Addressing filicide in Ghana: Linking cultural understanding with the law against Filicide. Does the law work?

Introduction: Consistent with international promulgation on the criminalization of filicide, Ghana’s Children’s Act 1998 (560) and the Criminal Justice Act criminalizes any form of torture against children. Yet, perpetrators of filicide in Ghana may go unpunished due to the beliefs in cultural norms that justify filicide acts. The cultural narratives of filicide can impede on the application and effectiveness of the laws of filicide. Method: The study employed a vignette approach to explore the views of 19 adults, who were parents between 69 years of age and 30 years of age, in rural and urban Ghana on the laws of filicide in Ghana and filicide intervention measures. The interviewees were provided with narratives on two different vignettes (developed based on real life cases), followed by semi-structured questions to probe the narratives. The interviews were analyzed following Fraser’s narrative thematic analysis procedure. Results: The study identifies the association between cultural beliefs and the communities’ understanding of the concept of filicide. Though community members are aware of the criminalization of filicide acts, the majority of them were not informed about the laws against filicide in Ghana. Addressing filicide cases within the community was the most preferred option for the participants, as they believe that some children, termed “spirit children” (SC), deserve to be killed. Resorting to spiritual intervention from concoction men emerged as the normative pathway to obtain community approval for filicide. Police interventions were considered necessary in non-spiritual related filicides. Community members were only prepared to cooperate with the law in filicide cases if the filicide act has no connection with spirituality. Conclusion: The study adds to understanding of the concept of filicide outside western societies. The importance of intensive community campaigns against filicide acts, and norms that support filicide acts, has relevance for all counties

Protective indigenous collective value of Ubuntu and child neglect: Implications for rural child protection practice

Theories on collective efficacy and social support suggest that indigenous values that support collective practices and sanction community obligations to childcare would be protective against child neglect. Likewise, new qualitative findings show that collective values are stronger in rural areas than in urban. This study tested the claims that the value of Ubuntu, which is a symbolic cultural value of ‘being for others’, will be protective against the likelihood of neglect; this relationship will be stronger in rural compared with urban communities in Ghana. Using data obtained from a nationally representative sample of 1100 mothers (from 22 communities) in Ghana, we tested the claims using fixed effects logistic regression. The Ubuntu norms were significantly endorsed in rural communities compared with the urban. The overall model showed that higher levels of Ubuntu are associated with lower odds of child neglect (OR.47, [.29,.76] p \u3c 0.05), and the relationship remained significant only in the rural sample (OR.13, [.06,.31] p \u3c 0.001). Similar evidence was recorded for the Ubuntu norms of community care and compassion. The results suggest that child protection in rural Ghana can be fruitful when interventions are developed to boost the value of Ubuntu and the norms of collective childcare

“Alunos são todos iguais, não têm sexo:” análise das práticas de educação sexual e o enfrentamento à homofobia nas escolas

