We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Healthcare workers in Africa face considerable stress due to factors like long working hours, heavy workloads and limited resources, leading to psychological distress. Generally, countries in the global north have well-established policies and employee wellness programs for mental health compared to countries in the global south. This scoping review aimed to synthesize evidence from published and grey literature on workplace mental health promotion interventions targeting African healthcare workers using Social Ecological Model (SEM) and the Job Demands-Resources (JD-R) model as an underlying theoretical framework for analysis. Arksey and O’Malley framework for scoping reviews was used. The search was conducted across multiple databases. A total of 5590 results were retrieved from Ovid MEDLINE, Ovid Embase, Ovid PsycINFO, Cochrane Library, CINAHL, Scopus and Web of Science. Seventeen (17) studies from ten (10) African countries were included after title, abstract and full text screening. Thematic analysis identified 5 key themes namely training programs, counselling services, peer support programs, relaxation techniques and informational resources. In conclusion, even though limited workplace mental health interventions for healthcare professionals were identified in Africa, individual-level interventions have been notably substantial in comparison to organizational and policy-level initiatives. Moving forward, a multi-faceted approach unique to the African context is essential.
Dignity is perceived as being valued and respected. Maintaining dignity throughout illness is a fundamental principle of palliative care. Dignity can be influenced through family caregiver’s communication, support, and acts of empathy or indifference among other factors. The perception of dignity and the practices adopted by family caregivers to preserve the dignity of their ill relative with serious illness in Lebanon are explored in this paper.
Methods
This is a part of a larger study that explored the understanding of dignity from patients’ and family caregivers’ perspectives in a palliative care context. Data collection involved in-depth interviews with 15 family caregivers. Interviews were analyzed using reflective thematic analysis.
Results
Four main themes, that explained how family caregivers understand, and uphold their relative’s dignity during illness, were developed:
(a) Familial duty expressed through presence and compassion;
(b) Holistic care and financial stability;
(c) Social connection and family roles;
(d) Compassionate services and communication.
Family caregivers maintained the dignity of their ill relatives through being there, compassionate communication, supporting the personal and medical needs of the patient, and helping them preserve their family role. Family caregiving was often underpinned by religious values and a sense of duty. Compassionate services and effective communication were essential to preserve dignity of the ill relative during hospitalizations.
Significance of results
Family caregivers assume multiple roles in fostering the dignity of relatives with serious illnesses. It is crucial that family caregivers are supported by policies, healthcare systems, and community initiatives as patients cannot thrive nor sustain dignity without their support.
There are sex-dependent differences in hematological and biochemical variables in adulthood attributed to the predominant effects of testosterone in males and estrogen in females. The Twin Testosterone Transfer (TTT) hypothesis proposes that opposite-sex females may develop male-typical traits due to exposure to relatively higher levels of prenatal testosterone than same-sex females. Additionally, prenatal testosterone exposure has been suggested as a correlate of current circulating testosterone levels. Consequently, opposite-sex females might exhibit male-typical patterns in their hematological and biochemical variables. Despite this hypothesis, routine laboratory investigations assign the same reference range to all females. Our cross-sectional study, conducted in Tamale from January to September 2022, included 40 twins, comprising 10 opposite-sex (OS) males (25%), 10 OS females (25%), and 20 same-sex (SS) females (50%), all aged between 18 and 27 years. Fasting venous blood samples were collected and analyzed using automated hematology and biochemistry laboratory analyzers. Results indicated that levels of hemoglobin, serum creatinine, gamma-glutamyl transferase, total protein, globulins, and total testosterone were significantly higher in OS males than OS females. Conversely, total cholesterol and low-density lipoprotein cholesterol were significantly higher in OS females than OS males. Unexpectedly, levels of low-density lipoprotein cholesterol and total testosterone were significantly higher in SS females than OS females. Contrary to expectations, opposite-sex females did not exhibit male-typical patterns in their hematological and biochemical variables. This suggests that the TTT effect may not occur or may not be strong enough to markedly affect hematological and biochemical variables in OS females.
This study assesses change in caregiver practices after integrating responsive care and early learning (RCEL) in nutrition and health services and community platforms in northern Ghana.
Design:
We trained health facility workers and community health volunteers to deliver RCEL counselling to caregivers of children under 2 years of age through existing health facilities and community groups. We assessed changes in caregivers’ RCEL practices before and after the intervention with a household questionnaire and caregiver–child observations.
