Investigating the Evidence of Behavioral, Cognitive, and Psychiatric Endophenotypes in Autism: A Systematic Review

Substantial evidence indicates that parents of autistic individuals often display milder forms of autistic traits referred to as the broader autism phenotype (BAP). To determine if discrete endophenotypes of autism can be identified, we reviewed the literature to assess the evidence of behavioral, cognitive, and psychiatric profiles of the BAP. A systematic review was conducted using EMBASE, MEDLINE, PsycINFO, PsycEXTRA, and Global Health. Sixty papers met our inclusion criteria and results are discussed according to the proportion of studies that yield significant deficits per domain. The behavioral, cognitive, and psychiatric endophenotypes in parents of autistic probands are still not clarified; however, evidence suggests mild social/communication deficits, rigid/aloof personality traits, and pragmatic language difficulties as the most useful sociobehavioral candidate endophenotype traits. The existence of deficits in the cognitive domain does suggest familial vulnerability for autism. Furthermore, increased depressed mood and anxiety can also be useful markers; however, findings should be interpreted with caution because of the small number of studies in such heterogeneously broad domains and several methodological limitations

Phytochemical and Antifungal Studies of Tapinathus globiferus Extract and Fractions

T. globiferus growing on Tamarindus indica is a hemi-parasitic plant used in ethomomedicine to treat different ailment including fungal infections. The aim of the study was to conduct phytochemical and antifungal studies of T. globiferus growing on Tamarindus indica. The plant material was collected, identified and air dried. Powdered plant material was subjected to maceration using methanol to obtained crude methanol leaf extract which was partitioned using n-hexane, chloroform ethyl acetate and n- The extract and the fractions obtained were subjected to phytochemical evaluation sing standard protocols. The antifungal studies of the methanol extract and its fractions against Aspergillus fumugatus, Aspergillus niger, Trychophytom rubrum and Trychophyton mentagrophyte were investigated using agar well diffusion method at different concentration (100 - 1.25 mg/mL). The phytochemical screening revealed the presence of various secondary metabolites which varies in the extract and fractions. The methanol  extract and its fractions showed significant (p< 0.05) antifungal activity against all the fungal isolates with the ethyl acetate fraction having the highest zone of inhibition ranging from 10-39 mm then followed by the n-butanol fraction with the mean zone of inhibitions from 10-28 mm. The methanol extract and the n-hexane fraction recorded lower zone of inhibition from 9-24 mm and 8-26 mm respectively. The standard drug ketoconazole had zone of inhibition from 6-22 mm. The most sensitive organism was A. niger while the least sensitive organisms were T. mentagraphyte and A. rubrum for the ethyl acetate fraction. The study has validated the ethnomedicinal claim for the use of this plant in treatment of the fungal infections. Keywords: Phytochemical; Tapinanthus globiferus; Tamarindus indic

The Quality of Learning and Care at Community-Based Early Childhood Development Centers in Malawi

This exploratory study examined the strengths and weaknesses in the quality of early childhood care and learning at selected community-based childcare centers (CBCCs) in Malawi, and aimed to understand underlying challenges and opportunities that may be addressed to improve quality and ultimately children’s outcomes. Classroom environments and interactions were systematically observed at 12 CBCCs. Early childhood caregivers were surveyed, and in-depth interviews were conducted with key informants from the community. Areas of relative strength at the CBCCs included the physical environment, adultchild interactions, and inclusiveness. However, the CBCCs struggled substantially with the quality of learning and play opportunities; the availability of play and learning materials; and the quality of instruction for literacy, numeracy, and science. Underlying challenges that emerged from surveys and interviews included the CBCCs’ reliance on unskilled and volunteer caregivers, lack of materials, lack of food for children, and lack of interest from parents in the CBCCs. A fundamental strength was that in almost all the communities, key stakeholders were aware of the challenges, were motivated and committed to improving quality at their CBCCs, and had already taken actions to address specific problems. CBCCs in Malawi hold tremendous potential to provide early childhood services to the most vulnerable children; however, communities need to be supported to improve the quality of learning and care at these centers to maximize the benefits for children’s development and long-term outcomes

Developmental Assets and Academic Performance of Adolescents in Ghana, Kenya, and South Africa

