Sexual lives and reproductive health outcomes among persons with disabilities: a mixed-methods study in two districts of Ghana.

INTRODUCTION: People with disabilities (PwDs) constitute a large and diverse group within the global population, however, their sexual and reproductive health (SRH) needs are often neglected, particularly in low-and middle-income countries. This may result in adverse outcomes, such as sexually transmitted infections (STIs), unintended pregnancies, and experience of interpersonal violence (IV). This study aimed to assess the factors that influence the sexual lives of PwDs in two districts of Ghana. METHODS: A sequential explanatory mixed-methods study design was used to collect data from PwDs. Quantitative data were obtained from 402 respondents using a pretested questionnaire, and qualitative data gathered from 37 participants using in-depth interviews. The quantitative data were analysed using descriptive and inferential statistics, while the qualitative data were analysed using inductive thematic analysis. RESULTS: Most PwDs (91%) reported that they have ever had sex, which was associated with age, disability severity, and household size. The prevalence of poor SRH status, STIs, unintended pregnancy, pregnancy termination, and unsafe abortion were 10.5%, 5.7%, 6.4%, 21.6%, and 36.9% respectively. These outcomes were influenced by education, income, health insurance subscription, and proximity to a health facility. The prevalence of IV was 65%, which was related to disability type and severity. The qualitative data revealed five main themes: curiosity to engage in sexual activities, feelings of despair and insecurity with abled partners, preference for sexual relationships with other PwDs, IV and its perpetrators, and adverse SRH outcomes. CONCLUSION: The study findings indicate that most adult PwDs have ever had sex and they face various challenges in their sexual lives. They experience multiple forms of abuse and neglect from different perpetrators at different levels of society, which have negative impacts on their well-being. There is a need for comprehensive and inclusive interventions that address the SRH needs of PwDs, as well as the underlying social and structural factors that contribute to their vulnerability. Further research is recommended to explore the perspectives of stakeholders on how to improve the SRH outcomes of PwDs.

People with disabilities make up 16 percent of the world population, but their sexual and reproductive health (SRH) needs are often unmet, especially in poorer countries, contributing to adverse outcomes. This study assessed factors influencing the sex lives of PwDs in two districts of Ghana. Quantitative data were collected from 402 respondents, while qualitative data were collected from 37 participants. The results showed that age, severity of disability, and household size influence sexual activity. Many respondents also reported adverse SRH issues including STIs and unintended pregnancies. Sixty-five percent reported experiencing violence or abuse, which is related to their disability type and severity. The study also found that PwDs encounter many challenges in their sexual lives, including abuse and neglect. The findings suggest the need to pay attention to the sexual health needs and the social issues that make PwDs vulnerable to various abuses.

A mixed-methods study of the awareness and functionality of sexual and reproductive health services among persons with disability in Ghana.

BACKGROUND: Persons with disabilities (PwDs) face barriers in accessing sexual and reproductive health (SRH) services due to lack of knowledge and awareness, stigma and discrimination, and inadequate service provision. This study aimed to examine the determinants of SRH knowledge and awareness among PwDs in Ghana, and to explore their perceptions of the functionality of SRH services. METHODS: A sequential explanatory mixed-methods study design was used to collect and analyse quantitative (n = 402) and qualitative (n = 37) data from PwDs in two districts in Ghana. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data was analysed thematically. RESULTS: Most of the participants had high awareness of SRH (94.3%), sexually transmitted infections (STIs) (92.5%) and HIV/AIDS (97.0%). Employment status was positively associated with SRH awareness [aOR = 1.62; 95% CI = 1.02, 2.59]. Disability type was a significant predictor of STI [aOR = 2.02; 95% CI = 1.39, 2.94] and HIV/AIDS [aOR = 2.32; 95% CI = 1.21, 4.44] awareness, with the visually impaired having higher odds than the physically disabled. Age group was also a significant predictor of STI awareness, with older respondents having higher odds than younger ones [aOR = 1.76; CI = 1.01,3.05 for 30-39 years; aOR = 2.48; CI = 1.22, 5.05 for 40-49 years]. The qualitative findings revealed four main themes: conceptualisation of SRH, active engagement in SRH information seeking, tensions between knowledge and religious beliefs and perceived utility of SRH services. CONCLUSION: Despite the high levels of SRH knowledge and awareness among PwDs, there are significant gaps and challenges related to disability type, age group, misconceptions, beliefs, and service non-functionality that limit the utility of SRH services. The findings call for tailored education to reduce misconceptions and put in pragmatic steps to deliver quality SRH services and information to PwDs. Further research is needed to assess the sexual lives of PwDs and explore the perspectives of all relevant stakeholders, including service providers and policymakers on how to enhance SRH outcomes for PwDs in Ghana.

