Self-medication practices of pregnant women attending antenatal clinic in northern Ghana: An analytical cross-sectional study

In Ghana, despite the dangers that self-medication poses to maternal and fetal health, there has been limited examination of self-medication among pregnant women. This study examines the practice of self-medication among pregnant women in Wa Municipality, Ghana. An analytical cross-sectional survey of 367 pregnant women was conducted in three health facilities. The prevalence of self-medication practice was 74.1%. The majority (68.4%) of pregnant women obtained unprescribed medicines from chemical shops; others utilized leftover drugs from previous hospital visits (15.8%) or herbal medications (9.9%), while others took unprescribed drugs from relatives or friends (5.9%). Analgesics (76.1%), antibiotics (24.6%), and antimalarials (16.2%) were the most frequently self-medicated drugs. The most common illnesses or symptoms for which pregnant women self-medicated were headaches (34.2%), back pain (33.1%), waist pain (32.7%), lower abdominal pain (20.6%), and malaria (16.2%). After adjusting for potential confounders, easy access to medication without prescription (AOR= 8.4), illness perceived as minor (AOR=4.1), availability of health facilities (AOR=4.2), and frequent lack of medicines at health facilities (AOR=1.7) were significantly associated with self-medication. Enforcing legislation to prevent the stocking and sale of certain analgesics and antibiotics, increasing service points, and improving service quality at antenatal clinics, outpatient departments and pharmacies could reduce self-medication.   Au Ghana, malgré les dangers que l'automédication fait peser sur la santé maternelle et foetale, l'examen de l'automédication chez les femmes enceintes a été limité. Cette étude examine la pratique de l'automédication chez les femmes enceintes de la municipalité de Wa, au Ghana. Une enquête transversale analytique auprès de 367 femmes enceintes a été menée dans trois formations sanitaires. La prévalence de la pratique de l'automédication était de 74,1 %. La majorité (68,4 %) des femmes enceintes ont obtenu des médicaments sans ordonnance dans les magasins de produits chimiques ; d'autres utilisaient des restes de médicaments provenant de visites antérieures à l'hôpital (15,8 %) ou des médicaments à base de plantes (9,9 %), tandis que d'autres prenaient des médicaments non prescrits de parents ou d'amis (5,9 %). Les antalgiques (76,1 %), les antibiotiques (24,6 %) et les antipaludiques (16,2 %) étaient les médicaments les plus fréquemment auto-médiqués. Les maladies ou symptômes les plus courants pour lesquels les femmes enceintes s'automédicament étaient les maux de tête (34,2 %), les maux de dos (33,1 %), les douleurs à la taille (32,7 %), les douleurs abdominales basses (20,6 %) et le paludisme (16,2 %). Après ajustement pour les facteurs de confusion potentiels, accès facile aux médicaments sans ordonnance (AOR = 8,4), maladie perçue comme mineure (AOR = 4,1), disponibilité des établissements de santé (AOR = 4,2) et manque fréquent de médicaments dans les établissements de santé (AOR = 1,7) étaient significativement associés à l'automédication. L'application de la législation pour empêcher le stockage et la vente de certains analgésiques et antibiotiques, l'augmentation des points de service et l'amélioration de la qualité des services dans les cliniques prénatales, les services de consultation externe et les pharmacies pourraient réduire l'automédicatio

Insistence on sameness relates to increased covariance of gray matter structure in autism spectrum disorder.

BACKGROUND: Autism spectrum disorder (ASD) is characterized by atypical development of cortical and subcortical gray matter volume. Subcortical structural changes have been associated with restricted and repetitive behavior (RRB), a core component of ASD. Behavioral studies have identified insistence on sameness (IS) as a separable RRB dimension prominent in high-functioning ASD, though no simple brain-behavior relationship has emerged. Structural covariance, a measure of morphological coupling among brain regions using magnetic resonance imaging (MRI), has proven an informative measure of anatomical relationships in typical development and neurodevelopmental disorders. In this study, we use this measure to characterize the relationship between brain structure and IS. METHODS: We quantified the structural covariance of cortical and subcortical gray matter volume in 55 individuals with high-functioning ASD using 3T MRI. We then related these structural metrics to individual IS scores, as assessed by the Repetitive Behavior Scale-Revised (RBS-R). RESULTS: We found that increased coupling among subcortical regions and between subcortical and cortical regions related to greater IS symptom severity. Most pronounced, the striatum and amygdala participated in a plurality of identified relationships, indicating a central role for these structures in IS symptomatology. These structural associations were specific to IS and did not relate to any of the other RRB subcomponents measured by the RBS-R. CONCLUSIONS: This study indicates that behavioral dimensions in ASD can relate to the coordination of development across multiple brain regions, which might be otherwise obscured using typical brain-behavior correlations. It also expands the structures traditionally related to RRB in ASD and provides neuroanatomical evidence supportive of IS as a separate RRB dimension. TRIAL REGISTRATION: ClinicalTrials.gov NCT01031407

