Infrastructure Development in the UK: Key Drivers and Implementation Challenges

Infrastructure is a critical factor in fostering strong and sustained economic growth, hence, sufficient attention should be given to the allocation of investment. Although UK infrastructure investment have risen in line with the global trend, the level of investment remains in the lower percentile when compared to other leading countries such as Singapore and China. The study examines the challenges of infrastructure development in the UK and explored the policies required to stimulate investment. Using semi-structured interviews, the views of key stakeholders involved in infrastructure operating across key sectors of transport and energy were captured to gain an insight into the key policy drivers of infrastructure investment. Findings from the research suggests that policy changes are required to stimulate significant investment if the UK is to become a world leader in infrastructure. Key criticisms of UK infrastructure policy focussed on comparatively low level of investment, inadequate collaboration between key stakeholders, and the regional bias of investment in favour of London which disproportionately affects the Northern regions. To facilitate economic growth, the identification of future investible pipeline of infrastructure projects, increasing collaboration with local stakeholders and addressing the regional biases will be critical to ensure synergy and ownership and to scale up the implementation of UK future infrastructure development plans. Considerations should also be given to the need to set up infrastructure banks similar to what is in operation in other countries such as China and Singapore to stimulate private investment and to complement public sector budget allocations. Improving infrastructure project implementation through institutional coordination will boost economic growth post Brexit, support the development of new trading agreements and enhance the country’s economic performance after the pandemi

One State, Two School Systems: the Instability of Ghana’s School System since the Fourth Republic

This paper examines the fickle nature of Ghana’s school system since colonialism. The school system has undergone several metamorphoses both in structure and content from the colonial epoch to post-independence. The management and reform of education in Ghana seem to have become synonymous with a change in political power. This paper argues that the management of Ghana’s educational system after fifty-five (55) years of independence is still undergoing turbulent experimentation to fine-tune to an efficient and effective school system. This instability in the structure and content of Ghana’s educational system looks more of a political jingle as well as military musical chairs rather than based on national consensus aimed at mitigating the many challenges facing the school system. Keywords: Education management, education reform/review, politics, quality educatio

Obesity is associated with poor surgical outcome in Crohn\u27s disease

BACKGROUND: Published data suggest a link between obesity and adverse outcomes in Crohn\u27s disease (CD). We aimed to test the hypothesis that obese CD patients would be more likely than non-obese CD patients to have poor surgical outcome when undergoing surgery for a complication of CD. METHODS: We designed a retrospective cohort study to test our hypothesis. The population comprised of adult CD patients who underwent CD related surgery at a tertiary referral center. The exposed and unexposed cohorts were represented by patients who were obese vs. non-obese at the pre-op visit respectively. Outcome was represented by successful vs. unsuccessful surgical outcome as deemed by the treating clinician. RESULTS: Ninety CD patients were eligible for inclusion into this cohort study of which 36 were obese (exposed cohort) and 54 were non-obese (unexposed cohort). Among obese CD patients, 64% had an unsuccessful surgical outcome vs. 41% with unsuccessful surgical outcome among the non-obese. Based on unadjusted bivariate analysis, potential confounders identified included age and type of surgery. Gender distribution, disease duration, ethnicity, tobacco use, steroid use, traditional and biological immune modulator use and clinical disease activity were similar between the two groups. Logistic regression adjusted for age and type of surgery revealed that obese CD patients were approximately 2.5 times more likely to have a poor surgical outcome than patients with CD who were not obese (P = 0.05 OR 2.53 95% CI 0.99 - 6.52). BMI as a continuous variable (adjusted for age and type of surgery) appeared to be associated with poor surgical outcome (P = 0.06 OR 1.07 95% CI 0.99 - 1.15). CONCLUSIONS: Obesity may be associated with poor surgical outcome in CD patients

Examining barriers to healthcare access and utilization of antenatal care services: evidence from demographic health surveys in sub-Saharan Africa