People with disability often encounter barriers in access sexual and reproductive health (SRH) services. These challenges arise from a lack of understanding and awareness about these services, stigma, and discrimination as well as unavailability of these services. This study sought to assess the extent of SRH knowledge and awareness among persons with disabilities (PwDs) in Ghana and to investigate their perceptions of the functionality of SRH services. To accomplish this, a study design that combined both quantitative and qualitative research methods was employed. The study collected and analysed data from 402 PwDs in two districts of Ghana. The quantitative data were subjected to descriptive and inferential statistical analyses, whereas the qualitative data, were thematically analysed. The findings indicated that a substantial number of participants demonstrated high awareness of SRH, including sexually transmitted infections (STIs) and HIV/AIDS. The participants' employment status was positively associated with their level of SRH awareness. Additionally, the type of disability played a significant role in predicting awareness of STIs and HIV/AIDS. Visually impaired individuals exhibited a greater likelihood of awareness compared to those with physical disabilities. Age also influenced STI awareness, with older respondents showing higher levels of awareness than their younger counterparts. Qualitative analyses unveiled four main themes: how SRH is conceptualised, the active seeking of SRH information, the tension between knowledge and religious beliefs, and the perceived usefulness of SRH services. The study concluded that PwDs have a high level of SRH knowledge and awareness. However, it identified gaps and challenges that stem from differences in disability type, age group, misconceptions, religious beliefs, and the effectiveness of the services provided. To address these issues, the study recommends tailored educational interventions to meet the unique needs and concerns of PwDs in relation to SRH. Furthermore, enhancing the quality and accessibility of SRH services for this population is suggested. The study underscores the need for further research on the sexual lives of PwDs and the views of stakeholders on how to enhance their SRH outcomes are needed.

"God is my only health insurance": a mixed-methods study on the experiences of persons with disability in accessing sexual and reproductive health services in Ghana.

Background: Access to sexual and reproductive health (SRH) services is a fundamental human right, but people with disabilities (PwDs) in low-and middle-income countries often face multiple barriers to utilisation. This study aimed to assess the level of SRH services utilisation and the enabling and inhibiting factors among PwDs in Ghana's Ashanti region. Methods: A sequential explanatory mixed-methods study design was employed, involving quantitative (n = 402) and qualitative (n = 37) data collection from PwDs. Quantitative data were analysed using descriptive and inferential statistics, while qualitative data were analysed using inductive thematic analysis. Results: The study found that only 33.8% of the PwDs had ever used SRH services. Utilisation was associated with sex, marital status and travel duration to health facility. The qualitative data revealed that factors at the individual, family/community and health facility levels influenced utilisation of SRH services, acting as both enablers and barriers. Conclusion: PwDs had relatively low utilisation of SRH services in Ghana's Ashanti region. To increase utilisation, it is recommended to address the stigma and discrimination towards PwDs, provide more training for healthcare providers, improve the accessibility of healthcare facilities, and strengthen the national health insurance scheme. Further research could explore PwDs' SRH outcomes and strategies to improve these outcomes in Ghana.

From talk to action: Developing a model to foster effective integration of traditional medicine into the Ghanaian healthcare system.

