Revisiting the agro-climatic zones of Ghana: a re-classification in conformity with climate change and variability

The Ghana Meteorological Agency delineated Ghana’s geographical space into four agro-climatic zones namely the north, transition, forest and coastal zones. Since the demarcation in the 1960s, previous studies have rarely provided a more dis-aggregated agro-climatic zone map in tandem with contemporary climate change and variability. The continued use of this age-old classified zones is a disservice to the public. In this study, therefore, we evaluated the existing agro-climatic zone map of Ghana and reconstructed it to a more appropriate and dis-aggregated map that reflect current climate change and variability impact. This was achieved by quantifying the contrast in rainfall and temperature amount over a 30 year period for different climate windows and mapped out areas with similar rainfall and temperature regimes. Our findings revealed significant changes in the existing agro-climatic zones especially in terms of number, the boundary size and geographical orientation of the zones. The newly proposed map consist of five distinctive climate zones namely: the Sudan Savannah, Guinea Savannah, Transition, Forest and Coastal zones. The Sudan and Guinea Savannah zones showed a southerly expansion. The transition zone shriveled in size as the Guinea Savannah zone took over most of it, notably in the southeast. The forest zone shrank in size with a northwest shift while the coastal belt grew to encompass the whole coast of Ghana. These changes are strong evidence of climate change and possible food production changes. These findings are useful to agriculture sector in planning their activities, the health sector in predicting specific diseases caused by changes in weather and climate, Ghana Meteorological Agency for weather forecasting purposes, and the National Disaster Management in identifying disaster prone zones

The current state of the use of large wood in river restoration and management

Trees fall naturally into rivers generating flow heterogeneity, inducing geomorphological features, and creating habitats for biota. Wood is increasingly used in restoration projects and the potential of wood acting as leaky barriers to deliver natural flood management by “slowing the flow” is recognised. However, wood in rivers can pose a risk to infrastructure and locally increase flood hazards. The aim of this paper is to provide an up-to-date summary of the benefits and risks associated with using wood to promote geomorphological processes to restore and manage rivers. This summary was developed through a workshop that brought together academics, river managers, restoration practitioners and consultants in the UK to share science and best-practice on wood in rivers. A consensus was developed on four key issues: (i) hydro-geomorphological effects, (ii) current use in restoration and management, (iii) uncertainties and risks, and (iv) tools and guidance required to inform process-based restoration and management

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2•72 (95% uncertainty interval [UI] 2•66–2•79) in 2000 to 2•31 (2•17–2•46) in 2019. Global annual livebirths increased from 134•5 million (131•5–137•8) in 2000 to a peak of 139•6 million (133•0–146•9) in 2016. Global livebirths then declined to 135•3 million (127•2–144•1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2•1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27•1% (95% UI 26•4–27•8) of global livebirths. Global life expectancy at birth increased from 67•2 years (95% UI 66•8–67•6) in 2000 to 73•5 years (72•8–74•3) in 2019. The total number of deaths increased from 50•7 million (49•5–51•9) in 2000 to 56•5 million (53•7–59•2) in 2019. Under-5 deaths declined from 9•6 million (9•1–10•3) in 2000 to 5•0 million (4•3–6•0) in 2019. Global population increased by 25•7%, from 6•2 billion (6•0–6•3) in 2000 to 7•7 billion (7•5–8•0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58•6 years (56•1–60•8) in 2000 to 63•5 years (60•8–66•1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global burden of 87 risk factors in 204 countries and territories, 1990�2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk�outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk�outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk�outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95 uncertainty interval UI 9·51�12·1) deaths (19·2% 16·9�21·3 of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12�9·31) deaths (15·4% 14·6�16·2 of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253�350) DALYs (11·6% 10·3�13·1 of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0�9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10�24 years, alcohol use for those aged 25�49 years, and high systolic blood pressure for those aged 50�74 years and 75 years and older. Interpretation: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Insight, psychosis, and depression in Africa : a cross-sectional survey from an in-patient in Ghana

Few studies of the relationship of insight to psychopathology have been conducted in non-Western populations. This study examined the relationships between insight and depression, anxiety, and positive and negative symptoms on patients with schizophrenia resident in a psychiatric hospital in Ghana. A sample of 49 participants, (37 men and 12 women), with DSM-IV defined schizophrenia took part in semistructured interviews consisting of the Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A); the Schedule for the Assessment of Insight - Expanded Version (SAI-E) and the Positive and Negative Syndrome Scale (PANSS). Bivariate correlations between variables were examined and those significantly correlated with an insight domain were included in multiple regression models. Variables associated with the total insight score were age, gender, anxiety symptoms, depression symptoms, and treatment compliance. In the final model, HAM-D positively predicted total SAI-E score, whilst PANSS-pos was negatively associated with total SAI-E score. The results are broadly consistent with those found in Western samples regarding insight and depressive symptoms. Implications of these results for competing theories of insight in psychoses are discussed. Patients able to identify themselves as ill may be aware of their affective symptoms

Relationship between locking-bolt torque and load pre-tension in the Ilizarov frame

The wire–bolt interface in an Ilizarov frame has been mechanically tested. The optimal torque to be applied to the frame locking-bolts during physiological loading has been defined. The set-up configuration was as is used clinically except a copper tube was used to simulate bone. The force–displacement curves of the Ilizarov wires are not altered by locking-bolt torque. The force in the bone model at which pre-tension is lost increases as the locking-bolts are tightened to 14 Nm torque, but decreases if torque exceeds 14 Nm. Thus, 14 Nm is the optimal locking-bolt torque in frame. The relationship between pre-tension versus load for different locking-bolt torques arises because at low and high clamping torques poor wire holding and plastic deformation respectively occur. Wire damage was seen under light and electron microscopy. Clinically, over or under-tightening locking-bolts will cause loss of pre-tension, reduction in frame stiffness and excessive movement at the fracture site, which may be associated with delayed union

Multivariate studies and heavy metal pollution in soil from gold mining area

Mining generates large volumes of waste, which if not regulated can release toxic metals, causing widespread environmental contamination. This study focused on heavy metal contamination in topsoil within a mining area at Nangodi in the Northern Region of Ghana. A total of 24 soil samples were collected from the study area and control samples were analyzed for Hg, Pb, Cd, As, Cr, and Fe using atomic absorption spectroscopy. Results of Pollution Index estimations and Geo-accumulation index (Igeo) classified the soil samples as moderately contaminated to heavily contaminated. Soil samples were severely enriched with As and moderately enriched with b, and Hg. Multivariate analyses such as factor analysis and cluster analysis were employed to examine the relationship between the metals and also differentiate the influence of the natural background content of metals from that due to human activities. Factor analysis identified three polluted soil factor associations. Cadmium, Fe, As, and Pb associated with factor 1, were due to anthropogenic activities. The high intercorrelation revealed by As and Pb shows similarity in their sources. Factor two dominated by Hg is considered an anthropogenic component. Factor 3 correlated with Cr and can be considered a natural component. Correlation analysis and cluster analysis supported each other. Results from the bi-plots showed that sites S1, S8, S11, and S18, have similar metal composition as the control site. Heavy metal contents in soils sampled from Zones A and B have been influenced by the mining activities as seen from the associations of these sites in the bi-plots. The results are useful for metal source identification, and can contribute to monitoring and regulatory programs