61 research outputs found
The SAGE Encyclopedia of Marriage, Family, and Couples Counseling
No full textStephaney Morrison is a contributing author, Counseling African American Families (pp.54-57), Racial disparities in social welfare (pp.1361-1364).
The SAGE Encyclopedia of Marriage, Family and Couples Counseling is a new, all-encompassing, landmark work for researchers seeking to broaden their knowledge of this vast and diffuse field. Marriage and family counseling programs are established at institutions worldwide, yet there is no current work focused specifically on family therapy. While other works have discussed various methodologies, cases, niche aspects of the field and some broader views of counseling in general, this authoritative Encyclopedia provides readers with a fully comprehensive and accessible reference to aid in understanding the full scope and diversity of theories, approaches and techniques and how they address various life events within the unique dynamics of families, couples and related interpersonal relationships. Key topics include: • Adolescence • Adoption • Assessment • Communication • Coping • Diversity • Divorce and Separation • Interventions and Techniques • Life Events/Transitions • Parenting Styles • Sexuality • Work/Life Issues, and more Key features include: • More than 500 signed articles written by key figures in the field span four comprehensive volumes • Front matter includes a Reader’s Guide that groups related entries thematically • Back matter includes a history of the development of the field, a Resource Guide to key associations, websites, journals, a selected Bibliography of classic publications, and a detailed Index • All entries conclude with References/Further Readings and Cross References to related entries to aid the reader in their research journeyhttps://digitalcommons.fairfield.edu/education-books/1051/thumbnail.jp
Teaching through Challenges for Equity, Diversity, and Inclusion (EDI)
No full textStephanie Burrell Storms and Jay Rozgonyi (with Kathi Rainville) are contributing authors, From Awareness to Action: Creating PSAs to Promote EDI, Chapter 5.
Betsy Bowen is a contributing author, Disturbing Voices: Literacy in the Archive and the Community, Chapter 6.
Paula Gill-Lopez is a contributing author, Know Thyself: Implicit Bias and Mindfulness, Chapter 8.
Stephaney Morrison is a contributing author, A Person-Centered Approach to Facilitate Students’ Social Advocacy, Chapter 11.
Colleges and universities cannot ignore the increasingly diverse student population in their classrooms, and how a focus on equity, diversity, and inclusion across disciplines trains students in the intercultural awareness they will need in competitive job markets. Yet while faculty may be aware of a need to understand EDI goals in relationship to their disciplines, and institutions may support EDI in theory, the onus of pedagogical training in EDI often falls on individual faculty. This book was written by faculty and administrators for educators who value the goals of EDI, and seek an intellectual community to help them develop their practice. Important to this book is an honest discussion of common challenges faculty may face when they engage in this difficult work, and effective strategies for addressing those challenges. The chapters are grouped according to six different themes: respect for divergent learning styles; inclusion and exclusion; technology and social action; affective considerations; reflection for critical consciousness; and safe spaces and resistance.https://digitalcommons.fairfield.edu/education-books/1065/thumbnail.jp
Climate, Air Quality and Their Contribution to Cardiovascular Disease Morbidity and Mortality in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis
No full textBACKGROUND: Increasing exposure to climatic features is strongly linked to various adverse health outcomes and mortality. While the link between these features and cardiovascular outcomes is well established, most studies are from high-income countries. OBJECTIVES: This review synthesizes evidence as well as research gaps on the relationship between climate indicators, household/ambient air pollution, and all-cause cardiovascular disease (CVD) morbidity and mortality in low- and middle-income countries (LMICs). METHODS: Seven electronic databases were searched up to June 15, 2024. Articles were included if they focused on LMICs, addressed all-cause CVD morbidity and/or mortality, and studied climate or environmental exposures. Studies were selected using ASReview LAB, extracted and analyzed with random effect meta-analysis performed if sufficient articles were identified. RESULTS & CONCLUSION: Out of 7,306 articles, 58 met the inclusion criteria: 26 on morbidity, 29 on mortality, and 3 on both. Exposures included PM10, PM2.5, NO2, SO2, BC, O3, CO, solid fuel usage, and temperature variation. Short-term exposure to PM2.5 was significantly associated with CVD morbidity (RR per 10 µg/m3 increase:1.006, 95% CI 1.003-1.009) and mortality (RR:1.007, 95% CI 1.002-1.012). Short-term exposure to NO2 and O3 also increased CVD mortality risk. Long-term exposure to PM2.5 elevated CVD morbidity (RR per 10 µg/m3 increase:1.131, 95% CI 1.057-1.210) and mortality (RR:1.092, 95% CI 1.030-1.159). High and low temperatures and long-term solid fuel use were linked to CVD deaths. The bulk of studies were from mainland China (72%), which may not accurately reflect the situation in other LMICs. Sub-Saharan Africa was particularly lacking, representing a major research gap
Potential effect modification of RTS,S/AS01 malaria vaccine efficacy by household socio-economic status.
