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Search Results: 1 - 10 of 2790 matches for " Raymond Aborigo "
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Clean delivery practices in rural northern Ghana: a qualitative study of community and provider knowledge, attitudes, and beliefs
Cheryl A Moyer, Raymond Aborigo, Gideon Logonia, Gideon Affah, Sarah Rominski, Philip B Adongo, John Williams, Abraham Hodgson, Cyril Engmann
BMC Pregnancy and Childbirth , 2012, DOI: 10.1186/1471-2393-12-50
Abstract: In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0.253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1) Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2) Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3) Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or “red earth sand.” Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill.This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of facility-based delivery, the disconnect between healthcare providers and the community, and the critical role grandmothers play in ensuring clean delivery practices. Future interventions to address clean delivery and prevention of neonatal infections include educating healthcare providers about harmful traditional practices so they are specifically addressed, strengthening facilities, and incorporating influential community members such as gr
Infant nutrition in the first seven days of life in rural northern Ghana
Raymond Aborigo, Cheryl A Moyer, Sarah Rominski, Philip Adongo, John Williams, Gideon Logonia, Gideon Affah, Abraham Hodgson, Cyril Engmann
BMC Pregnancy and Childbirth , 2012, DOI: 10.1186/1471-2393-12-76
Abstract: The study took place in the Kassena-Nankana District of the Upper East Region of northern Ghana. In-depth interviews were conducted with 35 women with newborn infants, 8 traditional birth attendants and local healers, and 16 community leaders. An additional 18 focus group discussions were conducted with household heads, compound heads and grandmothers. All interviews and discussions were audio taped, transcribed verbatim and analyzed using NVivo 9.0.Community members are knowledgeable about the importance of breastfeeding, and most women with newborn infants do attempt to breastfeed. However, data suggest that traditional practices related to breastfeeding and infant nutrition continue, despite knowledge of clinical guidelines. Such traditional practices include feeding newborn infants water, gripe water, local herbs, or traditionally meaningful foods such as water mixed with the flour of guinea corn (yara’na). In this region in Ghana, there are significant cultural traditions associated with breastfeeding. For example, colostrum from first-time mothers is often tested for bitterness by putting ants in it – a process that leads to a delay in initiating breastfeeding. Our data also indicate that grandmothers – typically the mother-in-laws – wield enormous power in these communities, and their desires significantly influence breastfeeding initiation, exclusivity, and maintenance.Prelacteal feeding is still common in rural Ghana despite demonstrating high knowledge of appropriate feeding practices. Future interventions that focus on grandmothers and religious leaders are likely to prove valuable in changing community attitudes, beliefs, and practices with regard to infant nutrition.Infant and young child nutrition is a vital component of childhood care and a major determinant of short- and long-term health outcomes in children [1]. Good infant nutrition stimulates intellectual development and is also associated with improved infant health, stronger immune systems, lowe
Understanding and retention of the informed consent process among parents in rural northern Ghana
Abraham R Oduro, Raymond A Aborigo, Dickson Amugsi, Francis Anto, Thomas Anyorigiya, Frank Atuguba, Abraham Hodgson, Kwadwo A Koram
BMC Medical Ethics , 2008, DOI: 10.1186/1472-6939-9-12
Abstract: The study involved 270 female parents who gave consent for their children to participate in a prospective cohort study that evaluated immune correlates of protection against childhood malaria in northern Ghana. A semi-structured interview with questions based on the informed consent themes was administered. Parents were interviewed on their comprehension and retention of the process and also on ways to improve upon the existing process.The average parental age was 33.3 years (range 18–62), married women constituted a majority (91.9%), Christians (71.9%), farmers (62.2%) and those with no formal education (53.7%). Only 3% had ever taken part in a research and 54% had at least one relation ever participate in a research. About 90% of parents knew their children were involved in a research study that was not related to medical care, and 66% said the study procedures were thoroughly explained to them. Approximately, 70% recalled the study involved direct benefits compared with 20% for direct risks. The majority (95%) understood study participation was completely voluntary but only 21% recalled they could withdraw from the study without giving reasons. Younger parents had more consistent comprehension than older ones. Maternal reasons for allowing their children to take part in the research were free medical care (36.5%), better medical care (18.8%), general benefits (29.4%), contribution to research in the area (8.8%) and benefit to the community (1.8%). Parental suggestions for improving the consent process included devoting more time for explanations (46.9%), use of the local languages (15.9%) and obtaining consent at home (10.3%).Significant but varied comprehension of the informed consent process exists among parents who participate in research activities in northern Ghana and it appears the existing practices are fairly effective in informing research participants in the study area.Informed consent as a process, enables persons to voluntarily decide whether or not
Seeking consent to genetic and genomic research in a rural Ghanaian setting: A qualitative study of the MalariaGEN experience
Paulina Tindana, Susan Bull, Lucas Amenga-Etego, Jantina de Vries, Raymond Aborigo, Kwadwo Koram, Dominic Kwiatkowski, Michael Parker
BMC Medical Ethics , 2012, DOI: 10.1186/1472-6939-13-15
Abstract: The study used a rapid assessment incorporating multiple qualitative methods including in depth interviews, focus group discussions and observations of consent processes. Differences between verbal information provided during community engagement processes, and consent processes during the enrolment of cases and controls were identified, as well as the factors influencing the tailoring of such information.MalariaGEN participants and field staff seeking consent were generally satisfied with their understanding of the project and were familiar with aspects of the study relating to malaria. Some genetic aspects of the study were also well understood. Participants and staff seeking consent were less aware of the methodologies employed during genomic research and their implications, such as the breadth of data generated and the potential for future secondary research.Moreover, trust in and previous experience with the Navrongo Health Research Centre which was conducting the research influenced beliefs about the benefits of participating in the MalariaGEN study and subsequent decision-making about research participation.It is important to recognise that some aspects of complex genomic research may be of less interest to and less well understood by research participants and that such gaps in understanding may not be entirely addressed by best practice in the design and conduct of consent processes. In such circumstances consideration needs to be given to additional protections for participants that may need to be implemented in such research, and how best to provide such protections.Capacity building for research ethics committees with limited familiarity with genetic and genomic research, and appropriate engagement with communities to elicit opinions of the ethical issues arising and acceptability of downstream uses of genome wide association data are likely to be important.
Why Are Babies Dying in the First Month after Birth? A 7-Year Study of Neonatal Mortality in Northern Ghana
Paul Welaga, Cheryl A. Moyer, Raymond Aborigo, Philip Adongo, John Williams, Abraham Hodgson, Abraham Oduro, Cyril Engmann
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0058924
Abstract: Objectives To determine the neonatal mortality rate in the Kassena-Nankana District (KND) of northern Ghana, and to identify the leading causes and timing of neonatal deaths. Methods The KND falls within the Navrongo Health Research Centre’s Health and Demographic Surveillance System (HDSS), which uses trained field workers to gather and update health and demographic information from community members every four months. We utilized HDSS data from 2003–2009 to examine patterns of neonatal mortality. Results A total of 17,751 live births between January 2003 and December 2009 were recorded, including 424 neonatal deaths 64.8%(275) of neonatal deaths occurred in the first week of life. The overall neonatal mortality rate was 24 per 1000 live births (95%CI 22 to 26) and early neonatal mortality rate was 16 per 1000 live births (95% CI 14 to 17). Neonatal mortality rates decreased over the period from 26 per 1000 live births in 2003 to 19 per 1000 live births in 2009. In all, 32%(137) of the neonatal deaths were from infections, 21%(88) from birth injury and asphyxia and 18%(76) from prematurity, making these three the leading causes of neonatal deaths in the area. Birth injury and asphyxia (31%) and prematurity (26%) were the leading causes of early neonatal deaths, while infection accounted for 59% of late neonatal deaths. Nearly 46% of all neonatal deaths occurred during the first three postnatal days. In multivariate analysis, multiple births, gestational age <32 weeks and first pregnancies conferred the highest odds of neonatal deaths. Conclusions Neonatal mortality rates are declining in rural northern Ghana, with majority of deaths occurring within the first week of life. This has major policy, programmatic and research implications. Further research is needed to better understand the social, cultural, and logistical factors that drive high mortality in the early days following delivery.
A Characterization of the Optimal Management of Heterogeneous Environmental Assets under Uncertainty  [PDF]
Frank Raymond
Theoretical Economics Letters (TEL) , 2012, DOI: 10.4236/tel.2012.25093
Abstract: The application herein involves the optimal management of renewable and nonrenewable resources within the context of a stochastic model of optimal control. By characterizing the two dimensional Bellman solution, three rules with respect to resource management are established. Within the context of coastal development, this analysis may help to explain why renewable resources may become increasingly vulnerable to random external shocks as nonrenewable resources are depleted. Although existence of an optimal closed form solution to the multi-sector Bellman model remains an open mathematical question, this analysis offers a characterization which can be applied to other scenarios in economics or finance in which two assets following stochastic processes interact.
Influence of Hot Spring Phages on Community Carbon Metabolism: Win, Lose or Draw?  [PDF]
Raymond Kepner
Advances in Microbiology (AiM) , 2015, DOI: 10.4236/aim.2015.59066
Abstract: Abundant virus-like particles were concentrated from large-volume samples from two hot springs. Both addition of viral concentrates and addition of samples induced by addition of mitomycin-C changed patterns of carbon source utilization by hot spring microbial communities. Specific effects of the two treatments depended upon both temperature and incubation period. Increased metabolic capability with greater exposure to free phages, consistent with the view that phages are major lateral transporters of metabolic genes, was observed most clearly in microbes incubated at a temperature lower than that encountered in situ. On the other hand, decreases in the diversity of utilizable C sources upon exposure to phages may have been due to lytic activity in which susceptible bacterial populations were differentially reduced by infective viruses, consistent with the “killing the winner” hypothesis. Treatment of cultures with MC-treated culture extracts, assumed to increase exposure to excised prophages, resulted in higher average metabolic rates after 18 h, but lower rates after 48 h of incubation. With incubation at in situ temperature, this same treatment led to an initial increase in the number of readily utilized C sources, followed by a decrease in community metabolic diversity relative to controls in samples from both hot springs. Thus, treatments designed to increase the interaction between hot spring microbes and either free or newly-excised phages had observable time- and temperature-dependent effects on community metabolism, demonstrating an important, yet complex, ecological role for phages in hot spring waters.
Dehumanization, Racial Minority and Female Leadership: An Analysis of Global Trends  [PDF]
Simon Raymond
Advances in Applied Sociology (AASoci) , 2016, DOI: 10.4236/aasoci.2016.68022
Abstract: Purpose: The use of dehumanization, directed toward racial minorities, impresses as a global trend of significance, spanning from broad generalisations with regards to black community members holding a lower status through to Russian politicians terming Barack Obama and Michelle Obama as mammalian apes (or, monkeys). This report analyses the use of dehumanization and the validity of racial degradation. Female leadership is also analysed. Methods: A comparative analysis was performed assessing the achievements of African Americans in comparison with white (including caucasian) society, with a gender comparison to assess for consistency across genders. The categorisation of racial minorities based on the satisfying of criteria for conscious being recognition was also considered. Results: African Americans have held positions, and achieved success, equally respectable with that of the white (including caucasian) community. These members of society also satisfy the criteria for conscious beings. There appears to be no validity to support black or Asian people as representative of a being less than that of a human being. Conclusion: There appears to be no validity behind categorisation of certain races as lesser members of society. Furthermore, there appears no validity behind the use of dehumanization.
Causes of Death in Patients with Aortic Aneurysmal Disease (1987-2014)  [PDF]
Raymond Englund
Surgical Science (SS) , 2017, DOI: 10.4236/ss.2017.81001
Abstract: Introduction: This study examined the cause of death of patients with aortic aneurysms treated for this disease between 1987 and 2014 to understand the current natural history of this condition. Methods: This study results from analysis of a prospectively maintained data base of patients treated by the author. Data points were obtained from practice records and supplemented by data made available through CHeRL (Centre for electronic Health Record Linkage). Six hundred and twenty two patients were treated consecutively between 1987 and 2014. At closure of the study in 2014, 402 patients had died and date of death was available. Cause of death was available by ICD (International Classification of Diseases) 9 or 10 in 89% of patients. Method of treatment of aneurysmal disease was available in all patients. Ethics approval for this study was obtained from the Centre for Health Research, Cancer Institute, New South Wales Department of Health. Statistical analysis was conducted by comparison of mean ±95% conference interval. Where appropriate contingency table analysis was constructed. Statistical significance was accepted at P < 0.05. Results: Mean age at presentation was 75.6 years (95%C.I. 74.8 - 76.3). Mean age at death was 81 years (95%C.I. 80.2 - 81.7). Predicted age at death based on Australian Bureau of Statistics life tables was 86.25 years (95%C.I. 85.8 - 86.8). Between 1987 and 1999, mean age at presentation was 74.5 years (95%C.I. 73.3 - 75, n = 304, Females = 78). Between 2000 and 2014, mean age at presentation was 75.3 years (95%C.I. 74.1 - 75, n = 318, females = 54). The difference for females presenting 1987 to 1999 compared 2000 to 2014 was significant, p < 0.01. Death was due to the following causes unknown 11%, cardiovascular disease 27.7%, pulmonary related disease 9.7% and aortic related disease 20.6%. Patients died of aortic related causes significantly earlier (within 2 years) compared to patients with other causes of death (5 to 8 years) due to presentation with ruptured aortic aneurysm. Cardiovascular related causes of death, malignancy and pulmonary related causes of death accounted for the majority of deaths post-treatment. There was no significant difference in length of survival among patients dying from these causes. Conclusion: Patients with successfully treated aneurysmal disease can expect to survive 5 - 8 years post-treatment. Presentation with aortic aneurysm rupture results in significantly shortened life expectancy. Patients presenting in the ninth
Towards a Classification of Left Common Iliac Vein Compression Based on Triplanar Phlebography  [PDF]
Raymond Englund
Surgical Science (SS) , 2017, DOI: 10.4236/ss.2017.81003
Abstract: Introduction: There is currently no consistent classification of the extent of left common iliac vein compression syndromes such that clinicians working in the area have a common terminology. Hypothesis: To create a classification of left common iliac vein compression based on the end point of triplanar pelvic phlebogrpahy. Methods: Based on 61 consecutive patients found to have left common iliac vein compression on triplanar phlebography in the course of treatment of venous disease, clinical presentation and symptomatology were retrospectively used to create a classification of left common iliac vein compression. Treatment of left common iliac vein compression was also retrospectively correlated with staging. Results: The following classification was arrived at: Stage 0, no compression and no intraluminal fibrous bands; Stage 1, evidence of compression by surrounding anatomical structures with or without the presence of fibrous bands; Stage 2: evidence of compression with or without fibrous bands as evidenced by cross-pelvic collaterals; Stage 3: compression of the left common iliac vein. Fibrous bands replaced by localised occlusion, with collateralisation and no involvement of adjacent venous segments; Stage 4a: as for Stage 3 but with the addition of thrombotic involvement of adjacent venous segments; Stage 4b: as for Stage 4a but with involvement of distal venous segments, femoral and popliteal. Stages 3, 4a or 4b correlated well with clinical presentations of DVT, PE, venous ulceration, vulval or cross-pelvic collaterals, ipsilateral limb swelling and claudication. The presence of varicose veins or recurrent varicose veins was a common finding amongst all groups. Conclusion: Acceptance of this classification system would provide a common terminology to allow more transparent assessment of modalities of treatment for this condition.
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