Prevalence of attention-deficit/hyperactivity disorder among primary school children in Oforikrom, Ghana based on the disruptive behavior disorders rating scale

OBJECTIVE: To determine the prevalence of attention-deficit/hyperactivity disorder (ADHD) among primary school children in Oforikrom, Kumasi, Ghana. METHODS: 10 of 35 primary schools in Oforikrom were readily available. Of 2000 children aged 5 to 13 years selected, 1540 (77%) of their parents/guardians consented to participate. Their parents/guardians and six teachers from each school were asked to complete the Disruptive Behavior Disorders Rating Scale to screen children for the presence of ADHD, oppositional defiant disorder, or conduct disorder. Children who displayed symptoms (pretty much or very much) in most related items as determined by parents and/or teachers were considered positive cases. RESULTS: The mean age of 1540 pupils was 9 ± 2.16 years. Most (31%) were primary 4 pupils. 5% of pupils displayed ADHD symptoms (attention deficit disorder subtype in 36%, hyperactivity disorder subtype in 27%, and combined subtype in 37%). Of them, 51% were male. Most (19%) of those who displayed the symptoms were in primary 5. CONCLUSION: The prevalence of ADHD among primary school children in Oforikrom was 5%. 51% of those with ADHD symptoms were male. Most (19%) of those with ADHD symptoms were in primary 5

Knowledge of HIV/AIDS among older adults (50 years and above) in a peri-urban setting: A descriptive cross-sectional study

Background: In the absence of vaccine or cure, public knowledge about Human Immune Virus (HIV) is a central tool for curbing HIV epidemic. This study sought to assess the knowledge of HIV among older adults (50 years and above) at the Methodist Faith Healing hospital, Ankaase, Ghana. Methods: Using a descriptive study design, older adults (50 years and above) who visited the Ankaase Methodist Faith Healing hospital were randomly sampled for the study. A structured questionnaire was administered to collect data which was analyzed quantitatively using Statistical Package for Social Sciences (SPSS version 16.0). Results: A total of 100 respondents who were aged 50 to 68 (54 ± 2.3) were recruited. Most of the respondents had average knowledge of the mode of HIV transmission (62%) as well as HIV prevention (58%) and signs and symptoms of HIV (60%). HIV status was significantly associated with HIV knowledge among older adults as HIV positive respondents were 2.25 times more knowledgeable in terms of signs and symptoms, mode of transmission and prevention of HIV [AOR (95% CI) 2.25(1.02-8.68)]. Conclusion: Most older adults (50 years and above) have average knowledge of the mode of transmission, prevention as well as signs and symptoms of HIV. The National Commission for Civic Education should collaborate with various key stakeholders to educate older adults on issues related to HIV/AIDS

Use and completion of partograph during labour is associated with a reduced incidence of birth asphyxia: a retrospective study at a peri-urban setting in Ghana

Background: Morbidity of birth asphyxia has been estimated to be 42 million disability-adjusted life years. The study sought to assess the impact of the use and completion of partograph during labour on reducing birth asphyxia at the St Anthony\u2019s Hospital, Dzodze, in the Volta Region of Ghana. Methods: A retrospective study design using a quantitative approach was adopted for the study. A simple random sampling technique was used to select a total of 200 folders of labouring women who were admitted and delivered at St Anthony\u2019s Hospital, Dzodze, between 1st May 2015 and 30th April 2016. A structured checklist, which was developed by using labour and foetal monitoring parameters based on the standards of the World Health Organization partograph usage, was used to review all the 200 existing maternal records. Results: The findings revealed that partographs were used by midwives at St Anthony\u2019s Hospital with the majority of the maternal folders fully completed. The use and completion of partograph were found to be associated with less non-asphyxiated birth outcomes. Labours which were monitored with partograph were 4.29 times less likely to result in birth asphyxia [AOR (95% CI) 4.29 (1.35\u201314.81)], and those that were monitored with a completed partograph were 5.3 times less likely to result in birth asphyxia [AOR (95% CI) 5.31 (2.011\u201316.04)]. Conclusion: Midwives used partographs during labour at St Anthony\u2019s Hospital. The use and completion of partograph were significantly associated with a reduced incidence of birth asphyxia at the hospital. Birth asphyxia could be reduced if partographs are used and completed by midwives during labour in all cases