This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point. Elements of an integrative healthcare delivery model including philosophies/values, structure, process and outcome were used to conduct a quality assessment of the integrated health system in Ghana. Each element clearly showed that Ghana is currently not running a coordinated health practice model, thus making it a tolerant, rather than an inclusive, health system. Therefore, the primary purpose of this research is to discuss the development of a new and appropriately customised model that could enhance the practice of integrated healthcare in Ghana. The model we present has flexibility and far-reaching applicability in other African countries because such countries share similar socio-cultural and economic characteristics. As such, governments and health practitioners could adapt this model to improve the practice of integrated healthcare in their specific settings. Hospital administrators and health system researchers could also adapt the model to investigate or to monitor the progress and efficacy of integrated healthcare practices within their settings. This might help to understand the relationships between the integration of traditional medicine and health outcomes for a given population. Please cite this article as: Ampomah IG, Malau-Aduli BS, Malau-Aduli AEO, Emeto TI. From talk to action: Developing a model to foster effective integration of traditional medicine into the Ghanaian healthcare system. J Integr Med. 2023; 21(5): 423-429.

A Systematic Review of the Factors That Influence Teachers' Occupational Wellbeing.

Teachers belong to a high-demand occupational group and experience work-related challenges and discretely diverse emotional turmoils of varying intensity while teaching and interacting with students. These experiences often result in high stress levels that contribute to burnout and, consequently, a breach of teachers' occupational wellbeing. Promoting positive teacher wellbeing substantially influences teaching quality, with a flow-on effect on student wellbeing and academic development. This literature review utilised a framework to systematically explore the factors that impact the occupational wellbeing of kindergarten, primary, and secondary schoolteachers. Thirty-eight (38) studies from an initial 3766 peer-reviewed articles sourced from various databases (CINAHL, Emcare, PychINFO, Scopus, ERIC, and PsycARTICLES) were utilized for this systematic review. Four major factors were identified, including personal capabilities, socioemotional competence, personal responses to work conditions, and professional relationships. Findings highlight the importance of teachers' occupational wellbeing in dealing with numerous challenges and competing demands, with the need for a high level of self-efficacy for instruction and behavioural management being critically significant. Teachers require adequate organisational support to successfully carry out their roles with stronger resilience and efficient job execution. Teachers also need to have social-emotional competence to be able to create a high-quality classroom environment and a conducive atmosphere that supports healthy teacher-student relationships, reduces stress and increases the occupational wellbeing of teachers. Collaborating with other relevant stakeholders such as parents, colleagues, and a school's leadership team is critical for creating a positive work environment. A good workplace has the potential to contribute to teachers' occupational wellbeing and provide a supportive platform for student learning and engagement. This review clearly points to the beneficial effects of prioritising teachers' occupational wellbeing and its intentional inclusion in the professional development plan of practising teachers. Finally, while primary school teachers and secondary school teachers share many similarities in terms of the challenges they face, there are also some differences in how these challenges impact their wellbeing, and these warrant further investigation.

"Sex Should Not Be Part of the Lives of Persons with Disabilities, but They Are Human Beings Too": Perceptions of Healthcare Providers and Factors Affecting Service Delivery in Ghana.

Persons with disabilities (PwDs) constitute about 16% of the global population and face many challenges in every society, including access to sexual and reproductive healthcare. The attitudes of healthcare providers (HPs) exert a major influence on PwDs accessing sexual and reproductive healthcare (SRH). A sequential explanatory mixed methods design was used to investigate the attitudes and perceptions of HPs towards PwDs and SRH delivery in Ghana's Ashanti region. Quantitative data analysis indicated that overall, 82% of HPs had received information on disability-related issues and had relatively positive attitude towards PwDs, which varied across sub-scales of the Attitude Towards Disability score and associated with their sociodemographic characteristics. HPs faced several challenges in SRH services delivery to PwDs, which included a lack of funding and training, and inadequate staff. Inductive thematic analysis of the qualitative data revealed eight overarching themes. The findings revealed that HPs had prejudice about the mental and sexual health abilities of PwDs. Inadequate skill set, inadequate resources, and limited funding were major challenges identified. Nonetheless, compassion and benevolence towards PwDs, improvision, economic and educational support, awareness creation, and referrals were strategies adopted to overcome these challenges. Mandatory training of HPs is recommended to ensure improved SRH service delivery to PwDs. Future research could explore the perceptions and coping strategies of PwDs.

Ghana's Adherence to PASCAR's 10-Point Action Plan towards Hypertension Control: A Scoping Review.