Background: Overall, youth well-being is crucial, particularly in developmental contexts, such as sub-Saharan Africa, which is experiencing the largest growth in the youth population internationally. The Positive Youth Development (PYD) framework considers the importance of positive experiences, positive relationships and positive environments regarding developmental (further distinguished as internal and external) assets. These assets are important for promoting positive outcomes among youth. Objective: The objective of this study is to examine the importance of developmental assets for academic performance in three sub-Saharan African contexts, represented by Ghana, Kenya, and South Africa. Method: In a cross-sectional study, youth from these three countries completed a questionnaire on sociodemographic measures, such as age, gender, parental education (as a proxy for socioeconomic status), measures of developmental assets and academic performance. We used Analysis of Variance to examine mean differences in developmental assets across countries and academic performance. Results: Results indicated that Ghanaian students reported fewer assets than Kenyan and South African students and that across all countries, adolescents who perform academically better reported more developmental assets, in particular, internal assets. Conclusion: This is one of the few studies, which consider developmental assets within the PYD framework beyond the Western context. While we found that mainly internal assets were associated with academic performance, it is important to reiterate that both internal and external assets are theoretically associated with positive outcomes, such as academic performance. Future research may benefit from testing interventions to improve academic performance in the sub-Saharan African contexts by fostering both types of assets. Research is needed to extend the framework to consider more culturally appropriate and contextually relevant assets

Comparison Between Urban and Rural of Anthropometry Indices in Women of Reproductive Age in Kano, Nigeria State

Recently, new indices have been developed for better prediction of health status. This study aimed to compare the new indices of anthropometric measurements of women of reproductive age (WRA) in urban and rural settings in Kano state. A cross sectional descriptive community-based study was performed in 240 WRA (15-49 years) in 4 randomly selected Local Government Areas (LGAs) in urban and rural settings each. A structured questionnaire was used to collect information on socio-demographic characteristics. Anthropometric indices which include body adiposity index (BAI), abdominal volume index (AVI), Conicity index (CI), a body shaped index (ABSI), a body shaped index z score (ABSI z score), hip index (HI), body roundness index (BRI) and ponderal index (PI) were measured. Socio-demographic result shows that age, occupation and monthly income were found to be significantly associated between the urban and rural participants whereas education, number of children and pregnancy status were not significantly associated. Urban and rural participants had a significant association in BAI (p=0.006), AVI (p=0.010), HI (p=0.030), BRI (p=0.003) and PI (p=0.002). There were no significant association in CI (p=0.219), ABSI (p=0.498) and ABSI z score (p=0.680). Further investigation of these indices and their association with nutritional status and different diseases could assist in efforts to prevent unfavorable health conditions among women of reproductive health

Isolation and characterization of some flavonoids from the leaf of Tapinanthus globiferus growing on Acacia nilotica

Tapinanthus globiferus is used ethnomedicinally for the treatment of bacterial infections, inflammation, stomach pain, ulcers among others. The aim of the study was to isolate bioactive compounds from the leaf of T. globiferus growing on Acacia nilotica. The powdered plant material was extracted with 90 % methanol using cold maceration and the resulting crude methanol leaf extract was partitioned into n-hexane, chloroform, ethylacetate and n-butanol fractions. The ethylacetate fraction was chromatographed on a silica gel, sephadex LH-20 column and preparative thin-layer chromatography. (-)-Epicatechin and Quercetin 3-O-β-D-glucopyranoside were isolated and characterized by means of physiochemical and spectroscopic (1D and 2D-NMR) analyses for the first time from T. globiferus growing on A. nilotica. Keywords:  Tapinanthus globiferus; Flavonoids; Isolation; NM

Navigating life with hiv as an older adult on the Kenyan Coast: perceived health challenges seen through the biopsychosocial model

Objectives: This study explores the perceptions of adults living with HIV aged ≥50 years (recognized as older adults living with HIV—OALWH), primary caregivers and healthcare providers on the health challenges of ageing with HIV at Kilifi, a low literacy setting on the coast of Kenya. Methods: We utilized the biopsychosocial model to explore views from 34 OALWH and 22 stakeholders on the physical, mental, and psychosocial health challenges of ageing with HIV in Kilifi in 2019. Data were drawn from semi-structured in-depth interviews, which were audio-recorded and transcribed. A framework approach was used to synthesize the data. Results: Symptoms of common mental disorders, comorbidities, somatic symptoms, financial difficulties, stigma, and discrimination were viewed as common. There was also an overlap of perceived risk factors across the physical, mental, and psychosocial health domains, including family conflicts and poverty. Conclusion: OALWH at the Kenyan coast are perceived to be at risk of multiple physical, mental, and psychosocial challenges. Future research should quantify the burden of these challenges and examine the resources available to these adults