Psychological distress and quality of life in asymptomatic adults following provision of imaging results for prevention of cardiovascular disease events: a scoping review

Aims: Psychological distress and changes in health-related quality of life (HRQoL) may occur after screening for disease. Reporting outcomes related to potential benefits and harms of screening is a key recommendation in the guidelines for reporting high-quality trials or interventions. However, no reviews have directly investigated outcomes related to psychological distress and/or changes in HRQoL following imaging assessment of cardiovascular risk and communication of cardiovascular findings to asymptomatic adults. A scoping review was conducted to map research on psychological distress and/or HRQoL following screening. Methods and results: Six electronic databases (MEDLINE, PsychINFO, Social Work Abstracts, Psychology and Behavioural Sciences Collection, CINAHL, and EMBASE) were searched for articles that assessed psychological distress and/or HRQoL following screening. Two investigators independently screened titles and abstracts for all records retrieved using predefined criteria. Studies were conducted among active smokers, military personnel, athletes, post-menopausal women, and high-risk individuals. Seven constructs related to psychological distress and HRQoL appeared across 11 articles (randomized controlled trials, n = 4 and non-randomized studies, n = 7). Worry, depression, perceived stress, anxiety, and quality of life were most prominent. Multiple-item measures of psychological distress (e.g. Taylor Anxiety Score and Beck Depression Inventory) were used in 5/9 (56%) studies. Key findings on psychological distress and/or changes in HRQoL following screening were mixed. Conclusions: Findings support the need for multiple-item measures with better psychometric properties to examine the psychological responses to screening results in future studies. Strategies to support individuals during and following vascular screening to maximise potential benefits of screening and minimize harms are discussed

Psychological distress and quality of life in asymptomatic adults following provision of imaging results for prevention of cardiovascular disease events: A scoping review

Aims Psychological distress and changes in health-related quality of life (HRQoL) may occur after screening for disease. Reporting outcomes related to potential benefits and harms of screening is a key recommendation in the guidelines for reporting high-quality trials or interventions. However, no reviews have directly investigated outcomes related to psychological distress and/or changes in HRQoL following imaging assessment of cardiovascular risk and communication of cardiovascular findings to asymptomatic adults. A scoping review was conducted to map research on psychological distress and/or HRQoL following screening. Methods and results Six electronic databases (MEDLINE, PsychINFO, Social Work Abstracts, Psychology and Behavioural Sciences Collection, CINAHL, and EMBASE) were searched for articles that assessed psychological distress and/or HRQoL following screening. Two investigators independently screened titles and abstracts for all records retrieved using predefined criteria. Studies were conducted among active smokers, military personnel, athletes, post-menopausal women, and high-risk individuals. Seven constructs related to psychological distress and HRQoL appeared across 11 articles (randomized controlled trials, n = 4 and non-randomized studies, n = 7). Worry, depression, perceived stress, anxiety, and quality of life were most prominent. Multiple-item measures of psychological distress (e.g. Taylor Anxiety Score and Beck Depression Inventory) were used in 5/9 (56%) studies. Key findings on psychological distress and/or changes in HRQoL following screening were mixed. Conclusions Findings support the need for multiple-item measures with better psychometric properties to examine the psychological responses to screening results in future studies. Strategies to support individuals during and following vascular screening to maximise potential benefits of screening and minimize harms are discussed

Impact of vascular screening interventions on perceived threat, efficacy beliefs and behavioural intentions: A systematic narrative review