The continuous increase in the prevalence of hypertension in Ghana has led to various interventions aimed at controlling the disease burden. Nonetheless, these interventions have yielded poor health outcomes. Subsequently, the Pan-African Society of Cardiology (PASCAR), established a 10-point action plan for inclusion in policies to aid control of hypertension. This scoping review assessed the adherence of health policies to the 10-point action plan towards hypertension control/reduction in Ghana. Eight health policies met the inclusion criteria and were assessed. The programme evaluation and policy design framework were used for synthesis and analysis of extracted data. Overall, there was poor adherence to hypertension control observed in the policies. Specifically, there were low levels of integrating hypertension control/reduction measures, a poor task-sharing approach, and poor financial resource allocations to tackle hypertension control/reduction in most of the policies. There was also low support for research to produce evidence to guide future interventions. For Ghana to achieve the global target of reducing hypertension by the year 2025, its health policies must adhere to evidence-based interventions in hypertension management/control. The study recommends a follow-up study among hypertension patients and healthcare professionals to evaluate the factors militating against hypertension management/control in Ghana.

Integrating traditional medicine into the Ghanaian health system: perceptions and experiences of traditional medicine practitioners in the Ashanti region.

BACKGROUND: Traditional medicine (TM) plays a vital role in the Ghanaian health system by serving as an alternative healthcare delivery system for the majority of people. However, the quality of practice and level of TM practitioners' involvement in the integration of TM into the health system have not been fully investigated. METHODS: This study employed a phenomenological qualitative study design to explore the perceptions, experiences and recommendations of TM practitioners in the Ashanti region regarding TM integration. Data were collected through individual interviews with 17 participants. RESULTS: Participants had knowledge about TM integration. They cited effective alternative healthcare delivery and improved patient outcomes as the key benefits of TM integration. However, they reported a shortage of approved TM products, poor visibility of TM integration and poor relational coordination of care as factors hampering the integration. Participants recommended improved interprofessional relationships, provision of financial support and improved publicity of TM as possible strategies to enhance TM integration in Ghana. CONCLUSIONS: The findings of the study clearly demonstrate that the Ghanaian health system is currently operating a consumer-led, tolerant health system with a parallel (between orthodox and TM practitioners) healthcare delivery model. Successful implementation of an effective TM integration would require improved integrative collaborative coordination of care between orthodox and TM practitioners in Ghana.

Next Generation Sequencing of Genotype Variants and Genetic Association between Heat Shock Proteins HSPA1B Single Nucleotide Polymorphism at the g.31829044 Locus and Heat Tolerance: A Pilot Quasi-Experimental Study.

Heat tolerance and exertional heat stroke (EHS) are rare health conditions that have been described and characterised but have never been genetically solved. Knowledge of the role of single nucleotide polymorphisms (SNPs) in heat shock proteins (HSPs) genes and their associations with heat tolerance and EHS is limited. This pilot study aimed to identify SNP in HSPA1B, HSP90AA2 and DNAJA1 genes and their associations with heat tolerance and EHS history in a quasi-experimental design. Participants comprised Australian Defence Force members (ADF) who had a history of EHS and the general population. Genomic DNA samples were extracted from the venous blood samples of 48 participants, sequenced and analysed for SNP. Forty-four per cent (44%) of the participants were heat intolerant, and 29% had a history of EHS. Among participants with a history of EHS, there was an association between heat tolerance and HSPA1B SNP at the g.31829044 locus. However, there were no associations between HSPA1B and HSP90AA2 SNP and heat tolerance. All participants had the same distribution for the DNAJA1 SNP. In conclusion, the findings indicate an association between the HSPA1B genetic variant at the g.31829044 locus and heat tolerance among ADF participants with a history of EHS. Further research with a larger number of military participants will shed more light on the associations between HSP genes and heat tolerance.

Lipogenic Gene Single Nucleotide Polymorphic DNA Markers Associated with Intramuscular Fat, Fat Melting Point, and Health-Beneficial Omega-3 Long-Chain Polyunsaturated Fatty Acids in Australian Pasture-Based Bowen Genetics Forest Pastoral Angus, Hereford, and Wagyu Beef Cattle.