Cardiovascular disease risk factors in autistic adults: The impact of sleep quality and antipsychotic medication use

Approximately 40% of American adults are affected by cardiovascular disease (CVD) risk factors (e.g., high blood pressure, high cholesterol, diabetes, and overweight or obesity), and risk among autistic adults may be even higher. Mechanisms underlying the high prevalence of CVD risk factors in autistic people may include known correlates of CVD risk factors in other groups, including high levels of perceived stress, poor sleep quality, and antipsychotic medication use. A sample of 545 autistic adults without intellectual disability aged 18+ were recruited through the Simons Foundation Powering Autism Research, Research Match. multiple linear regression models examined the association between key independent variables (self-reported perceived stress, sleep quality, and antipsychotic medication use) and CVD risk factors, controlling for demographic variables (age, sex assigned at birth, race, low-income status, autistic traits). Overall, 73.2% of autistic adults in our sample had an overweight/obesity classification, 45.3% had high cholesterol, 39.4% had high blood pressure, and 10.3% had diabetes. Older age, male sex assigned at birth, and poorer sleep quality were associated with a higher number of CVD risk factors. Using antipsychotic medications was associated with an increased likelihood of having diabetes. Poorer sleep quality was associated with an increased likelihood of having an overweight/obesity classification. Self-reported CVD risk factors are highly prevalent among autistic adults. Both improving sleep quality and closely monitoring CVD risk factors among autistic adults who use antipsychotic medications have the potential to reduce risk for CVD

Global variations in H_2O/Ce: 2. Relationships to arc magma geochemistry and volatile fluxes

We compiled a data set of 100 primitive arc magma compositions from melt inclusion and whole rock analyses to compare volatile contents, slab tracers, and calculated subduction component compositions between 18 subduction zone segments spanning the global range in slab thermal structure. The average primitive magma H_2O content in our data set is 3.3 ± 1.2 wt.% (1 s.d.) for melts erupted within 50 km of the volcanic front. While there is a wide range of volatile contents in magmas within individual arcs, the highest values occur in magmas erupted from vents along the volcanic front, where the subducting slab is located 104 ± 29 km (avg ± 1 s.d.) beneath the surface. This observation, coupled with positive correlations between H_2O, Cl, S, and B contents and predictions from geodynamic models, provides strong evidence for the active supply of volatile-rich slab-derived components from the subducting oceanic plate beneath volcanic arcs. We also show that temperature-sensitive ratios (e.g., H_2O/Ce) for both primitive arc magmas and calculated subduction components are similar and display monotonic behavior with slab thermal parameter. Furthermore, calculated subduction component compositions have higher trace element to H_2O ratios in arcs with hotter slabs (lower thermal parameter), suggesting that hydrous melts of differing compositions are added beneath different arcs. Finally, we present new volatile outflux estimates for Central Cascades magmatism and then compare these to estimates for the Central American and Kamchatka-Kurile arcs to create a combined data set spanning a large range in slab thermal parameter

Determining the Genetic Architecture of Reproductive Stage Drought Tolerance in Wheat Using a Correlated Trait and Correlated Marker Effect Model