No full textBACKGROUND: In the phase III RTS,S /AS01 trial, significant heterogeneity in efficacy of the vaccine across study sites was seen. Question on whether variations in socio - economic status (SES) of participant contributed to the heterogeinity of the vaccine efficacy (VE) remains unknown. METHODS: Data from the Phase III RTS,S /AS01 trial in children aged 5-17 months in Kintampo were re-analysed. SES of each child was derived from the Kintampo Health and Demographic Surveillance System, using principal component analysis of household assets. Extended Cox regression was used to estimate the interaction between RTS,S/AS01 VE and household SES. RESULTS: Protective efficacy of the RTS,S/AS0 vaccine significantly varied by participant's household SES, thus increase in household SES was associated with an increase in protective efficacy (P-value = 0.0041). Effect modification persisted after adjusting for age at first vaccination, gender, distance from community to the health facility, child's haemoglobin level, household size, place of residence and mothers' educational level. CONCLUSION: Household SES may be a proxy for malaria transmission intensity. The study showed a significant modification of the RTS,S/AS01 malaria vaccine efficacy by the different levels of child's household socio - economic status. TRIAL REGISTRATION: Efficacy of GSK Biologicals' candidate malaria vaccine (25049) against malaria disease in infants and children in Africa. NCT00866619 prospectively registered on 20 March 2009
Geospatial analysis of malaria mortality in the kintampo health and demographic surveillance area of central Ghana
No full textMalaria remains a menace to the existence of humanity in most contexts. Geospatial analysis of malaria mortality is crucial to identifying clusters of high disease burden and areas with limited access to malaria care for targeted control and remedial interventions. This study identified spatial and space-time clusters of malaria mortality in the Kintampo area of central Ghana. We used 1301 malaria deaths archived from 2005 to 2017 and Global Positioning System (GPS) point locations of the sub-districts in which these deaths occurred for our analysis. Mortality risks were smoothed and mapped using the Spatial Empirical Bayesian smoothing technique in Geoda (version 1.12.1.161) whereas spatial and spatio-temporal clustering analysis was done using SaTScan (version 9.6). Malaria mortality risks ranged between 1.2 and 2.4 deaths per 1000 population for persons of all ages and between 3.3 and 6.0 deaths per 1000 population for children under five years of age by sub-district. Two spatial clusters were detected for all-age malaria mortality with only the primary cluster (RR = 1.42, p = 0.001) being statistically significant. Also, two statistically significant space-time clusters were detected for all-age malaria mortality in the study area. The most likely cluster occurred between 2006 and 2011 in five sub-districts with a relative risk of 2.12 (p < 0.001) whilst the secondary cluster which had a relative risk of 2.47 (p < 0.001) occurred between 2005 and 2010 in four sub-districts. Similarly, only the most likely spatial cluster of under-five malaria mortality was statistically significant (RR = 1.36, p = 0.024). Furthermore, three spatio-temporal clusters of under-five malaria mortality were detected in the study area. The primary and second secondary clusters were statistically significant whilst the first secondary cluster had borderline significance. The primary cluster (RR = 4.49, p = 0.002) occurred in two sub-districts between 2006 and 2007. The first secondary cluster (RR = 2.21, P = 0.005) covered four sub-districts and was detected between 2006 and 2011 whereas the second secondary cluster (RR = 2.51, p = 0.003) covered two sub-districts between 2008 and 2013. Ultimately, our analysis identified a number of substantial spatial and apace-time clusters of malaria mortality in the study context, which could aid in the strategic planning, implementation and monitoring of targeted malaria control interventions
Prevalence and determinants of caesarean section deliveries in the Kintampo Districts of Ghana