This study used targeted sequencing aimed at identifying single nucleotide polymorphisms (SNP) in lipogenic genes and their associations with health-beneficial omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA), intramuscular fat (IMF), and fat melting point (FMP) of the M. longissimus dorsi muscle in Australian pasture-based Bowen Genetics Forest Pastoral Angus, Hereford, and Wagyu cattle. It was hypothesized that SNP encoding for the fatty acid-binding protein 4 (FABP4), stearoyl-CoA desaturase (SCD), and fatty acid synthase (FASN) genes will be significantly associated with health-beneficial n-3 LC-PUFA and the meat eating quality traits of IMF and FMP in an Australian pasture-based beef production system. Two SNP mutations, g.21267406 T>C and g.21271264 C>A, in the SCD gene were significantly (p < 0.05) associated with IMF, FMP, oleic acid (18:1n-9), linoleic acid (LA) 18:2n-6, alpha-linolenic acid (ALA) 18:3n-3, eicosapentaenoic acid (EPA) 20:5n-3, docosahexaenoic acid (DHA) 22:6-n-3, and docosapentaenoic acid (DPA) 22:5n-3. Significant positive correlations (p < 0.05) between FASN SNP g. 50787138 A>G and FMP, 18:1n-9, ALA, EPA, DHA, DPA, and total n-3 LC-PUFA were also detected. An SNP (g.44678794 G>A) in the FABP4 gene was associated with FMP. These results provide significant insights into the contributions of lipogenic genes to intramuscular fat deposition and the biosynthesis of health-beneficial n-3 LC-PUFA. The findings also unravel the potential use of lipogenic gene polymorphisms in marker-assisted selection to improve the content of health-promoting n-3 LC-PUFA and meat eating quality traits in Australian pasture-based Bowen Genetics Forest Pastoral Angus, Hereford, and Wagyu beef cattle.

Optimising care coordination strategies for physical activity referral scheme patients by Australian health professionals.

Physical activity (PA) has been identified as an essential tool for the prevention and management of multi-morbidity in patients. Coordination of patients' care through interventions like physical activity referral schemes (PARS) could foster the utilization of PA. This study explored the views of General Practitioners (GPs) and Exercise Physiologists (EPs) as key stakeholders, for optimizing patient care and efficiency of PARS. Sequential explanatory mixed methods design was used to explore the perceptions of these health professionals on PA and coordination strategies for PARS patient care. Data analyses included descriptive and inferential statistics for questionnaires and theoretical framework analysis for the semi-structured interviews. Participants demonstrated a good knowledge of PA and valued PARS. However, the findings unravelled external factors, inter-organisational mechanisms, and relational coordination obstacles that hinder efficient coordination of PARS patient care and delay/limit beneficial health outcomes for patients. Incentivising the PARS initiative and empowering patients to seek referral into the programme, are strategies that could boost PARS efficiency. Improving inter-professional relationships between GPs and EPs could lead to enhanced PARS functionality and efficient coordination of care for patients with chronic diseases.

Growth performance, carcass characteristics and cost implications of supplementing Turkey poults with toasted Bambara nut by-products.

Legumes provide high quality proteins with nutritional benefits for monogastric animals. Compared to other legume pulses, Bambara nuts (Vigna subterranean) grow in marginal soils, contain 12 different proteins and 214 identifiable peptides that readily provide nutritional and health benefits to consumers. Toasted Bambara nuts are consumed by humans, while the shells are ground and included in both poultry and ruminant rations as a readily degradable protein source. The hypothesis that turkey poults supplemented with toasted Bambara nuts by-products will respond with higher daily weight gains, faster growth, superior carcass characteristics, heavier organs and higher profit margins than unsupplemented poults was tested in this study with the primary objective of evaluating the response of grower turkey poults to supplementation with graded levels of Bambara nut by-products. The feeding trial lasted for 56 days and a completely randomised experimental design was utilised to randomly allocate 60 poults to five treatments of 12 poults each, comprising the control (0%), 7.5, 15, 22.5 and 30% inclusion level of toasted Bambara nut by-products. Compared to the control group, supplemented poults achieved a significantly better (P < 0.05) feed conversion ratio, heavier carcass traits, total and eviscerated organ weights and faster average daily gains. This superior performance was highest in poults supplemented at the 30% inclusion level which returned an 85% profit margin and a 10% reduction in feed cost compared to unsupplemented poults. These findings imply that turkey farmers can break even while achieving superior growth performance, heavier carcasses and nutritional benefits accruing from supplementation with toasted Bambara nuts by-products, hence the need to accept the tested hypothesis.

