AMS) at the directorate to help optimize the management of childhood infections and minimize the emergence and spread of antibiotic resistance.Originality/Value. This was an original project designed to generate evidence to inform interventions to promote the responsible use of antimicrobials in children

Starting a Laparoscopic Surgery Programme in the Second Largest Teaching Hospital in Ghana

Background: Komfo Anokye Teaching Hospital (KATH) is the second  largest hospital in Ghana. Two years have elapsed after performance of the first laparoscopic cholecystectomy.Objectives: To examine our experience and lessons learned.Design: Retrospective review.Setting: Komfo Anokye Teaching Hospital (KATH). Subjects: We reviewed leadership support, the role of a surgeon champion, training of physician and OR staff, influence of surgeons from outside Ghana and equipment status. The results of laparoscopic cholecystectomies performed from 2010-2012 were compared with information available from open cholecystectomies over the same period.Results: Evidence of leadership support included equipment purchase and invitation of outside experts yearly from 2008. A KATH surgeon champion was identified in 2010. A dedicated OR team received training and exhibited excellent ownership of equipment preparation. Since 2010, 25 laparoscopic cholecystectomies have been performed, 17 independently by a single surgeon. Average operative time was 1.41 hours and length of stay (LOS) 1.5 days. Conversion rate was 4.0%(1/25). Complication rate was 20.0%(5/25), none involving haemorrhage or injuries to bile ducts or bowel. Median patient satisfaction score was 5 on a scale of 1-5 where 5 is most satisfied. Complication rates and hospital stay were lower than for open cholecystectomy (20.0%vs34.5%, p>0.05 and 1.5days vs 6.6days, p<0.001 respectively). Operative times were on average 27min onger for laparoscopic cholecystectomy (p<0.01).Conclusion: Laparoscopic cholecystectomy at KATH has become a reality with less complications rates, shorter LOS, and trends towards improved patient satisfaction. Expanding laparoscopic surgery in Ghana requires its inclusion into residency training programmes and public education about its benefits for both patients and physicians

Prevalence of Giardia species in Cattle Faecal Matter in Selected Farms in Weija and Kpong Major Water Supply Heads to Accra, Ghana.

In developing countries including Ghana, giardiasis plays a major role in gastroenteritis in vertebrate. It poses health and socio-economic burden, and continues to be one of the causes of infant and calf mortality. Their infection continues to thrive in humans due to the zoonotic transmission of infected domesticated animals including cattle, dogs and cats, and their con­tinual presence in water bodies. The objective of this study was to establish their presence and evaluate the prevalence of Giardia sp. in cattle faecal matter in the environment in the Kpong and Weija communities. The Iron-haematoxylin staining techniques was used to analyze the faecal samples in order to identify Giardia sp. (Student t- test and Chi square were the statistical analyses) used for the studies. About five percent (5.3%) prevalence was obtained in both com­munities and this was significant (p> 0.05). The parasite was found to be most prevalent (9.4%) in calves less than 3 months old and this decreased with age of calf. It was also observed that Giardia plays an important role in the cause of diarrhoea in cattle. There is the need to educate people on the disease and its implication on the quality of water from the treatment plants. Keywords: Giardia sp, water, contamination, diarrhoea, infant mortality

Phenotypic and molecular evaluation of maize (Zea may L.) genotypes under field conditions in the Volta region of Ghana