No full textAbstract Background Globally, the increasing rate of caesarean section (CS) delivery has become a major public health concern due to its cost, maternal, neonatal, and perinatal risks. In Ghana, the Family Health Division of the Ghana Health Service in 2016 opted to initiate a program to prevent the abuse of CS and identify the factors contributing to its increase in the country. This study aimed to determine the prevalence and factors influencing CS deliveries in the Kintampo Districts of Ghana. Methods The current study used secondary data from the Every Newborn–International Network for the Demographic Evaluation of Populations and their Health (EN-INDEPTH) project in Kintampo, Ghana. The outcome variable for this study is CS delivery. The predictor variables were socio-demographic and obstetric factors. Results The prevalence of CS delivery in the study area was 14.6%. Women with secondary education were 2.6 times more likely to give birth by CS than those with primary education. Unmarried women were about 2.5 times more likely to deliver by CS compared to those who were married. There was an increasing order of CS delivery among women in the wealthy quintiles from poorer to richest. The likelihood of women with gestational ages from 37 to 40 weeks to give birth by CS was about 58% less compared to those with less than 37 gestational weeks. Women who had 4–7 and 8 or more antenatal care (ANC) visits were 1.95 and 3.5 times more likely to deliver by CS compared to those who had less than 4 ANC visits. The odds of women who have had pregnancy loss before to deliver by CS was 68% higher compared to women who have not lost pregnancy before. Conclusions Caesarean section delivery prevalence in the study population was within the Ghana Health Service and World Health Organization ranges. In addition to known socio-demographic and obstetric factors, this study observed that a history of pregnancy loss increased the chances of a woman undergoing a CS. Policies should aim at addressing identified modifiable factors to stem the rise in CS deliveries
Determinants of the varied profiles of Plasmodium falciparum infections among infants living in Kintampo, Ghana.
No full textBACKGROUND: Understanding why some infants tolerate infections, remaining asymptomatic while others succumb to repeated symptomatic malaria is beneficial for studies of naturally acquired immunity and can guide control interventions. This study compared demographic, host and maternal factors associated with being either parasite negative or having asymptomatic infections versus developing symptomatic malaria in the first year of life. METHODS: A birth cohort (n = 1264) was monitored longitudinally over two years for malaria infections in Kintampo, Ghana. Symptomatic and asymptomatic infections were detected actively through monthly home visits, complemented by passive case detection. Light microscopy was used to detect parasitaemia. Based on data from a minimum of eight monthly visits within the first year of life, infants were classified into one of four groups: "parasite negative", "only-asymptomatic", "only-symptomatic" or "alternating" i.e., sometimes symptomatic and other times asymptomatic. The host and maternal characteristics and demographic factors in relation to these four groups were compared. RESULTS: The parasite negative group formed 36% of the cohort, whilst the only-symptomatic were 35%. The alternating group were 22% and the only-asymptomatic were 7% of the cohort. There were significant associations between residence, socio-economic status (SES), parity, IPTp doses, delivery place of infant and having or not having malaria parasites. Maternal factors such as early commencement and frequency of ante-natal care (ANC) were significantly higher in the parasite negative group compared to all others. ITN use in pregnancy increased the odds of infant having only asymptomatic infections ("protected against disease"). Placental malaria was more common in the groups of infants with symptomatic malaria. Urban residence was significantly higher in the parasite negative group, while birth in the malaria transmission season were significantly more common in the alternating and parasite negative groups. Risk factors for infants with symptomatic malaria included low SES, birth in private maternity homes, sickle cell normal variant, lower MUAC, reported intake of anti-malarials and increased morbidity before the first microscopic infection was detected. CONCLUSION: Strengthening ANC by encouraging early and regular attendance, the use of IPTp, maternal bed nets and improving the nourishment of infants help reduce the frequency of symptomatic malaria over the first year of life