Background:Antenatal care utilization is one of the means for reducing the high maternal mortality rates in sub-Saharan Africa. This study examined the association between barriers to healthcare access and implementation of the 2016 WHO antenatal care services model among pregnant women seeking antenatal care in selected countries in sub-Saharan Africa. Methods: This study considered only Demographic and Health Survey data collected in 2018 in sub-Saharan Africa. Hence, the Demographic and Health Survey data of four countries in sub-Saharan Africa (Nigeria, Mali, Guinea and Zambia) were used. A sample of 6761 from Nigeria, 1973 from Mali, 1690 from Guinea and 1570 from Zambia was considered. Antenatal care visits, categorized as  3 months (as per the WHO recommendations) were the outcome variables for this study. Both descriptive statistics and ordinal logistic regression were used to analyze the data. Crude odds ratios (cOR) and adjusted odds ratios (aOR) and p-values < 0.05 were used for the interpretation of results. Results: With timing of antenatal care visits, getting money needed for treatment (aOR = 1.38, 95% CI = 1.03–1.92) influenced early timing of antenatal care visits in Mali whereas getting permission to visit the health facility (aOR = 1.62, 95% CI = 1.15–2.33) motivated women to have early timing of antenatal care visits in Guinea. We found that women who considered getting money needed for treatment as not a big problem in Nigeria were more likely to have the recommended number of antenatal care visits (aOR = 1.38, 95% CI= 1.11–1.73). On the contrary, in Guinea, Zambia and Mali, getting permission to visit health facilities, getting money for treatment, distance to the health facility and not wanting to go alone were not barriers to having ≥ 8 antenatal care visits. Conclusion: Our study has emphasized the role played by barriers to healthcare access in antenatal care utilization across sub-Saharan African countries. There is the need for governmental and non-governmental organizations to ensure that policies geared towards improving the quality of antenatal care and promoting good interaction between health care seekers and health care providers are integrated within the health system

Expression of the Ordeals of “kayayie” through Mixed-Media Textile Art

The practice of kayayie by young ladies in southern Ghana exposes them to varying difficulties and struggles just to make a living. To bring to the fore such challenges in textile art, the study employed mixed-media materials and techniques to produce art works that communicate their struggles. To achieve the study’s focus, the studio-based practice was exercised supported by the Aesthetico-Action Research model by Cora Marshal. Non-participant observation and unstructured interview were the main instruments used for data collection. The study revealed three major findings. The first set of findings revealed that, super glue is suitable for varieties of materials and has the ability to wet the fabric to give strong bond with high resistance. Un-primed background before painting resulted in more absorption of paint to fill the amorphous areas of the canvas. Cotton fabric is a suitable substrate for producing mixed media textile art works. The project reveals the possibility of producing textile art using materials available in the environment employing combined techniques like assemblage, painting, sewing and applique to communicate a message. The project recommends that vocational training centres should be built to train kayayie and practicing artists as well as students how to use waste materials in the environment to produce textile art. Keyword: Mixed-media, Textile Art, Kayayie, techniques DOI: 10.7176/ADS/89-02 Publication date: January 31st 202

Utilization of deworming medication and its associated factors among pregnant married women in 26 sub-Saharan African countries: a multi-country analysis

Background Deworming is one of the strategies to reduce the burden of anemia among pregnant women. Globally, pregnant women in sub-Saharan Africa are more affected by anemia. Therefore, this study examined both the coverage and demographic, socioeconomic, and women empowerment-related factors associated with the utilization of deworming medication among pregnant married women in sub-Saharan Africa. Methods We used data from the most recent Demographic and Health Surveys of 26 countries in sub-Saharan Africa conducted between 2010 and 2019. Using Stata version-14 software, analysis was done on 168,910 pregnant married women. Bivariate and multivariable logistic regression analyses were conducted to examine the factors associated with the utilization of deworming medication. The results were presented using adjusted odds ratios (aORs) at 95% confidence intervals (CIs). Results The pooled results showed that about 50.7% (95% CI 48.2–53.3%) of pregnant married women in the studied countries took deworming medications, and this varied from as high as 84.1% in Sierra Leone to as low as 2% in Angola. Regarding sub-regional coverage, the highest and lowest coverages were seen in East Africa (67.6%, 95% CI 66.0–69.1%) and West Africa (24.3%, 95% CI 22.4–26.4%) respectively. We found higher odds of utilization of deworming medication among older pregnant married women (aOR=1.93, 95% CI 1.32–2.84), women with educated husbands (aOR=1.40, 95% CI 1.11–1.77), wealthier women (aOR=3.12, 95% CI 1.95–4.99), women exposed to media (aOR=1.46, 95% CI 1.18–1.80), and those who had four or more antenatal care visits (aOR=1.51, 95% CI 1.24–1.83). Conclusions Enhancing women’s education, disseminating information about maternal healthcare services through mass media, and ensuring that women from economically disadvantaged households benefit from national economic growth can be considered as deworming medication improvement strategies in sub-Saharan Africa. Moreover, providing more attention to adolescents or young pregnant women and increasing the number of antenatal care visits could be considered to increase deworming uptake among pregnant married women

Association between Attitude towards Wife Beating and Childhood Diarrhea: A Demographic and Health Survey-Based Study in 25 Sub-Saharan African Countries.

