Adolescent health in rural Ghana: A cross-sectional study on the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors.

In sub-Saharan Africa, infectious diseases and malnutrition constitute the main health problems in children, while adolescents and adults are increasingly facing cardio-metabolic conditions. Among adolescents as the largest population group in this region, we investigated the co-occurrence of infectious diseases, malnutrition and cardio-metabolic risk factors (CRFs), and evaluated demographic, socio-economic and medical risk factors for these entities. In a cross-sectional study among 188 adolescents in rural Ghana, malarial infection, common infectious diseases and Body Mass Index were assessed. We measured ferritin, C-reactive protein, retinol, fasting glucose and blood pressure. Socio-demographic data were documented. We analyzed the proportions (95% confidence interval, CI) and the co-occurrence of infectious diseases (malaria, other common diseases), malnutrition (underweight, stunting, iron deficiency, vitamin A deficiency [VAD]), and CRFs (overweight, obesity, impaired fasting glucose, hypertension). In logistic regression, odds ratios (OR) and 95% CIs were calculated for the associations with socio-demographic factors. In this Ghanaian population (age range, 14.4-15.5 years; males, 50%), the proportions were for infectious diseases 45% (95% CI: 38-52%), for malnutrition 50% (43-57%) and for CRFs 16% (11-21%). Infectious diseases and malnutrition frequently co-existed (28%; 21-34%). Specifically, VAD increased the odds of non-malarial infectious diseases 3-fold (95% CI: 1.03, 10.19). Overlap of CRFs with infectious diseases (6%; 2-9%) or with malnutrition (7%; 3-11%) was also present. Male gender and low socio-economic status increased the odds of infectious diseases and malnutrition, respectively. Malarial infection, chronic malnutrition and VAD remain the predominant health problems among these Ghanaian adolescents. Investigating the relationships with evolving CRFs is warranted

Fertilizer and Genotype Effects on Maize Production on Two Soils in the Northern Region of Ghana

Soils in the Guinea Savanna agro-ecological zone of Ghana are depleted in major nutrients by continuous cropping and residue removal, resulting in low maize yields. While many studies have assessed the fertilizer requirements for maize, most did not account for the role of the soil type and maize genotype. A study was conducted on Plinthosol and Lixisol in the Tolon district of the Northern Region of Ghana to assess fertilizer and genotype effects on maize productivity. Two maize genotypes (i.e. Obatanpa -110 days to maturity) and (Dodzie - 75 days to maturity) were compared at three fertilizer application rates (i.e. 0-0-0, 60-15-35 and 90-25-50 kg ha-1 N, P K) in a randomized complete block design using four replications, with genotype allocated to the main plots and fertilizer levels to the subplots. Soils were characterized, revealing very low total N and available P concentrations in the top layers. Grain yield was significantly affected by maize genotype, irrespective of the soil type. The longer-duration (Obatanpa) tended to out yield the short duration genotype (Dodzie), and generally outperformed Dodzie in all yield parameters except for the harvest index on Plinthosol. Inorganic fertilizers significantly (P<0.001) increased yield and all yield parameters over the control on both soils, with yield increases of 84 and 90% at 60-15-35 and 90-25-50 kg ha-1 N, P K, respectively. Genotype by fertilizer interaction was highly significant (P<0.001) for grain yield on both soils. We conclude that farmers in the Guinea Savannah agro-ecological zone of Ghana need to supply nutrients to enhance grain yields of maize, irrespective of the prevailing soil type

Can we measure long-term treatment effects in multiple sclerosis?

The gold standard for measuring treatment effects is the randomized controlled trial. In patients with multiple sclerosis (MS), trial durations are typically 2-3 years, and the long-term effects of drugs for MS can only be assessed through trial extensions or observational studies that take advantage of data from registries or large single-centre databases. The main limitation of observational studies is an unavoidable selection bias that is introduced through nonrandom assignment of the intervention. Propensity score methods can mitigate this bias by balancing the groups with respect to baseline covariates, but this approach cannot correct for unmeasurable confounding factors. Extensions of clinical trials are free from selection biases because of the initial randomization, but they can only provide an assessment of early versus delayed treatment effects. Here, we discuss these methodological issues and analyse how they have been managed in studies of the long-term effects of IFN-\u3b2 in patients with MS

Attitudes Toward the Insanity Defense: Examination of the Factor Structure of Insanity Defense Attitude-Revised (IDA-R) Scale in Ghana

Decades of research have revealed the potential of individuals to be partial toward defendants pleading insanity at the time of offense. This study examines the internal structure of the Insanity Defense Attitude-Revised (IDA-R) scale as well as predictors of insanity defense attitude in a Ghanaian sample (N = 253). Using principal component analysis, we identified three distinct latent factors, two (i.e., strict liability, unprofessional behavior and safety concerns) of which corroborate the findings of previous studies, and a unique factor- expression of sympathy. Participants who were highly involved in religious activities were more likely to be sympathetic. Views regarding the causes and treatability of mental illness did not significantly predict insanity defense attitudes.</p