Maize streak disease (MSD) is the most devastating and destructive disease of maize (Zea mays L.) in sub-Saharan Africa (SSA). Field trials were conducted in the 2014 minor and 2015 major cropping seasons to screen 16 and 17 maize genotypes, respectively, for high yield and resistance to maize streak virus (MSV) infections. The plants were scored for disease severity at 4, 6, 8 and 10 weeks after planting (WAP) based on a 1-5 visual scale (1= No infection and 5= Very severe infection). Polymerase chain reaction (PCR) test was done to detect the presence of MSV in the diseased leaf samples in order to confirm field resistance. Both phenotypic and PCR test revealed that all the maize genotypes tested in the study were infected by MSV. There was a significant varietal effect on the incidence and severity of MSD in both the major and minor seasonal trials. Genotypes ‘Abontem’,’Aburohemaa’, ‘Akposoe’, ‘Dapango’, ‘Dorke’, ‘Etubi’, ‘Honampa’, ‘Mamaba’, ‘Obatanpa’, ‘Omankwa’ and PAN 12 showed mild disease symptoms during both major and minor cropping seasons. On the other hand, genotypes ‘Dormabin’, ‘Dzinu-Eve’, ‘Enibi’, Keta 60 and PAN 53 exhibited moderate to severe symptoms during the two cropping seasons. Incidence and severity of MSD were significantly higher in the minor season than in the major season, indicating a significant seasonal effect of MSV on the maize genotypes. The yield and yield components were observed to vary significantly among the different maize genotypes and between the cropping seasons with mean yields significantly higher in the major season than in the minor season. Genotypes ‘Abontem’, ‘Aburohemaa’, ‘Akposoe’, ‘Dorke’, ‘Etubi’, ‘Honampa’, ‘Omankwa’, ‘Obatanpa’ and PAN 12 (All improved varieties), which exhibited partial resistance to MSV infection gave high seed yields during both seasons. The improved maize genotypes that were high yielding and resistant to MSV infection should be evaluated for uniform yield trials on farmers’ fields towards their release as varieties to farmers

Cardiopulmonary ultrasound for critically ill adults improves diagnostic accuracy in a resourceâ limited setting: the AFRICA trial

ObjectiveTo assess the effects of a cardiopulmonary ultrasound (CPUS) examination on diagnostic accuracy for critically ill patients in a resourceâ limited setting.MethodsApproximately half of the emergency medicine resident physicians at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, were trained in a CPUS protocol. Adult patients triaged to the resuscitation area of the emergency department (ED) were enrolled if they exhibited signs or symptoms of shock or respiratory distress. Patients were assigned to the intervention group if their treating physician had completed the CPUS training. The physician’s initial diagnostic impression was recorded immediately after the history and physical examination in the control group, and after an added CPUS examination in the intervention group. This was compared to a standardised final diagnosis derived from post hoc chart review of the patient’s care at 24 h by two blinded, independent reviewers using a clearly defined and systematic process. Secondary outcomes were 24â h mortality and use of IV fluids, diuretics, vasopressors and bronchodilators.ResultsOf 890 patients presenting during the study period, 502 were assessed for eligibility, and 180 patients were enrolled. Diagnostic accuracy was higher for patients who received the CPUS examination (71.9% vs. 57.1%, Î 14.8% [CI 0.5%, 28.4%]). This effect was particularly pronounced for patients with a â cardiacâ diagnosis, such as cardiogenic shock, congestive heart failure or acute valvular disease (94.7% vs. 40.0%, Î 54.7% [CI 8.9%, 86.4%]). Secondary outcomes were not different between groups.ConclusionsIn an urban ED in Ghana, a CPUS examination improved the accuracy of the treating physician’s initial diagnostic impression. There were no differences in 24â h mortality and a number of patient care interventions.ObjectifEvaluer les effets de l’examen échographique cardioâ pulmonaire (CPUS) sur la précision du diagnostic chez les patients gravement malades dans un cadre à ressource limitée.MéthodesEnviron la moitié des médecins résidents en médecine d’urgence à la Komfo Anokye Teaching Hôpital (KATH) à Kumasi, au Ghana ont été formés pour un protocole de CPUS. Les patients adultes triés dans l’unité de ressuscitation des soins intensifs ont été inscrits s’ils présentaient des signes ou des symptômes de choc ou d’une détresse respiratoire. Les patients ont été assignés au groupe d’intervention si leur médecin traitant avait suivi la formation CPUS. Le diagnostic initial du médecin a été enregistré immédiatement après l’anamnèse et l’examen physique dans le groupe témoin, et après un examen CPUS ultérieur dans le groupe d’intervention. Cela a été comparé à un diagnostic final standard dérivé de l’analyse postâ hoc en aveugle des dossiers de soins du patient à 24 heures par deux examinateurs indépendants, au moyen d’un processus clairement défini et systématique. Les résultats secondaires étaient la mortalité de 24 heures et l’utilisation de fluides en IV, de diurétiques, de vasopresseurs et de bronchodilatateurs.RésultatsSur 890 patients présentés au cours de la période dâ étude, 502 ont été évalués pour lâ éligibilité et 180 patients ont été inscrits. La précision du diagnostic était plus élevée chez les patients ayant reçu l’examen CPUS (71,9% contre 57,1%, Î 14,8% [IC: 0,5% à 28.4%]). Cet effet était particulièrement marquée pour les patients avec un diagnostic «cardiaque», tel que le choc cardiogénique, l’insuffisance cardiaque congestive ou une maladie aiguë valvulaire (94,7% contre 40,0%, Î 54,7% [IC: 8,9% à 86,4%]). Les résultats secondaires nâ étaient pas différents entre les groupes.ConclusionsDans un service de soins intensifs urbain au Ghana, un examen CPUS améliorait la précision du diagnostic initial du médecin traitant. Il n’y avait aucune différence dans la mortalité de 24 heures et dans le nombre des interventions de soins.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141626/1/tmi12992.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141626/2/tmi12992_am.pd