BackgroundChildhood diarrhea remains a major public health problem in sub-Saharan Africa (SSA). Women empowerment reduces child mortality, and wife beating attitude is one of the indicators of women empowerment. There is a dearth of evidence about wife beating attitudes and childhood diarrhea in SSA. Therefore, the present study aimed to examine the association between attitude towards wife beating and diarrhea among under-five children.MethodsWe used Demographic and Health Surveys from 25 countries in SSA that were conducted between 2010 and 2020. Using Stata version 14 software, we carried out the analysis on 153,864 children under five. Bivariate and multivariate logistic regression analyses were applied, and the results were presented using adjusted odd ratios (aOR) at 95% confidence interval (CI).ResultsThe pooled results show that 71.4% of married women disagreed with wife beating. About 20.5% of under-five children of married women had diarrhea. Childhood diarrhea varied from highest prevalence in Chad (27.9%) to the lowest prevalence in Sierra-Leone (8.5%). The study showed lower odds of diarrhea among children of married women who disagreed with wife beating (aOR = 0.66 95% CI; 0.54-0.80) compared to children of married women who agreed with wife beating. Moreover, the study results show that women's age (35-39 years-aOR = 0.48, 95% CI; 0.31-0.74, 40-44 years-aOR = 0.57, 95% CI; 0.35-0.93, 45-49 years-aOR = 0.35, 95% CI; 0.16-0.79) was negatively associated with childhood diarrhea, while husband's education (primary school-aOR = 1.36, 95% CI; 1.05-1.77), parity (ever born 3-4 children-aOR = 1.36, 95% CI; 1.09-1.70, and 5+ children-aOR = 1.56, 95% CI; 1.14-2.12), and religion (Muslim-aOR = 3.56, 95% CI; 1.44-8.83) were positively associated with diarrhea among under-five children.ConclusionsThe study shows association between women attitude towards wife beating and childhood diarrhea. Therefore, empowering women, especially young women by increasing awareness about domestic violence, their rights, and empowering them through education and economic advancement need to be considered in order to reduce childhood diarrhea. Moreover, fertility control or birth spacing and working closely with religious leaders are important factors to consider in reducing childhood diarrhea

Determining Prevalence of Anemia and Its Associated Factors in Cameroon: A Multilevel Analysis.

BackgroundAnemia constitutes a major public health concern, which is associated with maternal and perinatal mortality. In low- and middle-income countries, the burden of anemia is profoundly high. Cameroon, as one of the low- and middle-income countries, has a disproportionate anemia burden. Factors associated with anemia prevalence are largely unknown in Cameroon. Hence, we determined the prevalence of anemia and its individual/household and community-level factors among adult women in Cameroon.MethodsWe derived data from the 2018 Cameroon Demographic and Health Survey for analysis in this study. Using the Stata version 14 software, univariate multilevel logistic regression analysis was used to select variables that had significant association with anemia at p ResultsA total of 6,809 women aged 15-49 years were involved in this study with a mean age 30 ± 11.87 years. Approximately two-fifths of women were anemic. Of them, 0.8% were severely anemic, while 17.4% and 21.5% were moderately and mildly anemic, respectively. Current employment status (yes AOR = 0.77, 95% CI; 0.61-0.96) and parity (1-2 children AOR = 0.61, 95% CI; 0.44-0.86) were the main individual level factors associated with anemia, whereas region (Douala region AOR = 2.65, 95% CI; 1.61-4.36, North-West region AOR = 0.53, 95% CI; 0.28-0.99) was the community-level factor associated with anaemia.ConclusionEmpowerment of women through employment opportunities as well as focusing special attention in region where high prevalence of anemia could be crucial to decrease the burden of anemia and related maternal and perinatal mortality in the country