By analyzing the public policies which aim at combating homophobia implemented in Brazil over the past 15 years and the researches on this subject, we can come to the conclusion that there is awareness that homophobia is an important and priority problem in Brazil. Studies also indicated that, although there is consensus that the fight against homophobia should start from the childhood, little is known about the state of homophobia in the school community and very little about why this problem persists in schools. A descriptive and exploratory study was carried out, by using qualitative approach and content analysis, aiming to describe the homophobia situation in the school community in 11 Brazilian state capitals. We used: in-depth interviews with education secretaries who work for the states and for the cities; directors and education coordinators; focus groups with teachers and students; informal interviews with administrative staff; and observation of the school environment. While legislation related to sex education should be a cross-cutting theme and include aspects of gender and sexual diversity, it is noted a great distance from what really happens. This survey corroborates with national data and several surveys that were done at local levels, in several Brazilian cities. The authorities’ discourse concluded that public sex education policies that consider sexual diversity exist, but when in practice, it happens in a spontaneously form and focuses only on the biological aspects of pregnancy and STI / HIV-AIDS prevention. The data here displayed has a strong presence of homophobic prejudice and the school’s unpreparedness to deal with sexual diversity. This configuration is problematic when it comes to dealing with the sexuality, since it is an isolation from the larger dimensions of life and prevents its motivating force from participating in other school practices.A análise das políticas públicas de enfrentamento à homofobia implementadas no Brasil nos últimos 15 anos e as pesquisas realizadas sobre o tema indicam que há consciência de que a homofobia no país é um problema importante e prioritário. Os estudos também indicam que, embora haja consenso de que o enfrentamento da homofobia deveria começar desde a infância, pouco se sabe sobre a situação da homofobia na comunidade escolar e muito pouco sobre as causas que a mantém nas escolas. Realizou-se um estudo descritivo e exploratório de abordagem qualitativa, com análise de conteúdo, com o objetivo de descrever a situação da homofobia na comunidade escolar em 11 capitais brasileiras. Utilizaram-se: entrevistas em profundidade com secretários/as estaduais e municipais de educação, diretor/a e coordenador/a de ensino; grupos focais com professores/as e estudantes; entrevistas informais com pessoal administrativo; e observação do ambiente escolar. Embora a legislação aponte que a educação sexual deve ser um tema transversal e incluir aspectos de gênero e diversidade sexual, constatou-se uma grande distância ao que realmente acontece. A pesquisa corrobora com dados nacionais pesquisas que foram feitas em âmbitos locais em diversas cidades brasileiras. O discurso de autoridades foi de que existem políticas públicas de educação sexual que consideram a diversidade sexual, mas na prática, quando ocorre, esta se da de forma espontânea e enfoca somente os aspectos biológicos de prevenção da gravidez e das ITS/HIV-Aids. Os dados mostraram a forte presença de preconceito homofóbico e o despreparo da escola para lidar com a diversidade sexual. Esta configuração é problemática para o tratamento da sexualidade, pois a isola das demais dimensões da vida e impede que sua força motivadora participe das demais práticas escolares

Acanthosis Nigricans associated with clear-cell renal cell carcinoma

Acanthosis nigricans (AN), an entity recognized since the 19th century, is a dermatopathy associated with insulin-resistant conditions, endocrinopathies, drugs, chromosome abnormalities and neoplasia. The latter, also known as malignant AN, is mostly related to abdominal neoplasms. Malignant AN occurs frequently among elderly patients. In these cases, the onset is subtle, and spreading involves the flexural regions of the body, particularly the axillae, palms, soles, and mucosa. Gastric adenocarcinoma is the most frequent associated neoplasia, but many others have been reported. Renal cell carcinoma (RCC), although already reported, is rarely associated with malignant AN. The authors report the case of a woman who was being treated for depression but presented a long-standing and marked weight loss, followed by darkening of the neck and the axillary regions. Physical examination disclosed a tumoral mass in the left flank and symmetrical, pigmented, velvety, verrucous plaques on both axillae, which is classical for AN. The diagnostic work-up disclosed a huge renal mass, which was resected and further diagnosed as a RCC. The post-operative period was uneventful and the skin alteration was evanescent at the first follow-up consultation. The authors call attention to the association of AN with RC

Acanthosis Nigricans associated with clear-cell renal cell carcinoma

Acanthosis nigricans (AN), an entity recognized since the 19th century, is a dermatopathy associated with insulin-resistant conditions, endocrinopathies, drugs, chromosome abnormalities and neoplasia. The latter, also known as malignant AN, is mostly related to abdominal neoplasms. Malignant AN occurs frequently among elderly patients. In these cases, the onset is subtle, and spreading involves the flexural regions of the body, particularly the axillae, palms, soles, and mucosa. Gastric adenocarcinoma is the most frequent associated neoplasia, but many others have been reported. Renal cell carcinoma (RCC), although already reported, is rarely associated with malignant AN. The authors report the case of a woman who was being treated for depression but presented a long-standing and marked weight loss, followed by darkening of the neck and the axillary regions. Physical examination disclosed a tumoral mass in the left flank and symmetrical, pigmented, velvety, verrucous plaques on both axillae, which is classical for AN. The diagnostic work-up disclosed a huge renal mass, which was resected and further diagnosed as a RCC. The post-operative period was uneventful and the skin alteration was evanescent at the first follow-up consultation. The authors call attention to the association of AN with RC

Professional care workforce: a rapid review of evidence supporting methods of recruitment, retention, safety, and education

