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Substance use contributes to poor health and increases the risk of mortality in the homeless population. This study assessed the prevalence and risk levels of substance use and associated factors among adults experiencing homelessness in Accra, Ghana. 305 adults currently experiencing sheltered and unsheltered homelessness in Accra aged ≥ 18 years were recruited. The World Health Organization's (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to assess substance use risk levels. Association of high-risk substance use with sociodemographic, migration, homelessness, and health characteristics were assessed using logistic regression. Nearly three-quarters (71%, n = 216) of the sample had ever used a substance, almost all of whom engaged in ASSIST-defined moderate-risk (55%) or high-risk (40%) use. Survivors of physical or emotional violence (AOR = 3.54; 95% confidence interval [CI] 1.89-6.65, p<.001) and sexual violence (AOR = 3.94; 95%CI 1.85-8.39, p<.001) had significantly higher odds of engaging in high-risk substance use, particularly alcohol, cocaine, and cannabis. The likelihood of engaging in high-risk substance use was higher for men than women (AOR = 4.09; 95%CI 2.06-8.12, p<.001) but lower for those in the middle-income group compared to low-income (AOR = 3.94; 95%CI 1.85-8.39, p<.001). Risky substance use was common among adults experiencing homelessness in Accra, and strongly associated with violent victimisation, gender, and income levels. The findings highlight the urgent need for effective and targeted preventive and health-risk reduction strategies to address risky substance use in the homeless population in Accra and similar cities within Ghana and sub-Sahara Africa with a high burden of homelessness.

PurposeThis study aimed to identify barriers impeding circular economy (CE) uptake in the construction industry in literature, categorize them for the development of a framework and to seek the interrelationships among the categorized barriers. This allowed for identifying integrated solutions to holistically address the barriers. The study also sought to identify the “hot” themes, the knowledge gaps and future research directions on barriers impeding CE.Design/methodology/approachForty-eight relevant articles were desk reviewed from different construction peer-reviewed journals and published conference papers. A scientometric analysis allowed for co-occurrence of keywords relating to CE. A content analysis enabled the identification of 79 barriers impeding the uptake of CE in the construction industry which were further categorized into six distinct categories for the development of a framework showing the interrelationships among the categorized barriers.FindingsThe identified barriers include construction sector inertia, lack of design standards, lack of knowledge, awareness and understanding, design cost, and perception of second-hand materials as substandard among others. The study categorized the identified barriers for better understanding into six different groups: cultural barriers, social barriers, environmental barriers, economic barriers, technical barriers and technological barriers. Strategies to address the barriers were also proposed. The interrelationships among the various barriers were also shown in a proposed framework to educate professionals on the interconnectivity of the barriers.Practical implicationsCategorization of the various barriers impeding CE uptake contributes to the body of knowledge. Also, the interrelationships among the various categorized barriers in the framework will enable construction professionals make informed decisions regarding the successful integration of CE in the industry, better appreciate the barriers that impede CE uptake and apply strategies to holistically address the barriers. This will expand current knowledge outside the narrow scope of isolated barriers.Social implicationsTo the global construction industry, the review presents a list of barriers and their interrelationships that could provide implementation strategies for the uptake of CE in the industry.Originality/valueThe geographical scope of this study is not limited, and therefore encourages wide applicability of the findings to the global construction industry.

Purpose Aging increases the prevalence of health problems that are often chronic, resulting in more sleep problems for people with poor health or chronic conditions. Relatively fewer studies have been conducted on the relationship between sleep duration and chronic conditions in Sub-Saharan Africa compared to Western or Asian populations. This study uses a nationally representative sample of older adults in Ghana to examine the association between sleep duration and chronic conditions. Method Data were gathered from the World Health Organization Study on Global AGEing and Adult Health (SAGE) Wave 1 in Ghana ( n  = 3617). Data on duration of sleep and chronic conditions were derived from self-reported data and validated symptom reporting. Multinomial logistic regression was conducted to examine the association between sleep duration and chronic conditions. Results Women had a significantly longer period of sleep than men. Older people (> 60 years) were more likely than people under 60 years old to sleep for longer periods. The prevalence of stroke, depression, and chronic lung disease among long sleepers was high compared with short and medium sleepers. Our study found that respondents with stroke, arthritis, depression, chronic lung disease, asthma, and hypertension were likely to sleep for a long time. Conclusion This study showed a significant association between long hours of sleep and chronic conditions. To health professionals, paying particular attention to this association among older adults is medically important.