Health-related behaviours contribute to the global burden of cardiovascular disease (CVD). Cardiovascular imaging can be used to screen asymptomatic individuals for increased risk of CVD to enable earlier interventions to promote health-related behaviours to prevent or reduce CVD risk. Some theories of behaviour and behaviour change assume that engagement in a given behaviour is a function of individual threat appraisals, beliefs regarding the performance of behaviour, self-efficacy for performing the desired behaviour and/or dispositions to act (e.g. behavioural intentions). To date, little is known about the impact of cardiovascular imaging interventions on these constructs. This article summarises evidence related to perceived threat, efficacy beliefs, and behavioural intentions after CVD screening. We identified 10 studies (2 RCTs and 8 non-randomised studies, n = 2498) through a combination of screening citations from published systematic reviews and meta-analyses and searching electronic databases. Of these, 7 measured behavioural intentions and perceived susceptibility and 3 measured efficacy beliefs. Findings showed largely encouraging effects of screening interventions on bolstering self-efficacy beliefs and strengthening behavioural intentions. Imaging results that suggest the presence of coronary or carotid artery disease also increased perceived susceptibility to CVD. However, the review also identified some gaps in the literature, such as a lack of guiding theoretical frameworks and assessments of critical determinants of health-related behaviours. By carefully considering the key issues highlighted in this review, we can make significant strides towards reducing CVD risks and improving population health

A randomised controlled crossover trial investigating the short-term effects of different types of vegetables on vascular and metabolic function in middle-aged and older adults with mildly elevated blood pressure: the VEgetableS for vaScular hEaLth (VESSEL) study protocol

A diet rich in fruits and vegetables is recommended for cardiovascular health. However, the majority of Australians do not consume the recommended number of vegetable servings each day. Furthermore, intakes of vegetables considered to have the greatest cardiovascular benefit are often very low. Results from prospective observational studies indicate that a higher consumption of cruciferous vegetables (e.g. broccoli, cabbage, cauliflower) is associated with lower cardiovascular disease risk. This may be due to the presence of specific nutrients and bioactive compounds found almost exclusively, or at relatively high levels, in cruciferous vegetables. Therefore, the aim of this randomised controlled crossover trial is to determine whether regular consumption of cruciferous vegetables results in short-term improvement in measures related to cardiovascular disease risk, including ambulatory blood pressure, arterial stiffness, glycaemic control, and circulating biomarkers of oxidative stress and inflammation

Implementation, mechanisms of impact and key contextual factors involved in outcomes of the Modification of Diet, Exercise and Lifestyle (MODEL) randomised controlled trial in Australian adults: Protocol for a mixed-method process evaluation

Introduction The Modification of Diet, Exercise and Lifestyle (MODEL) study aims to examine the impact of providing visualisation and pictorial representation of advanced structural vascular disease (abdominal aortic calcification), on ‘healthful’ improvements to diet and lifestyle. This paper reports the protocol for the process evaluation for the MODEL study. Methods and analysis The overall aim of the process evaluation is to understand the processes that took place during participation in the MODEL study trial and which elements were effective or ineffective for influencing ‘healthful’ behavioural change, and possible ways of improvement to inform wider implementation strategies. A mixed-method approach will be employed with the use of structured questionnaires and semistructured in-depth interviews. All 200 participants enrolled in the trial will undertake the quantitative component of the study and maximum variation sampling will be used to select a subsample for the qualitative component. The sample size for the qualitative component will be determined based on analytical saturation. Interviews will be digitally recorded and transcribed verbatim. Qualitative data will be analysed thematically and reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Ethics and dissemination The MODEL study process evaluation has received approval from Edith Cowan University Human Research Ethics Committee (Project Number: 20513 HODGSON). Written informed consent will be obtained from all participants before they are included in the study. The study results will be shared with the individuals and institutions associated with this study as well as academic audiences through peer-reviewed publication and probable presentation at conferences

Modification of diet, exercise and lifestyle (MODEL) study: a randomised controlled trial protocol

Introduction: Most cardiovascular disease (CVD)-related events could be prevented or substantially delayed with improved diet and lifestyle. Providing information on structural vascular disease may improve CVD risk factor management, but its impact on lifestyle change remains unclear. This study aims to determine whether providing visualisation and pictorial representation of structural vascular disease (abdominal aortic calcification (AAC)) can result in healthful diet and lifestyle change. Methods and analysis: This study, including men and women aged 60–80 years, is a 12-week, two-arm, multisite randomised controlled trial. At baseline, all participants will have AAC assessed from a lateral spine image captured using a bone densitometer. Participants will then be randomised to receive their AAC results at baseline (intervention group) or a usual care control group that will receive their results at 12 weeks. All participants will receive information about routinely assessed CVD risk factors and standardised (video) diet and lifestyle advice with three simple goals: (1) increase fruit and vegetable (FV) intake by at least one serve per day, (2) improve other aspects of the diet and (3) reduce sitting time and increase physical activity. Clinical assessments will be performed at baseline and 12 weeks. Outcomes: The primary outcome is a change in serum carotenoid concentrations as an objective measure of FV intake. The study design, procedures and treatment of data will adhere to Standard Protocol Items for Randomized Trials guidelines. Ethics and dissemination: Ethics approval for this study has been granted by the Edith Cowan University and the Deakin University Human Research Ethics Committees (Project Numbers: 20513 HODGSON and 2019-220, respectively). Results of this study will be published in peer-reviewed academic journals and presented in scientific meetings and conferences. Information regarding consent, confidentiality, access to data, ancillary and post-trial care and dissemination policy has been disclosed in the participant information form

Exploring the psychological and behavioural responses to cardiovascular screening interventions

Screening for asymptomatic cardiovascular disease (CVD) by non-invasive imaging can detect CVD risk, often decades before a clinical event. Early detection of CVD can improve health outcomes by allowing for earlier intervention and treatment. Psychological and behavioural responses to screening can influence health outcomes. However, the impact of screening for asymptomatic CVD from a psychological and behavioural perspective is not well understood. Furthermore, little is known about how to best support individuals in coping with screening-related psychological and behavioural responses, and more research is needed to identify effective interventions to promote healthy responses and behaviours. This thesis aims to provide insight into the psychological and behavioural responses to cardiovascular screening as a beginning step in the development of effective interventions. The thesis is comprised of 7 chapters including literature reviews, a meta-analysis and a mixed method process evaluation of a randomised controlled trial (RCT). The first chapter of the thesis includes a comprehensive introduction to CVD and rationale for the thesis. This is followed by the second chapter, a description of key concepts/constructs and theories that feature prominently in behaviour change literature. The systematic narrative review presented in chapter 3 synthesised evidence on the impact of cardiovascular screening interventions on perceived threat, efficacy beliefs and behavioural intentions. The findings showed largely encouraging effects of screening interventions on increased self-efficacy beliefs, behavioural intentions and individual perceptions of CVD risk. Evidence of the impact of cardiovascular screening interventions on perceived threat, efficacy beliefs and behavioural intentions was limited. Chapter 4 mapped the evidence related to health-related quality of life and the potential psychological harms of communicating screening findings. The scoping review showed some mixed evidence related to health-related quality of life, and psychological distress following provision of screening results. Evidence on psychological distress following vascular screening is limited by the use of measures with poor psychometric properties and the paucity of high-quality studies. In Chapter 5, the effects of the provision of vascular imaging results on medication adherence are examined. Findings showed that the detection of asymptomatic coronary and carotid atherosclerosis assessed by carotid ultrasound and coronary computed tomography significantly increases the likelihood of CVD medication adherence. The delivery of the Modification Of Diet, Exercise, and Lifestyle (MODEL) RCT is evaluated in chapter 6 together with the mechanisms underlying behaviour change after screening. The results revealed several psycho-social barriers and enablers for modification of lifestyle including weather, social relationships, and behavioural intentions. Participants also encountered some challenges related to completing questionnaires, and interpreting screening results. Participants requested for more clarity about screening results and support to perform recommended behaviours. To conclude, Chapter 7 provides an overall discussion of all the studies included in the thesis, conclusions, and future directions for research. It underscores the benefits of screening for asymptomatic CVD in terms of the potential impact on behavioural modification and CVD management. Strategies to improve CVD risk communication and support individuals to make lasting changes to their lifestyles are also discussed