Genetics and nutrition impacts on herd productivity in the Northern Australian beef cattle production cycle.

Genetics and nutrition drive herd productivity due to significant impacts on all components of the beef cattle production cycle. In northern Australia, the beef production system is largely extensive and relies heavily on tropical cattle grazing low quality, phosphorus-deficient pastures with seasonal variations in nutritive value. The existing feedlots are predominantly grain-based; providing high-energy rations, faster turn-off and finishing of backgrounded cattle to meet market specifications. This review focusses on the beef cattle production cycle components of maternal nutrition, foetal development, bull fertility, post-natal to weaning, backgrounding, feedlotting, rumen microbes and carcass quality as influenced by genetics and nutrition. This student-driven review identified the following knowledge gaps in the published literature on northern Australian beef cattle production cycle: 1. Long-term benefits and effects of maternal supplementation to alter foetal enzymes on the performance and productivity of beef cattle; 2. Exogenous fibrolytic enzymes to increase nutrient availability from the cell wall and better utilisation of fibrous and phosphorus deficient pasture feedbase during backgrounding; 3. Supplementation with novel encapsulated calcium butyrate and probiotics to stimulate the early development of rumen papillae and enhance early weaning of calves; 4. The use of single nucleotide polymorphisms as genetic markers for the early selection of tropical beef cattle for carcass and meat eating quality traits prior to feedlotting; The review concludes by recommending future research in whole genome sequencing to target specific genes associated with meat quality characteristics in order to explore the development of breeds with superior genes more suited to the North Australian beef industry. Further research into diverse nutritional strategies of phosphorus supplementation and fortifying tropically adapted grasses with protein-rich legumes and forages for backgrounding and supplementing lot-fed beef cattle with omega-3 oil of plant origin will ensure sustainable production of beef with a healthy composition, tenderness, taste and eating quality.

The practice of integrated healthcare and the experiences of people in Ghana's Ashanti region.

BACKGROUND: The Ghanaian government has implemented interventions that integrate traditional medicine (TM) into its national health system in response to the high prevalence of TM use. However, empirical evidence of the experiences of service users and the practice of integrated health in Ghana is scanty. Therefore, this study explored the experiences of people with TM integration into the formal health system in Ashanti region using an adapted TM integration framework. METHODS: A sequential explanatory mixed methods study design comprising survey administration and in-depth interviews for data collection was utilised to address the research objective. Framework analysis was used in analysing the qualitative data and for triangulation of results. RESULTS: Participants were aware of licensing and training of TM practitioners in a science-based university in Ghana. However, knowledge of the existence of TM units in selected hospitals in the region was minimal. Integration knowledge was largely influenced by sex, marital status, household size and residential status, where males and urban dwellers were more familiar with the process than females and rural dwellers. Low patronage of integrated health services in the region was attributable to weak cross referrals. However, service users who had engaged with the integrated system recounted a satisfactory outcome. CONCLUSION: Service users' unfamiliarity with the presence of integrated facilities in Ghana could be an impediment to the practice of integrated healthcare. Sensitisation of the public about the practice of an integrated system could refine the Ghanaian integrated system. Regular evaluation of patient satisfaction and outcome measures might also serve as an effective strategy for improving health services delivery since evaluation is becoming an important component of health service design and implementation. There is the need for future studies to focus on exploring the perceptions and experiences of health practitioners and hospital administrators regarding the practice of integrated health in Ghana.

Effect of incremental proportions of Desmanthus spp. in isonitrogenous forage diets on growth performance, rumen fermentation and plasma metabolites of pen-fed growing Brahman, Charbray and Droughtmaster crossbred beef steers.