Water stress during reproductive growth is a major yield constraint for wheat (Triticum aestivum L). We previously established a controlled environment drought tolerance phenotyping method targeting the young microspore stage of pollen development. This method eliminates stress avoidance based on flowering time. We substituted soil drought treatments by a reproducible osmotic stress treatment using hydroponics and NaCl as osmolyte. Salt exclusion in hexaploid wheat avoids salt toxicity, causing osmotic stress. A Cranbrook x Halberd doubled haploid (DH) population was phenotyped by scoring spike grain numbers of unstressed (SGNCon) and osmotically stressed (SGNTrt) plants. Grain number data were analyzed using a linear mixed model (LMM) that included genetic correlations between the SGNCon and SGNTrt traits. Viewing this as a genetic regression of SGNTrt on SGNCon allowed derivation of a stress tolerance trait (SGNTol). Importantly, and by definition of the trait, the genetic effects for SGNTol are statistically independent of those for SGNCon. Thus they represent non-pleiotropic effects associated with the stress treatment that are independent of the control treatment. QTL mapping was conducted using a whole genome approach in which the LMM included all traits and all markers simultaneously. The marker effects within chromosomes were assumed to follow a spatial correlation model. This resulted in smooth marker profiles that could be used to identify positions of putative QTL. The most influential QTL were located on chromosome 5A for SGNTol (126cM; contributed by Halberd), 5A for SGNCon (141cM; Cranbrook) and 2A for SGNTrt (116cM; Cranbrook). Sensitive and tolerant population tail lines all showed matching soil drought tolerance phenotypes, confirming that osmotic stress is a valid surrogate screening method

Neural correlates of taste reactivity in autism spectrum disorder.

Selective or \u27picky\u27 eating habits are common among those with autism spectrum disorder (ASD). These behaviors are often related to aberrant sensory experience in individuals with ASD, including heightened reactivity to food taste and texture. However, very little is known about the neural mechanisms that underlie taste reactivity in ASD. In the present study, food-related neural responses were evaluated in 21 young adult and adolescent males diagnosed with ASD without intellectual disability, and 21 typically-developing (TD) controls. Taste reactivity was assessed using the Adolescent/Adult Sensory Profile, a clinical self-report measure. Functional magnetic resonance imaging was used to evaluate hemodynamic responses to sweet (vs. neutral) tastants and food pictures. Subjects also underwent resting-state functional connectivity scans.The ASD and TD individuals did not differ in their hemodynamic response to gustatory stimuli. However, the ASD subjects, but not the controls, exhibited a positive association between self-reported taste reactivity and the response to sweet tastants within the insular cortex and multiple brain regions associated with gustatory perception and reward. There was a strong interaction between diagnostic group and taste reactivity on tastant response in brain regions associated with ASD pathophysiology, including the bilateral anterior superior temporal sulcus (STS). This interaction of diagnosis and taste reactivity was also observed in the resting state functional connectivity between the anterior STS and dorsal mid-insula (i.e., gustatory cortex).These results suggest that self-reported heightened taste reactivity in ASD is associated with heightened brain responses to food-related stimuli and atypical functional connectivity of primary gustatory cortex, which may predispose these individuals to maladaptive and unhealthy patterns of selective eating behavior. Trial registration: (clinicaltrials.gov identifier) NCT01031407. Registered: December 14, 2009

Global variations in H2O/Ce: 1. Slab surface temperatures beneath volcanic arcs

We have calculated slab fluid temperatures for 51 volcanoes in 10 subduction zones using the newly developed H2O/Ce thermometer. The slab fluid compositions were calculated from arc eruptives, using melt inclusion-based H2O contents, and were corrected for background mantle contributions. The temperatures, adjusted to h, the vertical depth to the slab beneath the volcanic arc, range from ~730 to 900°C and agree well (within 30°C on average for each arc) with sub-arc slab surface temperatures predicted by recent thermal models. The coherence between slab model and surface observation implies predominantly vertical transport of fluids within the mantle wedge. Slab surface temperatures are well reconciled with the thermal parameter (the product of slab age and vertical descent rate) and h. Arcs with shallow h (~80 to 100 km) yield a larger range in slab surface temperature (up to ~200°C between volcanoes) and more variable magma compositions than arcs with greater h (~120 to 180 km). This diversity is consistent with coupling of the subducting slab and mantle wedge, and subsequent rapid slab heating, at ~80 km. Slab surface temperatures at or warmer than the H2O-saturated solidus suggest that melting at the slab surface is common beneath volcanic arcs. Our results imply that hydrous melts or solute-rich supercritical fluids, and not H2O-rich aqueous fluids, are thus the agents of mass transport to the mantle wedge

Study protocol for the Australian autism biobank: an international resource to advance autism discovery research