Background Homelessness is a growing concern as it affects a large number of people worldwide. Individuals and families experiencing homelessness are vulnerable in terms of health and underutilise health services. Despite being a global problem, not much is known about the range and breath of literature exploring health problems and health care service utilisation among homeless adults in Africa. Objectives To identify the nature and scope of existing evidence on physical and mental health, and health service utilisation among homeless adults in Africa. The review aimed to examine how research is conducted, identify gaps, guide future research, and make recommendations for development and implementation of policies and practices. Methods A search of articles and reports involving six databases: Scopus, MEDLINE, CINAHL, PubMed, African Journal Online, and Google Scholar was conducted from June 2018 to February 2019. Studies published between 1980 and 2019 that examined the health problems and health service utilisation among homeless adults in Africa were considered. Manual search in reference lists and grey literature was also done to add reports. Data was extracted manually using a charting developed. A descriptive analysis and narrative synthesis were performed. Results Of 761 records found, 14 satisfied the pre-determined inclusion and exclusion criteria. Three themes emerged from the studies: Physical health problems, mental health problems; and healthcare services utilisation. Of the 14 included studies, nine studied and reported physical health problems such as sexually transmitted infections, injuries and disabilities, respiratory and cardiac diseases. Five studies explored mental health problems such as psychotic disorders, mood disorders, self-harm and suicidal behaviour. Only five studies investigated utilisation of different types of health care services among homeless people. Conclusions Evidence shows that homeless adults suffered from a range of physical and mental health problems, and underutilisation of health care services. However, there is lack of information on the complex interrelationship between homelessness and health, as well as differences in prevalence of health problems among the various sub-groups of homeless. There is also lack of information regarding utilisation other important healthcare services such as mental health services, alcohol and drugs services, and accident and emergency service, and future researches should address that. Also, attention should be given to intervention models for complex and effective physical and psychiatric care as well as social support to address the homeless people’s health vulnerabilities.

The aim of the study was to investigate university students’ use of the Internet for health purpose in the Ghanaian context. The study employed a quantitative cross-sectional design. A total of 650 out of 740 students selected from 3 different universities participated, giving a response rate of 87.7% (650/740). Data were obtained using questionnaires and frequency and percentages were used to analyze data. The results show that university students are active users of the Internet as 78.3% (509/650) used Internet daily and 67.7% (440/650) use Internet for health purposes, for reasons including availability and ease of accessing information, privacy, confidentiality, and affordability. Use of Internet was constrained by unreliable and slow connection, high cost of Internet, and unreliable power supply. Also, 72.4% (315/435) used the online health information obtained as a basis for lifestyle change and only 39.5% (170/430) consulted health professionals after obtaining online information. The study concludes that students use Internet to seek online health support. The use of Internet to communicate with young people in relation to their health must therefore be explored. There is the need to be aware of online safety issues for young adults, including the need to provide information on privacy options.

Background Most research on the homeless population has focused on the negative attributes and adversities they face. While these are important issues for research, focusing on them alone through a deficit lens may further advance the belief that such people have little or no capacities and skills for survival. This study seeks to address this gap by exploring the resilience of people experiencing homelessness in Accra, Ghana. Methods Qualitative data were collected via in-depth interviews with 27 purposively sampled homeless adults aged 18 + years. Interview data were analysed using interpretative phenomenological analysis. Results Three main themes were identified from the data: internal/individual resilience including their personal strengths; survival through resourcefulness including diversified income sources; and aspects of the participants’ social and physical ecology (facilitative environment) that protect against homelessness-related adversities. Conclusions This study provides some valuable insights into sources of resiliency for people experiencing homelessness in Ghana. The study’s findings highlight the need for government to provide adequate housing, resources, and targeted policies and interventions for the homeless population in Accra and other similar settings.

PurposeEmployee unsafe behaviours and failure to adhere to safety standards resulting from poor safety perception among employees contribute to the high rate of accidents in the construction industry. This study seeks to examine the role of respectable engagement in improving construction workers' safety perceptions in the Ghanaian Construction Industry.Design/methodology/approachThe study adopted a quantitative research method where survey questionnaires were administered to respondents. Sixty-six construction workers who were actively involved in ongoing construction projects in Kumasi and Greater Accra regions of Ghana were selected through stratified purposive sampling. The analytical tools utilised in the data analysis include a one-sample t-test, descriptive statistics and mean score ranking.FindingsThe study identified five key drivers and strategies of respectable engagement from pertinent literature. The findings confirmed that all these drivers and strategies play a key role in improving workers' safety perception. The study further revealed that improving employees' safety perception will enhance and sustain their awareness of the organisation's commitment to health and safety. Employees will therefore portray positive safety behaviour by adhering to the safety standards of their organisation.Practical implicationsThe findings of this study will contribute to construction site safety improvement by informing contractors, site supervisors and other stakeholders of their role and the need to improve their worker's safety perception.Originality/valueThis research is unique in that; it identifies the role of respectable engagement in improving construction workers' safety perception. This research creates awareness among management and site supervisors on the need to be present for their workers, affirm them, attend to their needs, understand and appreciate them, and communicate and listen to them.