Background: Across the care economy there are major shortages in the health and care workforce, as well as high rates of attrition and ill-defined career pathways. The aim of this study was to evaluate current evidence regarding methods to improve care worker recruitment, retention, safety, and education, for the professional care workforce. Methods: A rapid review of comparative interventions designed to recruit, retain, educate and care for the professional workforce in the following sectors: disability, aged care, health, mental health, family and youth services, and early childhood education and care was conducted. Embase and MEDLINE databases were searched, and studies published between January 2015 and November 2022 were included. We used the Quality Assessment tool for Quantitative Studies and the PEDro tools to evaluate study quality. Results: 5594 articles were initially screened and after applying the inclusion and exclusion criteria, 30 studies were included in the rapid review. Studies most frequently reported on the professional nursing, medical and allied health workforces. Some studies focused on the single domain of care worker education (n = 11) while most focused on multiple domains that combined education with recruitment strategies, retention strategies or a focus on worker safety. Study quality was comparatively low with a median PEDro score of 5/10, and 77% received a weak rating on the Quality Assessment tool for Quantitative Studies. Four new workforce strategies emerged; early career rural recruitment supports rural retention; workload management is essential for workforce well-being; learning must be contextually relevant; and there is a need to differentiate recruitment, retention, and education strategies for different professional health and care workforce categories as needs vary. Conclusions: Given the critical importance of recruiting and retaining a strong health and care workforce, there is an immediate need to develop a cohesive strategy to address workforce shortfalls. This paper presents initial evidence on different interventions to address this need, and to inform care workforce recruitment and retention. Rapid Review registration PROSPERO 2022 CRD42022371721 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD4202237172

Analysis of shared heritability in common disorders of the brain

ience, this issue p. eaap8757 Structured Abstract INTRODUCTION Brain disorders may exhibit shared symptoms and substantial epidemiological comorbidity, inciting debate about their etiologic overlap. However, detailed study of phenotypes with different ages of onset, severity, and presentation poses a considerable challenge. Recently developed heritability methods allow us to accurately measure correlation of genome-wide common variant risk between two phenotypes from pools of different individuals and assess how connected they, or at least their genetic risks, are on the genomic level. We used genome-wide association data for 265,218 patients and 784,643 control participants, as well as 17 phenotypes from a total of 1,191,588 individuals, to quantify the degree of overlap for genetic risk factors of 25 common brain disorders. RATIONALE Over the past century, the classification of brain disorders has evolved to reflect the medical and scientific communities' assessments of the presumed root causes of clinical phenomena such as behavioral change, loss of motor function, or alterations of consciousness. Directly observable phenomena (such as the presence of emboli, protein tangles, or unusual electrical activity patterns) generally define and separate neurological disorders from psychiatric disorders. Understanding the genetic underpinnings and categorical distinctions for brain disorders and related phenotypes may inform the search for their biological mechanisms. RESULTS Common variant risk for psychiatric disorders was shown to correlate significantly, especially among attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder (MDD), and schizophrenia. By contrast, neurological disorders appear more distinct from one another and from the psychiatric disorders, except for migraine, which was significantly correlated to ADHD, MDD, and Tourette syndrome. We demonstrate that, in the general population, the personality trait neuroticism is significantly correlated with almost every psychiatric disorder and migraine. We also identify significant genetic sharing between disorders and early life cognitive measures (e.g., years of education and college attainment) in the general population, demonstrating positive correlation with several psychiatric disorders (e.g., anorexia nervosa and bipolar disorder) and negative correlation with several neurological phenotypes (e.g., Alzheimer's disease and ischemic stroke), even though the latter are considered to result from specific processes that occur later in life. Extensive simulations were also performed to inform how statistical power, diagnostic misclassification, and phenotypic heterogeneity influence genetic correlations. CONCLUSION The high degree of genetic correlation among many of the psychiatric disorders adds further evidence that their current clinical boundaries do not reflect distinct underlying pathogenic processes, at least on the genetic level. This suggests a deeply interconnected nature for psychiatric disorders, in contrast to neurological disorders, and underscores the need to refine psychiatric diagnostics. Genetically informed analyses may provide important "scaffolding" to support such restructuring of psychiatric nosology, which likely requires incorporating many levels of information. By contrast, we find limited evidence for widespread common genetic risk sharing among neurological disorders or across neurological and psychiatric disorders. We show that both psychiatric and neurological disorders have robust correlations with cognitive and personality measures. Further study is needed to evaluate whether overlapping genetic contributions to psychiatric pathology may influence treatment choices. Ultimately, such developments may pave the way toward reduced heterogeneity and improved diagnosis and treatment of psychiatric disorders

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe