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BackgroundMotorcycles are a major source of road traffic injuries, with a preponderance of head injuries (HIs), especially among children and young adults. The reported prevalence of HI among children and young adults ranges between 17% and 67%. This study examined the determinants of motorcycle-related HIs among children and youth in northern Ghana.MethodsA case–control study was conducted among children and youth (ages: 1–24 years) with motorcycle injuries seen at a tertiary hospital in northern Ghana. A case was defined as Glasgow Coma Scale<14 and/or head Abbreviated Injury Score>1, while controls were patients with no HI. A questionnaire was used to collect sociodemographic, crash and road characteristics data. The determinants of HI were assessed using multivariable logistic regression analysis at p<0.05.ResultsThe proportion of survivors with HI was 52.0%, which was higher in children (<15 years, 57.4%) than in youth (15–24 years, 48.85%). The rate of helmet use was low (24%) and significantly lower in children (17.82%) compared with youth (27.59%). There was an increased odds of HI for non-helmet use among youth (adjusted OR=5.73, 95% CI 2.47 to 13.31) and in the combined group (OR=9.49, 95% CI 4.34 to 20.76).ConclusionLack of helmet use was the only significant risk factor for HI among youth and the combined group in this study. Motorcycle safety efforts in the study area should emphasise helmet promotion. Injury prevention strategies should enhance riders’ education and enforce road safety regulations, especially on helmet use.

Draws on a wide range of disciplines, including history, literature, and philosophy, to examine the imaginary boundaries people have drawn around themselves and other cultures and to challenge people to redraw those boundaries and appreciate the connections between people of different cultures, religions, and nations.

There is evidence that persons with disabilities often encounter grave barriers when accessing sexual and reproductive health services. To the best of our knowledge, however, no systematic review has been conducted to pull together these pieces of research evidence for us to understand the nature, magnitude and extent of these barriers in different settings in sub-Saharan Africa. We do not yet have a good understanding of the strength/quality of the evidence that exist on the barriers persons with disabilities face when accessing sexual and reproductive health services in sub-Saharan Africa. We therefore conducted a systematic review to examine the barriers persons with disabilities face in accessing sexual and reproductive health services in sub-Saharan Africa. A systematic review was conducted using PRISMA guidelines (PROSPEROO protocol registration number: CRD42017074843). An electronic search was conducted in Medline, EMBASE, CINAHL, PsycINFO, and Web of Science from 2001 to 2020. Manual search of reference list was also conducted. Studies were included if they reported on barriers persons with disability face in accessing sexual and reproductive health services. The Critical Appraisal Skills Programme and Centre for Evidence Based Management (CEBMa) appraisal tools were used to assess methodological quality of eligible studies. A total of 1061 studies were identified. Only 26 studies covering 12 sub-Saharan African countries were eligible for analysis. A total of 33 specific barriers including inaccessible physical health infrastructure and stigma and discrimination were identified. These barriers were further categorised into five levels: broader national level barriers; healthcare system/institutional barriers; individual level barriers; community level barriers; and economic barriers. Persons with disabilities face a myriad of demand and supply side barriers to accessing sexual and reproductive healthcare in sub-Saharan Africa. Multilevel interventions are urgently needed to address these barriers.

\"Who do you think you are? That's a question bound up in another: What do you think you are? Gender. Religion. Race. Nationality. Class. Culture. Such affiliations give contours to our sense of self, and shape our polarized world. Yet the collective identities they spawn are riddled with contradictions, and cratered with falsehoods. Kwame Anthony Appiah's The Lies That Bind is an incandescent exploration of the nature and history of the identities that define us. It challenges our assumptions about how identities work. We all know there are conflicts between identities, but Appiah shows how identities are created by conflict. Religion, he demonstrates, gains power because it isn't primarily about belief. Our everyday notions of race are the detritus of discarded nineteenth-century science. Our cherished concept of the sovereign nation--of self-rule--is incoherent and unstable. Class systems can become entrenched by efforts to reform them. Even the very idea of Western culture is a shimmering mirage. From Anton Wilhelm Amo, the eighteenth-century African child who miraculously became an eminent European philosopher before retiring back to Africa, to Italo Svevo, the literary marvel who changed citizenship without leaving home, to Appiah's own father, Joseph, an anticolonial firebrand who was ready to give his life for a nation that did not yet exist, Appiah interweaves keen-edged argument with vibrant narratives to expose the myths behind our collective identities. These 'mistaken identities,' Appiah explains, can fuel some of our worst atrocities--from chattel slavery to genocide. And yet, he argues that social identities aren't something we can simply do away with. They can usher in moral progress and bring significance to our lives by connecting the small scale of our daily existence with larger movements, causes, and concerns. Elaborating a bold and clarifying new theory of identity, The Lies That Bind is a ringing philosophical statement for the anxious, conflict-ridden twenty-first century. This book will transform the way we think about who--and what--'we' are.\"--Dust jacket.

Hundreds of millions of doses of Praziquantel (PZQ) have been administered to persons with and without schistosomiasis living in schistosomiasis endemic settings, through the mass drug administration (MDA) strategy which started in the early 2000s. A recent publication suggested high risk of PZQ-related visual disorders, raising public health concerns. We aim to systematically synthesize evidence on the magnitude of PZQ-related visual disorders. We will search PubMed, Google Scholar, CINAHL, SCOPUS, CENTRAL and LILACS from 1977 (when the first human clinical trials on PZQ started) to 31st May 2024, with no language restrictions. The key search terms will include \"Praziquantel\", \"PZQ\", \"visual disorder\", \"adverse events\", \"side effects\", \"blurry vision\" and \"visual impairment\" together with alternative terms and synonyms. All the countries endemic for schistosomiasis will be included as search terms. We will also search HINARI, Africa Journals Online, Thesis Databases and Preprint Repositories. Where necessary, we will contact expert researchers working in the field of schistosomiasis, UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), pharmaceutical industries, country-specific Food and Drug Authorities (FDAs) and the European Medicines Agency databases. We will search Conference Proceedings and reference lists of relevant studies for additional studies. At least two authors will independently select studies, extract data and assess risk of bias in the included studies. Any disagreements or discrepancies will be resolved through discussion between the reviewers. Heterogeneity will be explored graphically, and statistically using the I2-statistic. We will conduct random-effects meta-analysis when heterogeneity is appreciable, and express dichotomous outcomes (visual adverse events including excessive lacrimation, blurry vision and visual impairments) as risk ratio (RR) or Odds Ratio (OR) with their 95% confidence interval (CI). We will perform subgroup analysis to assess the impact of heterogeneity, and sensitivity analyses to test the robustness of the effect estimates. The overall level of evidence will be assessed using GRADE. The present review expects to identify and categorize visual disorders occurring after administration of PZQ, alone or in combination with other drugs. By synthesizing the data from multiple studies, the review aims to present a quantitative assessment of the risk or odds of experiencing a visual disorder in different populations after ingesting PZQ. The review will also generate insights into whether PZQ in combination with other drugs are associated with increased odds of visual disorders and whether the occurrence of visual disorders correlates with dosage or treatment duration. Policymakers, public health experts and stakeholders could rely on the review findings to deliver context-sensitive preventive chemotherapy programs by adjusting drug combinations or dosing schedules to reduce risk of visual adverse effects in populations treated with PZQ. The review aims to identify gaps in the current evidence regarding visual disorders following PZQ administration in schistosomiasis endemic settings which can serve as the basis for future research on important but unanswered questions. The findings of this study will be disseminated through stakeholder forums, conferences, and peer-review publications. The review protocol has been registered in the International Prospective Register for Systematic Reviews (PROSPERO)- CRD42023417963.

Idealization is a central feature of human thought. We build ideal models in the sciences, our politics is guided by pictures of impossible utopias, and our thinking about the arts and moral life is guided by images of how things might have been. In all these cases we sometimes proceed with a representation of the world that we know is not true or aim at a world we accept we cannot realize. This is the world of the \"as if,\" which the philosopher Hans Vaihinger delineated at the turn of the century, in ways he traced back to Kant. In this book, I aim to explore idealization in aesthetics, ethics, and metaphysics, as well as in the philosophy of mind, of language, of religion, and of the social and natural sciences. No one could be an expert on all of these things, but sometimes in philosophy it helps to stand back and take a broader view. On the way I hope to illuminate many issues, large and small, but there is one over-arching lesson: our best chance of understanding the world must be to have a plurality of ways of thinking about it. This book is about why we need a multitude of pictures of the world. It is a gentle jeremiad against theoretical monism.-- Provided by publisher

Stroke survivors have complex and long-term care needs requiring navigation of multiple care services and providers. Care coordination interventions provide wholistic care that meets the needs of the patient and improves their clinical outcomes and expectations. This systematic review will identify the key components of stroke care coordination interventions implemented in low and middle-income countries (LMICs) and assess their effectiveness on stroke outcomes such as motor recovery, cognitive function, mental health, stroke type and the role of stroke severity, type, and the nature of the interventions in influencing these outcomes. Electronic databases, trial registries and non-database sources will be searched for published and unpublished studies. PubMed, LILACS, CINAHL via EBSCOhost, Scopus, Web of Science Core Collection, Cochrane CENTRAL and Google Scholar will be searched from 2000 to 31st May 2025, without language restriction. Trial registries including the WHO International Clinical Trials Registry Platform (ICTRP) and Clinicaltrials.gov will also be searched. Grey literature including dissertations, preprint repositories and conference proceedings will be searched. The key search terms include \"stroke\", \"care integration\", \"continuity of care\", \"information exchange\", \"patient-centred care\", \"multidisciplinary care\", \"case management\" and \"low and middle-income countries\", together with their alternative terms and synonyms, singular and plural forms and American and British spelling. Hand search of references of relevant studies will be carried out and experts in the field of stroke care coordination interventions will be contacted for their knowledge about any study missed by our searches. The studies will be collated in Rayyan and duplicates removed. Study selection will be done using a study selection flow chart developed from the pre-specified eligibility criteria defined by the PICOS elements (P ─ patient, I ─ intervention, C ─ comparator, O ─ outcomes and S ─study). Quality in the included studies will be assessed for risk of bias using the Cochrane Risk of Bias tool (version 2) for Randomized Controlled Trials (RoB 2) and ROBINS-I for Non-randomized Studies of Intervention. Data will be extracted using a pre-tested data extraction form developed from Microsoft Excel. Study selection, data extraction and risk of bias assessment will be conducted independently by two reviewers (SKJO and ADA). Disagreements between the reviewers will be resolved through discussion. Risk ratio (RR) will be used as the effect measure for binary/dichotomous outcomes. For continuous outcomes mean difference (MD) with standard deviation (SD) or standardized mean difference (SMD) for outcomes measured on different instruments or scales will be used as effect measures for expressing effectiveness of care coordination interventions. Random-effects meta-analyses will be employed to pool studies, and all effects estimates will be reported with their 95% confidence interval (CI). Heterogeneity will be assessed using the I2 statistic. The overall certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). This review will attempt to identify the components of stroke-coordinated care interventions in low- and middle-income countries. It will assess whether these interventions improve clinical outcomes such as motor and cognitive functioning, mental wellbeing, mortality, and disability-adjusted life years (DALYs) of stroke survivors. The review will also explore how factors -such as stroke type, severity, and the nature of care coordination interventions (including the specific components) influence clinical, functional and psychosocial outcomes. The findings will help in determining the most effective care coordination interventions that should be adopted as care models to improve patient outcomes, whilst identifying evidence gaps for future research. This systematic review and meta-analysis protocol has been registered in PROSPERO [CRD42024587311]. The findings of the study will be shared with the relevant stakeholders and disseminated through scientific conferences and peer review publications.

Existing evidence on the burden of mental health problems among pregnant and postpartum women living with HIV, a vulnerable population in sub-Saharan Africa (SSA), is limited and fragmented, affecting the development of context-sensitive and integrated interventions. This systematic review aims to provide an up-to-date and comprehensive synthesis of available evidence to estimate the burden and identify the determinants of mental health problems among pregnant and postpartum women living with HIV across countries in sub-Saharan Africa. We will retrieve all relevant studies (published and unpublished) through searches in PubMed, Embase, PsycINFO, CINAHL, LILACS, Google Scholar, Scopus and Web of Science from inception to 30th June 2024, without language restriction. We will use the following search terms 'mental health disorder', 'mental health problem', 'pregnant women', 'postpartum women' and 'HIV' nested with all applicable alternate terms and the names of countries in SSA for running the searches. We will also search HINARI, African Index Medicus, African Journals Online, Academic Search Premier, medRxiv, ProQuest, EBSCO Open Dissertations, and reference lists of relevant studies. We will contact experts in the field for potentially relevant unpublished studies. All retrieved articles from the electronic databases and grey literature will be collated and deduplicated using Endnote and exported to Rayyan QCRI. Two reviewers will independently select studies using a pretested study selection flow chart developed from the pre-specified eligibility criteria. Two reviewers will extract data using a pretested data extraction form and assess the risk of bias in the included studies using the risk of bias tool for prevalence studies by Hoy et al. (2012). Any disagreements will be resolved through discussion between the reviewers. Binary outcomes (prevalence and incidence of mental health problems among pregnant and postpartum women living with HIV) will be evaluated using pooled proportions (for non-comparative studies) and odds ratio (OR) or risk ratio (RR) (for comparative studies), and mean difference for continuous outcomes, all will be reported with their 95% confidence intervals (CIs). Heterogeneity will be assessed graphically for overlapping CIs and statistically using the I2 statistic. If substantial heterogeneity is found, random-effects model meta-analysis will be performed; otherwise, fixed-effect meta-analysis will be employed. We will conduct subgroup analysis (to assess the impact of heterogeneity) and sensitivity analyses to test the robustness of the generated effect estimates to the quality domains. The overall level of evidence will be assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluations). The review is expected to produce an up-to-date and comprehensive synthesis of the available evidence, allowing for the generation of country-specific estimates of the burden of mental health problems among mothers living with HIV across SSA populations. Also, the review will attempt to identify the determinants of mental health problems among pregnant and postpartum women living with HIV, to shed light on the factors that contribute to the occurrence of mental health problems in this vulnerable population. The systematic review protocol has been registered in the International Prospective Register for Systematic Reviews (PROSPERO), with registration ID CRD42023468537.