PurposeThis research presents a comprehensive review of the literature on the barriers to incorporating indoor environmental quality (IEQ) principles into building designs. The aim was to identify these barriers in the literature and subsume them under broad categories for the development of a framework showing the interrelationships among the barriers.Design/methodology/approachThe research design used a systematic desktop review which comprised of three levels of screening. The first level allowed for a broad selection of papers; the second level of screening was done to limit the results to papers within the construction industry, and the third level of screening limited the documents strictly to the publication period of 2000–2021.FindingsTwenty-four (24) barriers were identified in the literature, including lack of integrated design teams, which ranked the highest in appearance, high initial costs, poor market for IEQ buildings and higher design charges among others. The identified barriers were classified into six (6) categories namely capacity barriers, economic barriers, process-related barriers, cultural barriers, client-related barriers and steering barriers.Practical implicationsThe findings of this study would enable practitioners and policymakers to better understand what is preventing the widespread adoption of IEQ designs in the built environment and devise actionable strategies to overcome them. It adds to the body of knowledge on IEQ research by categorizing the various barriers that prevent the delivery of IEQ projects.Social implicationsThe developed barriers in this research can serve as a useful checklist to future researchers who may want to validate the barriers to IEQ designs in empirical studies and in different settings.Originality/valueThe interconnectivity revealed by the web-like framework allows for an appreciation of the various barriers of IEQ adoption which would help in expanding the current knowledge on IEQ beyond the narrow scope of isolated barriers. The fact that the papers selected in this study are not limited geographically, underscores the wide applicability of the findings in the global construction industry.

Purpose>The aim of this study was to identify these enablers in literature and subsume them under broad categories for the development of a framework showing the interrelationships among the enablers.Design/methodology/approach>Fifty-four (54) relevant articles were desk reviewed from different construction peer-reviewed journals and published conference proceedings to identify 20 core enablers of incorporating indoor environmental quality (IEQ) into building designs.Findings>The identified enablers include improved occupants' health, well-being and satisfaction, environmental conservation, high return on investments and co-operative methods of design and construction management among others. To better understand the enablers identified, they were classified into seven main interconnected categories: economic enablers, environmental enablers, occupant and end-user enablers, process enablers, corporate image, culture and vision enablers, client-related enablers and external enablers.Research limitations/implications>The interconnectedness brought to the fore a subtler appreciation of the drivers of IEQ, which could help expand current knowledge outside the narrow scope of isolated drivers. The fact that the papers selected in this study are not limited geographically underscores the wide applicability of the findings to the global construction industry.Practical implications>Understanding that the enablers will enhance the adoption and design of quality indoor environments, help in building the capacity of consultants to adopt the design of quality IEs and reduce the impact of construction on the environment.Social implications>These identified enablers are not limited geographically and thus could promote the design of quality indoor environments globally, particularly in green building design. To the global construction community, this review presents a list of enablers that would expedite the adoption of principles of IEQ designs in buildings thus taking the global construction industry one more step towards sustainable built forms. Promoting the identified enablers would ultimately steer stakeholders to design and build better indoor environments.Originality/value>The fact that the papers selected in this study are not limited geographically underscores the wide applicability of the findings to the global construction industry.

The proliferation of illegal mining in Ghana, coupled with its environmental impacts, especially on water bodies has compelled the government to ban all artisanal small-scale mining (ASM) activities in the country. The ban is intended to promote environmental sustainability while the government takes steps to provide sustainable health, and environmental-friendly ASM in Ghana. This paper assesses the perception of registered miners on the current approach by the Ghanaian government to stop illegal mining. Analyses of data from focus group discussions and key informant interviews revealed that the miners felt “left out” of the entire process. They maintained that they were not directly involved in the process to ban illegal mining in Ghana. To them, the proliferation of illegal mining in Ghana is the result of non-performing government institutions, corruption, and cumbersome licensing procedures. The article calls for improvement in the collaboration between the government and miners through a simplified participatory framework for the management of ASM in Ghana.