Setting:
The study took place in Sagnarigu, Gushegu, Wa East and Mamprugu-Moagduri districts from April 2022 to March 2023. Study sites included seventy-nine child welfare clinics (CWC) at Ghana Health Service facilities and eighty village savings and loan association (VSLA) groups.
Participants:
We enrolled 211 adult caregivers in the study sites who had children 0–23 months at baseline and were enrolled in a CWC or a VSLA.
Results:
We observed improvements in RCEL and infant and young child feeding practices, opportunities for early learning (e.g. access to books and playthings) in the home environment and reductions in parental stress.
Conclusions:
This study demonstrates the effectiveness of integrating RCEL content into existing nutrition and health services. The findings can be used to develop, enhance and advocate for policies integrating RCEL into existing services and platforms in Ghana. Future research may explore the relationship between positive changes in caregiver behaviour and improvements in child development outcomes as well as strategies for enhancing paternal engagement in care practices, improving child supervision and ensuring an enabling environment.
Increasingly most people have their meals outside their homes and are vulnerable to illnesses caused by unsafe foods. Unsafe food preparation and supply by vendors have made food safety a concern for public health. The present study evaluated the nutrition knowledge, attitude and food safety and hygienic practices of street food vendors (SFVs) in Northern Ghana. An analytical cross-sectional study design was conducted among 424 SFVs, and the data were collected using questionnaires and observation. The mean ± sd nutrition knowledge score of the SFVs was 7⋅08 ± 1⋅75 in which the majority of the participants (68⋅6 %) knew foods that help fight diseases and build immunity. The mean ± sd food safety and hygienic practice score was 7⋅61 ± 2⋅66 with more than half of the participants reportedly not using hand gloves while preparing and serving food. Factors that were associated with food safety and hygienic practices of the SFVs were level of education (β = −0⋅36, P < 0⋅001), number of hours worked (β = 0⋅15, P = 0⋅002), food hygiene and safety knowledge (β = 0⋅21, P = 0⋅002), having a business certificate (β = −0⋅15, P = 0⋅004) and having medical check-up (β = 0⋅11, P = 0⋅029). The food safety and hygienic practices of the SFVs may constitute a food safety risk to consumers. Improving food safety and hygiene knowledge may be important but regular monitoring and check-up by the FDA could result in SFVs following the required food safety and hygienic practices.
The integration of people-centred services is key to improving the performance of health systems. This chapter explores the rationale and definitions of integrated and people-centred services, considers frameworks to inform and drive integrated care, and describes common barriers as well as enabling strategies related to values and policy, the engagement of key stakeholders and operational considerations. It highlights the unique role of family practice (also called family medicine) as a community-based and community-oriented discipline, and as a driver of comprehensive integrated people-centred care. It concludes with a description of the key strategies used in the re-organization of primary care services into a family health model by United Nations Relief and Works Agency for Palestine Refugees (UNRWA) in the Near East in 2011.
The objectives of the study were to describe outcomes of children with uncomplicated severe acute malnutrition (SAM) attending community-based management of acute malnutrition (CMAM) treatment centres in Accra Metropolitan Area (AMA) and explore factors associated with non-adherence to clinic visits and defaulting from the treatment programme.
Design:
A retrospective cohort study analysing routinely collected data on children with uncomplicated SAM enrolled into CMAM in 2017 was conducted.
Setting:
Study was conducted at seven sites comprising Princess Marie Louise Children’s Hospital, three sub-metropolitan health facilities and three community centres, located in five sub-metropolitan areas in AMA.
Participants:
Children with uncomplicated SAM aged 6–59 months, enrolled from community-level facilities (pure uncomplicated SAM, PUSAM) or transferred after completing inpatient care (post-stabilisation uncomplicated SAM, PSSAM), participated in the study.
Results:
Out of 174 cases studied (105 PUSAM, sixty-nine PSSAM), 56·3 % defaulted, 34·5 % recovered and 8·6 % were not cured by 16 weeks. No deaths were recorded. Mid-upper arm circumference (MUAC) increased by 2·2 (95 % CI 1·8, 2·5) mm/week with full compliance and 0·9 (95 % CI 0·6, 1·2) mm/week with more than two missed visits. In breast-feeding children, MUAC increased at a slower rate than in other children by 1·3 (95 % CI 1·0, 1·5) mm/week. Independent predictors of subsequent missed visits were diarrhoea and fever, while children with MUAC < 110 mm on enrolment were at increased risk of defaulting.
Conclusion:
A high default rate and a long time to recovery are challenges for CMAM in AMA. Efforts must be made to improve adherence to treatment to improve outcomes.
Narrower corn row widths, higher crop densities, and interrow cultivation may be used as part of integrated weed management (IWM). During a three-year study, we tested whether these factors affected corn growth, development and grain yield at final harvest, and weed biomass when weeds were late-emerging (after the three-leaf stage of corn). Increasing corn density from 7 to 10 plants m−2 or decreasing row width from 75 to 50 cm significantly increased corn leaf area index (LAI), and reduced photosynthetic photon flux density (PPFD) available for a mixture of weed species located below the corn canopy. Narrower rows and higher corn density significantly reduced biomass of late-emerging weeds. Corn yields increased significantly (10 to 15%) only when narrower rows were used. Intraspecific competition between corn plants in the higher density significantly reduced early corn growth and offset any gain in yield from reduced weed competition. In comparison to plots where late-emerging weeds grew uncontrolled, interrow cultivation did not decrease biomass of late-emerging weeds, hence did not increase corn yield. We recommend using narrower row widths to reduce weed competition and increase corn yield. Increased corn densities had no net yield benefit. Early-season weed management is crucial as the later-emerging weeds were less important in terms of their effect on yield.
Research results and facts about indigenous Muscovy duck production in Nigeria
are reviewed with the aim of assessing its current status and delivering
relevant information to stakeholders and other potential beneficiaries. There
are large variations in phenotypic and biochemical characteristics of indigenous
Muscovy ducks in the country, which could serve as a basis for genetic
improvement. These ducks have the potential for a mean live weight of 2.73 and
1.52 kg and dressing percentage of 71.2% and 69.8% for drakes and ducks,
respectively. Under scavenging, backyard farming conditions, the ducks can lay
between 60 and 80 eggs each per year, and about 100 and 125 eggs per bird per
year with an egg weight of about 72g under improved management conditions. The
morphological, meat and egg attributes of local Muscovy ducks may be exploited
in management decisions geared towards ensuring an increase in productivity,
thereby making an important contribution to food security in a developing
economy.
Natural fiber composites are becoming more attractive for applications as energy absorbers in the automotive industry despite their high moisture absorption characteristics. The main objective of this paper is to study the impact strength and moisture absorption properties of long fiber and short fiber hybrid composites using a kenaf/polyethylene terephthalate fiber reinforced in the polyoxymethylene matrix. The results obtained from the impact test gave 10.8 J/cm for the longer fiber hybrid composites, which is higher compared to 8.0 J/cm obtained for the short fiber hybrid composites due to less fiber pullout from the matrix. A moisture content of 0.92% and percentage water absorption of 6.77% were obtained for the long fiber composite due to poor interfacial adhesion between the fiber and the matrix. A high void content of 0.52% and porosity of 1.21% also accounted for high water and moisture absorption of the long fiber hybrid composite.
A cross-sectional study was conducted from 10 January to 9 April 2012, to determine the seroprevalence of tuberculosis (TB) of all captive Asian elephants and their handlers in six locations in Peninsular Malaysia. In addition, trunk-wash samples were examined for tubercle bacillus by culture and polymerase chain reaction (PCR). For 63 elephants and 149 elephant handlers, TB seroprevalence was estimated at 20·4% and 24·8%, respectively. From 151 trunk-wash samples, 24 acid-fast isolates were obtained, 23 of which were identified by hsp65-based sequencing as non-tuberculous mycobacteria. The Mycobacterium tuberculosis-specific PCR was positive in the trunk-wash samples from three elephants which were also seropositive. Conversely, the trunk wash from seven seropositive elephants were PCR negative. Hence, there was evidence of active and latent TB in the elephants and the high seroprevalence in the elephants and their handlers suggests frequent, close contact, two-way transmission between animals and humans within confined workplaces.