BACKGROUND: The phenotypic and genetic heterogeneity of autism spectrum disorder (ASD) presents considerable challenges in understanding etiological pathways, selecting effective therapies, providing genetic counselling, and predicting clinical outcomes. With advances in genetic and biological research alongside rapid-pace technological innovations, there is an increasing imperative to access large, representative, and diverse cohorts to advance knowledge of ASD. To date, there has not been any single collective effort towards a similar resource in Australia, which has its own unique ethnic and cultural diversity. The Australian Autism Biobank was initiated by the Cooperative Research Centre for Living with Autism (Autism CRC) to establish a large-scale repository of biological samples and detailed clinical information about children diagnosed with ASD to facilitate future discovery research. METHODS: The primary group of participants were children with a confirmed diagnosis of ASD, aged between 2 and 17 years, recruited through four sites in Australia. No exclusion criteria regarding language level, cognitive ability, or comorbid conditions were applied to ensure a representative cohort was recruited. Both biological parents and siblings were invited to participate, along with children without a diagnosis of ASD, and children who had been queried for an ASD diagnosis but did not meet diagnostic criteria. All children completed cognitive assessments, with probands and parents completing additional assessments measuring ASD symptomatology. Parents completed questionnaires about their child's medical history and early development. Physical measurements and biological samples (blood, stool, urine, and hair) were collected from children, and physical measurements and blood samples were collected from parents. Samples were sent to a central processing site and placed into long-term storage. DISCUSSION: The establishment of this biobank is a valuable international resource incorporating detailed clinical and biological information that will help accelerate the pace of ASD discovery research. Recruitment into this study has also supported the feasibility of large-scale biological sample collection in children diagnosed with ASD with comprehensive phenotyping across a wide range of ages, intellectual abilities, and levels of adaptive functioning. This biological and clinical resource will be open to data access requests from national and international researchers to support future discovery research that will benefit the autistic community

Complications and outcomes associated with 13 cases of triceps tendon disruption in dogs and cats (2003-2014).

This study reports data from a larger number of cases of triceps tendon disruption. Records from 10 veterinary referral hospitals between 2003 and 2014 were searched for canine and feline cases diagnosed with triceps tendon disruption, based on orthopaedic examination confirmed during surgery. Long-term follow-up and owner satisfaction were assessed using a questionnaire. There were 13 cases of triceps tendon disruption diagnosed across seven hospitals (nine dogs, four cats). Trauma, history or presence of a wound, surgery in the region of tendon attachment or corticosteroid treatment preceded triceps tendon disruption. Radiographic signs or histopathology suggestive of a chronic tendinopathy was common. All cases underwent surgical repair involving a tendon suture pattern, 12 of which were secured through bone tunnels. Immobilisation was used in all cases in the form of transarticular external skeletal fixation (TAESF) (8/9 dogs) or spica splint (four cats, two dogs; in one dog a TAESF was applied after complications associated with the spica splint). Complications occurred in 11 cases (17 total complications), frequently associated with the immobilisation method. One case had traumatic tendon rerupture two years following surgery. A wound at presentation was associated with the development of multiple complications. Nine cases had long-term follow-up; five achieved normal function, four achieved acceptable function. Despite the complications, overall return to subjective normal or acceptable function, as assessed by the owners, was achieved in the majority of cases

COVID-19 in sub-Saharan Africa: impacts on vulnerable populations and sustaining home-grown solutions

© 2020, The Canadian Public Health Association. This commentary draws on sub-Saharan African health researchers’ accounts of their countries’ responses to control the spread of COVID-19, including social and health impacts, home-grown solutions, and gaps in knowledge. Limited human and material resources for infection control and lack of understanding or appreciation by the government of the realities of vulnerable populations have contributed to failed interventions to curb transmission, and further deepened inequalities. Some governments have adapted or limited lockdowns due to the negative impacts on livelihoods and taken specific measures to minimize the impact on the most vulnerable citizens. However, these measures may not reach the majority of the poor. Yet, African countries’ responses to COVID-19 have also included a range of innovations, including diversification of local businesses to produce personal protective equipment, disinfectants, test kits, etc., which may expand domestic manufacturing capabilities and deepen self-reliance. African and high-income governments, donors, non-governmental organizations, and businesses should work to strengthen existing health system capacity and back African-led business. Social scientific understandings of public perceptions, their interactions with COVID-19 control measures, and studies on promising clinical interventions are needed. However, a decolonizing response to COVID-19 must include explicit and meaningful commitments to sharing the power—the authority and resources—to study and endorse solutions