Malaria in infants : asymptomatic and symptomatic infections the first year of life
No full textMalaria causes the majority of deaths in children below five years of age, but asymptomatic infections are more frequent. An understanding of the interplay of human and parasite factors which predispose to symptomatic malaria has guided clinical and preventive practices including intermittent preventive treatment and bed net usage, to reduce the global malaria burden. Yet, the asymptomatic state which potentially offers a window for understanding protection against symptomatic malaria is rarely monitored.In-depth knowledge of how individuals with parasites are protected against symptoms at one time but not another time is needed. In this thesis, the overall aim was to identify over time, the unique characteristics of asymptomatic infections, for in-depth understanding of protection against symptomatic malaria in the first year of life. Therefore, the host and parasite factors influencing susceptibility to Plasmodium falciparum asymptomatic infections or symptomatic malaria were investigated among 1264 infants followed from birth to twelve months of age in Kintampo, a high malaria transmission area of Ghana.In study I we profiled the monthly order of malaria parasite positivity detected by light microscopy at scheduled home (19231 visits) and unscheduled hospital visits (5254 visits) and distinguished periods of asymptomatic infection from symptomatic malaria. We discovered four main longitudinal sequence patterns of infection: some infants had (i) only symptomatic infections, some (ii) only asymptomatic infections, (iii) both symptomatic and asymptomatic infections (iv) and some infants were parasite negative throughout the first year of life. There was significant variation in parasite densities and age at infection between the groups of infants.In study II, we investigated the maternal, host genetic, demographic and parasite parameters which predisposed the groups of infants to symptomatic malaria or asymptomatic infections. Improved socio-economic status, adequate antenatal care, less exposure of mothers to malaria during pregnancy and improved nourishment of infants were associated with reduced symptomatic malaria in the first year of life.In study III, we used qPCR to study in-depth the extent of parasite positivity below the detection limit of light microscopy within the infection patterns discovered in study I. The qPCR, rather than the microscopy, detected symptomatic and asymptomatic infections frequently in the scheduled home and unscheduled hospital visits, and particularly asymptomatic infections in the first six months of life. By qPCR, parasites undetected by microscopy were found in the four microscopy-defined sequence patterns of infection, and while some infants were still parasite negative, others remained with either asymptomatic infections only or alternating asymptomatic infections and symptomatic malaria through the first year of life. The findings show many undiagnosed infections and suggests complexity of protection against symptomatic malaria that is highly influenced by socio-economic status and that partly begins in utero.We conclude that frequent sampling and analysis by molecular methods were useful for identifying the complete infection profiles and the determinants of protection against symptomatic malaria in infants living in a high malaria transmission area. Despite living in the same transmission area, infants experienced diverse patterns of symptomatic and asymptomatic P. falciparum infections the first year of life. Further understanding of the underlying mechanisms for asymptomatic infections will help improve malaria control and elimination strategies.List of scientific papersI. Akua Kyerewaa Botwe, Seth Owusu-Agyei, Muhammad Asghar, Ulf Hammar, Felix Boakye Oppong, Stephaney Gyaase S, David Dosoo, Gabriel Jakpa, Ellen Boamah E, Mieks Frenken Twumasi, Faith Osier, Anna Färnert, Kwaku Poku Asante. Profiles of Plasmodium falciparum infections detected by microscopy through the first year of life in Kintampo a high transmission area of Ghana. PLoS ONE. 2020. 15(10). https://doi.org/10.1371/journal.pone.0240814 II. Akua Kyerewaa Botwe, Felix Boakye Oppong, Stephaney Gyaase, Seth Owusu-Agyei, Muhammad Asghar, Kwaku Poku Asante, Anna Färnert, Faith Osier. Determinants of the Varied Profiles of Plasmodium falciparum Infections among Infants Living in Kintampo, Ghana. Malaria Journal. 2021. 20 (1): p. 240. https://doi.org/10.1186/s12936-021-03752-9 III. Akua Kyerewaa Botwe, Latifatu Alhassan, Seth Owusu-Agyei, Felix Boakye Oppong, Anna Leber, Kristine Bilgrav Sæther, David Plaza, Kwaku Poku Asante, Faith Osier, Muhammad Asghar#, Anna Färnert#. Submicroscopic Plasmodium falciparum infections detected by PCR in monthly samples from birth among infants in Kintampo, Ghana. #These are shared last authors. [Manuscript]</p