Indigenous livestock resources are strategic in the socio-economics of rural agricultural systems to ensure food security in resource-poor countries. Therefore, better understanding of genetic variation holds the key to future utilization through conservation. We report the first analysis of genetic diversity of Nigerian sheep based on the D-loop region of the Ovis aries mitochondrial genome using 1 179 bases between sites 15 437 and 16 616 base pairs. A sample of 290 animals made up of Balami, West African Dwarf (WAD), Uda and Yankasa breeds were randomly collected from across Nigeria. Ninety-six haplotypes were observed with a high mean haplotype diversity of 0.899 ± 0.148. Gene diversity was highest in Uda (0.921 ± 0.021) and lowest in WAD (0.852 ± 0.061). Population specific FST indices varied from 0.00133 in Uda to 0.00335 in WAD. Yankasa had the highest number of polymorphic sites (201), while the least was in Uda (96). Analysis of molecular variance revealed that 0.23 percent of the variation is found among populations compared with 99.77 percent variation found within populations. The phylogenetic tree indicates that the mitochondrial lineages of these sheep breeds originated from a common source consistent with first divergence of Yankasa followed by WAD, while Balami and Uda remain more closely related. These results suggest that evolutionary divergence of Nigerian sheep breeds based on mitochondrial DNA D-loop sequence may be coincident with geographical distribution in Nigeria and suggest significant interbreeding. This could have implications for managing improvement and conservation strategies and long-term conservation of Nigerian indigenous sheep.
This investigation explored the ability to distinguish the morphological and heat-tolerant traits of Nigerian indigenous, exotic and cross-bred turkeys using multivariate discriminant analysis. A total of 228 turkeys that were 20 weeks old were utilized in the study. The body parameters measured were body weight (BW), body length (BL), shank length (SL), thigh length (TL), keel length (KL), breast girth (BG), rectal temperature (RT), pulse rate (PR), respiratory rate (RR) and heat stress index (HI). Analysis of variance revealed that the exotic turkeys had significantly (p < 0.05) higher values than Nigerian indigenous and cross-bred turkeys in all the morphological traits with the exception of TL. However, the indigenous and cross-bred turkeys appeared to have more adaptive capability than the exotic ones based on their low HI. Sexual dimorphism was observed only in the morphological traits with male birds having significantly (p < 0.05) higher BW, BL, SL, TL and KL than that in females. However, the stepwise discriminant analysis revealed that BW, TL and HI were the most discriminating variables to separate the three genetic groups. The longest Mahalanobis distance was observed between the indigenous and exotic turkeys (36.68) while the shortest distance was recorded for the indigenous turkeys and their cross-bred counterparts (7.97). The canonical plot revealed the heterogeneity of the turkey populations as the birds clustered separately. In the nearest-neighbour discriminant analysis, 100.00, 98.73 and 96.43 percent of exotic, cross-bred and indigenous turkeys were correctly assigned into their source genetic groups. The present findings could aid the implementation of a conservation and improvement strategy of indigenous turkeys towards sustainable development of animal genetic resources.
The genomes of 34 recent United Kingdom isolates of Neisseria meningitidis serogroup C were examined by restriction enzyme digestion and by conventional and pulsed-field gel electrophoresis (PFGE). Strains were assigned to groups on the basis of the Dice similarity coefficient; strains with values of >92% were considered to be clonally related. Twelve clones were identified by PFGE. Strains of two clonal groups predominated. Restriction endonuclease analyses using the ‘high frequency cleavage’ endonuclease Stu I and conventional electrophoresis gave 11 groups; in general it had lower resolving power than PFGE.
Orbital cellulitis and abscess are known complications of ethmoiditis in children, but they are very rare in the newborn. The authors report a case of orbital abscess caused by methicillin-resistant Staphylococcus aureus (MRSA) in a four-week-old neonate born four weeks prematurely.
The present study examined the ontogeny of mitochondrial protein abundance in adipose tissue and lungs over the first month of life in the sheep and the extent to which this may be altered by maternal undernutrition during the final month of gestation. The ontogeny of uncoupling protein (UCP), voltage-dependent anion channel (VDAC) and cytochrome c abundance were determined in adipose tissue and lungs sampled from near-term fetuses and young sheep aged 4 h, 1, 7 and 30 d. In adipose tissue, the abundance of UCP1, VDAC and cytochrome c all peaked at 1 d of age and then decreased by 30 d of age, at which stage the brown adipose tissue-specific UCP1 was no longer detectable but UCP2 was clearly abundant. For the lungs, however, UCP2 and VDAC abundance both peaked 7 d after birth and then decreased by 30 d of age. During postnatal development, therefore, a marked change in mitochondrial protein abundance occurs within both adipose tissue and lungs. Maternal nutrient restriction had no effect on lamb growth or tissue weights at 30 d of age but was associated with increased abundance of UCP2 and VDAC but not cytochrome c in both adipose tissue and lungs. These mitochondrial adaptations within both adipose tissue and the lungs of offspring born to previously nutrient-restricted mothers may compromise adipose tissue and lung function during periods of environmental stress.