Psychometric Properties of the Berger HIV Stigma Scale: A Systematic Review

Addressing HIV-related stigma requires the use of psychometrically sound measures. However, despite the Berger HIV stigma scale (HSS) being among the most widely used measures for assessing HIV-related stigma, no study has systematically summarised its psychometric properties. This review investigated the psychometric properties of the HSS. A systematic review of articles published between 2001 and August 2021 was undertaken (CRD42020220305) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Additionally, we searched the grey literature and screened the reference lists of the included studies. Of the total 1241 studies that were screened, 166 were included in the review, of which 24 were development and/or validation studies. The rest were observational or experimental studies. All the studies except two reported some aspect of the scale’s reliability. The reported internal consistency ranged from acceptable to excellent (Cronbach’s alpha ≥ 0.70) in 93.2% of the studies. Only eight studies reported test–retest reliability, and the reported reliability was adequate, except for one study. Only 36 studies assessed and established the HSS’s validity. The HSS appears to be a reliable and valid measure of HIV-related stigma. However, the validity evidence came from only 36 studies, most of which were conducted in North America and Europe. Consequently, more validation work is necessary for more precise insight

Interventions for Prevention of Non-Communicable Diseases among Adolescents Living with HIV: A Systematic Review

While the uptake of antiretroviral drugs has rapidly expanded among adolescents and adults living with HIV, research evidence suggests that people living with HIV have a higher risk of non-communicable diseases (NCDs). With more than 35% of the global burden of NCDs stemming from adolescence, there is a need to comprehend the existing evidence on early prevention, detection, and disease management, especially among the at-risk population. In line with the WHO Global Action Plan, 2013–2020 and “Best Buys”, recommendations on practical interventions for NCDs prevention, this systematic review seeks to synthesise evidence on the current interventions for preventing NCDs among adolescents living with HIV (ALHIV) and assessing the efectiveness of interventions targeted at preventing cardiovascular diseases, diabetes, and cancer among ALHIV. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The bibliographic database search yielded 2588 articles, though only four (4) studies met the inclusion criteria after screening for eligibility. While sub-Saharan Africa (SSA) sufers the brunt of HIV and NCDs, only one study was conducted in SSA, and three in high-income countries (Brazil and the USA). Physical activity and aerobic exercises (lifestyle interventions) indicated potential benefcial health efects in reducing cardiovascular conditions and improving quality of life among ALHIV. Hospital-based training and a home-based exercise program efectively improved ftness strengths and changes in body composition. Despite the disproportionate global burden of the HIV and NCDs comorbidities, limited adolescent-specifc evidence exists on the interventions for the prevention of NCDs among ALHIV. Thus, there is a need for health policy experts and researchers to steer research on interventions focused on the various NCDs among the ALHI

Strategies for improving mental health and wellbeing used by adults ageing with HIV from the Kenyan coast: a qualitative exploration

Background: Physical and mental health problems are common among older adults living with HIV (OALWH). Adaptive coping strategies play a vital role in improving these adults\u27 mental health and well-being despite the deleterious effects of HIV and ageing. However, in sub-Saharan Africa, limited evidence exists on the commonly utilized coping strategies in this population. We explore the coping strategies used by Kenyan OALWH to improve their mental health and wellbeing. Methods: Semi-structured in-depth interviews were conducted between October and December 2019 with 56 participants: 34 OALWH (53% female), 11 healthcare providers (63% female) and 11 primary caregivers (73% female) in Kilifi County. All interviews were audiorecorded and transcribed verbatim. We used the framework approach to synthesize the qualitative data. Results: Five major themes emerged from the analysis of participants’ narratives, including self-care practices, religion and spirituality, relational living (social connectedness), generativity, identity, and mastery. Our study further revealed maladaptive coping strategies, including reliance on over-the-counter medications, self-isolation, waiting to see if symptoms would subside despite doing nothing, and HIV treatment interruptions during prolonged periods of prayer and fasting. Conclusions: Our findings provide an initial understanding of the coping strategies used by OALWH to confront HIV and ageing challenges in a low-literacy, low socio-economic Kenyan setting. Our results suggest that interventions designed to enhance personal capacity, social support, positive religiosity and spirituality, and intergenerational connections may be beneficial in improving the mental health and well-being of OALWH