A Fermi-degenerate three-dimensional optical lattice clock

Strontium optical lattice clocks have the potential to simultaneously interrogate millions of atoms with a high spectroscopic quality factor of $4 \times 10^{-17}$. Previously, atomic interactions have forced a compromise between clock stability, which benefits from a large atom number, and accuracy, which suffers from density-dependent frequency shifts. Here, we demonstrate a scalable solution which takes advantage of the high, correlated density of a degenerate Fermi gas in a three-dimensional optical lattice to guard against on-site interaction shifts. We show that contact interactions are resolved so that their contribution to clock shifts is orders of magnitude lower than in previous experiments. A synchronous clock comparison between two regions of the 3D lattice yields a $5 \times 10^{-19}$ measurement precision in 1 hour of averaging time.Comment: 19 pages, 4 figures; Supplementary Material

Three-dimensional jamming and flows of soft glassy materials

Various disordered dense systems such as foams, gels, emulsions and colloidal suspensions, exhibit a jamming transition from a liquid state (they flow) to a solid state below a yield stress. Their structure, thoroughly studied with powerful means of 3D characterization, exhibits some analogy with that of glasses which led to call them soft glassy materials. However, despite its importance for geophysical and industrial applications, their rheological behavior, and its microscopic origin, is still poorly known, in particular because of its nonlinear nature. Here we show from two original experiments that a simple 3D continuum description of the behaviour of soft glassy materials can be built. We first show that when a flow is imposed in some direction there is no yield resistance to a secondary flow: these systems are always unjammed simultaneously in all directions of space. The 3D jamming criterion appears to be the plasticity criterion encountered in most solids. We also find that they behave as simple liquids in the direction orthogonal to that of the main flow; their viscosity is inversely proportional to the main flow shear rate, as a signature of shear-induced structural relaxation, in close similarity with the structural relaxations driven by temperature and density in other glassy systems.Comment: http://www.nature.com/nmat/journal/v9/n2/abs/nmat2615.htm

Mental Toughness in South African Youth: Relationships With Forgivingness and Attitudes Towards Risk

Young people are particularly vulnerable to health risk behaviors and interpersonal violence, stimulating scholars’ attention towards identifying factors that may reduce the likelihood that these actions will occur. Associated with positive outcomes in a variety of domains, mental toughness in young people might protect them from engaging in potentially deleterious interpersonal or health-risk behaviors, while potentially promoting positive psychological behaviors. Within this framework, the present study investigated the relationships between mental toughness, attitudes towards physical and psychological risk-taking, and trait forgiveness in a sample of 123 (males = 54, females = 69) South African youth (M age = 23.97 years, SD = 4.46). Univariate and multivariate analyses indicated higher levels of mental toughness were associated with being more forgiving, (η2pηp2 = .036), perceiving physical risk-taking more positively (η2pηp2 = .062), but having more negative attitudes towards psychological risk-taking (η2pηp2 = .036). These findings give credence to mental toughness as a psychological characteristic involved in youth risk-taking perceptions and interpersonal functioning. Future research might explore the integration of mental toughness into the development of future youth risk behavior interventions