Islam and Image-Making: Effects of Learning Visual Art on the Muslim Child in Tamale

The idea of prohibition of Image-Making in Islam has become a source of worry to the Muslim Ummah worldwide and Tamale is no exception. The term Ummah refers to the Community of Muslims, used both for local and wider groups at national and international levels. In this paper it refers to the Ummah of the Tamale Metropolitan area. The premise of this study stems from the researcher’s personal experience and observation where Muslim children are influenced to avoid expressing their artistic skills and talents especially in the Image-Making aspect of Arts and Culture. Thus, the researcher sought to dig into the reasons that account for this by looking at the existing views from the Quran, the Hadith, Islamic Scholars, Islamic education and the history of Islamic Arts and Culture. The study mainly used questionnaires, interview and observation in eliciting the data regarding the views of Islamic Scholars, Teachers, and Students based on the existing views from the Quran and Hadith. Out of hundred and forty-two (142) respondents for the questionnaires, hundred (100) were Students, twenty were Teachers (20) and twenty-two (22) were Islamic Scholars. Form the twenty-two Scholars who answered the Questionnaire, eleven (11) were interviewed and their environments were observed. Data from the questionnaire were analysed using the Statistical Package for Social Science (SPSS) version 20 and Excel. The data collected helped the researcher to map out the patterns among conceptions and perceptions of the Muslim Ummah in Tamale regarding the said prohibition of Image-Making in Islam. The cross-sectional survey design was employed in the collection and analysis stages. Tamale Metropolis has no single structured Islamic Administration presiding over issues regarding the Ummah. The data suggest that the Ummah is divided into three sections, each holding a different view and position regarding the prohibition of Image-Making. The study also shows the weaknesses of Islamic Scholars, in their varying interpretations of the Quran and Hadith, regarding issues of Culture and Arts among the Ummah. The study reveals that none of the Islamic Senior High Schools within the Tamale Metropolis offers Visual Art programmes. Only three other secondary schools in Tamale offered Visual Art in their curricular. It also revealed that most Muslim Students gave up Visual arts for other courses due to the gravity of fear Islamic Scholars instilled in them concerning the divine punishment for violating the said prohibition of Image-Making. There are a few Muslim Artists, Students and Teachers of the Image-Making related disciplines in Tamale and even beyond, and it is therefore important for the stakeholders of Art and Culture in the Educational and Training Institutions in Ghana to constructively engage with, and encourage the Muslim Ummah to develop these aspects of Knowledge and skill among their children and adherents for holistic individual and collective developments. Keywords: Islam, Image-making, Ummah, Quran, Hadith, Visual Arts DOI: 10.7176/JPCR/47-03 Publication date: December 31st 201

Occupational Exposure to Trichloroethylene and Cancer Risk for Workers at the Paducah Gaseous Diffusion Plant

Objective: The Paducah Gaseous Diffusion Plant (PGDP) became operational in 1952; it is located in the western part of Kentucky. We conducted a mortality study for adverse health effects that workers may have suffered while working at the plant, including exposures to chemicals. Materials and Methods: We studied a cohort of 6820 workers at the PGDP for the period 1953 to 2003; there were a total of 1672 deaths to cohort members. Trichloroethylene (TCE) is a specific concern for this workforce; exposure to TCE occurred primarily in departments that clean the process equipment. The Life Table Analysis System (LTAS) program developed by NIOSH was used to calculate the standardized mortality ratios for the worker cohort and standardized rate ratio relative to exposure to TCE (the U.S. population is the referent for age-adjustment). LTAS calculated a significantly low overall SMR for these workers of 0.76 (95% CI: 0.72-0.79). A further review of three major cancers of interest to Kentucky produced significantly low SMR for trachea, bronchus, lung cancer (0.75, 95% CI: 0.72-0.79) and high SMR for Non-Hodgkin\u27s lymphoma (NHL) (1.49, 95% CI: 1.02-2.10). Results: No significant SMR was observed for leukemia and no significant SRRs were observed for any disease. Both the leukemia and lung cancer results were examined and determined to refect regional mortality patterns. However, the Non-Hodgkin\u27s Lymphoma finding suggests a curious amplification when living cases are included with the mortality experience. Conclusions: Further examination is recommended of this recurrent finding from all three U.S. Gaseous Diffusion plants