Opinions of Health Professionals on Tailoring Reproductive Health Services to the Needs of Adolescents
No full textIntroduction. Tailoring sexual and reproductive health programs and services to the needs of adolescents will help adolescents make informed decisions and choices regarding their sexual and reproductive health. Objective. To assess the opinions of service providers on tailoring sexual and reproductive health services to the needs of adolescents. Method. A qualitative study using indepth interviews was held among eight decision-makers and service providers in two hospitals within the Kintampo North Municipality and Kintampo South District as well as the Municipal and District Health Directorates in Kintampo North and South between April and May 2011. Results. All respondents expressed the opinion that it is a good idea to tailor sexual and reproductive health services to the needs of adolescents. They admitted that very limited sexual and reproductive health programs targeting adolescent needs were available in the study area. Service providers also reported very low levels of health facilities use by adolescents for sexual and reproductive health information and services. Health professionals attributed the poor sexual and reproductive health services utilization by adolescents to stigma from the society and attitudes of service providers. Conclusion. There are no targeted sexual and reproductive health programmes and services for adolescents. Services providers indicated that it is important to tailor sexual and reproductive health services to the needs of adolescents to prevent stigma, unwanted pregnancy, abortion, and sexually transmitted infections.</jats:p
Intermittent preventive treatment of pregnant women in Kintampo area of Ghana with sulphadoxine-pyrimethamine (SP): trends spanning 2011 and 2015.
No full textOBJECTIVE: In Ghana, intermittent preventive treatment during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) is recommended for the prevention of malaria-related adverse outcomes. This study demonstrates the coverage of IPTp-SP use among pregnant women over a period (2011-2015) and the impact of various sociodemographic groups on the uptake of IPTp-SP. DESIGN: Retrospective analysis using data from all pregnant women in the Kintampo Health and Demographic Surveillance System area on the uptake of IPTp-SP. SETTING: Kintampo North Municipality and Kintampo South District of Ghana. PARTICIPANTS: All pregnant women in the Kintampo Health and Demographic Surveillance System area. PRIMARY AND SECONDARY OUTCOME MEASURES: The number of doses of IPTp-SP taken by pregnant women were examined. Logistic regression was used to assess the determinant of uptake of IPTp-SP while adjusting for within-subject correlation from women with multiple pregnancies. RESULTS: Data from 2011 to 2015 with a total of 17 484 pregnant women were used. The coverage of the recommended three or more doses of IPTp-SP among all pregnant women was 40.6%, 44.0%, 45.9%, 20.9% and 32.4% in 2011, 2012, 2013, 2014 and 2015, respectively. In the adjusted analysis, age, household size, education, religion, number of antenatal care visits, ethnicity, marital status, wealth index and place of residence were significantly associated with the uptake of three or more doses of IPTp-SP. Having middle school education or higher, aged 20 years and above, visiting antenatal care five times or more (OR 2.83, 95% CI 2.64 to 3.03), being married (OR 1.10, 95% CI 1.02 to 1.19) and those in higher wealth quintiles were significantly more likely to take three or more doses of IPTp-SP. CONCLUSION: The uptake of the recommended three or more doses of IPTp-SP is low in the study area. We recommend a community-based approach to identify women during early pregnancy and to administer IPTp-SP
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