Desmanthus (Desmanthus spp.), a tropically adapted pasture legume, is highly productive and has the potential to reduce methane emissions in beef cattle. However, liveweight gain response to desmanthus supplementation has been inconclusive in ruminants. This study aimed to evaluate weight gain, rumen fermentation and plasma metabolites of Australian tropical beef cattle in response to supplementation with incremental levels of desmanthus forage legume in isonitrogenous diets. Forty-eight Brahman, Charbray and Droughtmaster crossbred beef steers were pen-housed and fed a basal diet of Rhodes grass (Chloris gayana) hay supplemented with 0, 15, 30 or 45% freshly chopped desmanthus forage on dry matter basis, for 140 days. Varying levels of lucerne (Medicago sativa) hay were added in the 0, 15 and 30% diets to ensure that all diets were isonitrogenous with the 45% desmanthus diet. Data were analyzed using the Mixed Model procedures of SAS software. Results showed that the proportion of desmanthus in the diet had no significant effect on steer liveweight, rumen volatile fatty acids molar proportions and plasma metabolites (P ≥ 0.067). Total bilirubin ranged between 3.0 and 3.6 µmol/L for all the diet treatments (P = 0.67). All plasma metabolites measured were within the expected normal range reported for beef cattle. Rumen ammonia nitrogen content was above the 10 mg/dl threshold required to maintain effective rumen microbial activity and maximize voluntary feed intake in cattle fed low-quality tropical forages. The average daily weight gains averaged 0.5 to 0.6 kg/day (P = 0.13) and were within the range required to meet the target slaughter weight for prime beef markets within 2.5 years of age. These results indicate that desmanthus alone or mixed with other high-quality legume forages can be used to supplement grass-based diets to improve tropical beef cattle production in northern Australia with no adverse effect on cattle health.

Main regulatory factors of marbling level in beef cattle.

The content of intramuscular fat (IMF), that determines marbling levels is considered as one of the vital factors influencing beef sensory quality including tenderness, juiciness, flavour and colour. The IMF formation in cattle commences around six months after conception, and continuously grows throughout the life of the animal. The accumulation of marbling is remarkably affected by genetic, sexual, nutritional and management factors. In this review, the adipogenesis and lipogenesis process regulated by various factors and genes during fetal and growing stages is briefly presented. We also discuss the findings of recent studies on the effects of breed, gene, heritability and gender on the marbling accumulation. Various research reported that feeding during pregnancy, concentrate to roughage ratios and the supplementation or restriction of vitamin A, C, and D are crucial nutritional factors affecting the formation and development of IMF. Castration and early weaning combined with high energy feeding are effective management strategies for improving the accumulation of IMF. Furthermore, age and weight at slaughter are also reviewed because they have significant effects on marbling levels. The combination of several factors could positively affect the improvement of the IMF deposition. Therefore, advanced strategies that simultaneously apply genetic, sexual, nutritional and management factors to achieve desired IMF content without detrimental impacts on feed efficiency in high-marbling beef production are essential.

Lipid Metabolism, Carcass Characteristics and Longissimus dorsi Muscle Fatty Acid Composition of Tropical Crossbred Beef Cattle in Response to Desmanthus spp. Forage Backgrounding.

Lipid metabolism, carcass characteristics and fatty acid (FA) composition of the Longissimus dorsi (loin eye) muscle were evaluated in tropical crossbred steers backgrounded on Desmanthus spp. (desmanthus) with or without feedlot finishing. It was hypothesized that steers backgrounded on isonitrogenous diets augmented with incremental proportions of desmanthus will produce carcasses with similar characteristics and FA composition. Forty-eight Brahman, Charbray and Droughtmaster crossbred beef steers were backgrounded for 140 days on Rhodes grass (Chloris gayana) hay augmented with 0, 15, 30 or 45 percent desmanthus on dry matter basis. Lucerne (Medicago sativa) hay was added to the 0, 15 and 30 percent desmanthus diets to ensure that they were isonitrogenous with the 45 percent desmanthus diet. After backgrounding, the two heaviest steers in each pen were slaughtered and the rest were finished in the feedlot for 95 days before slaughter. Muscle biopsy samples were taken at the beginning and end of the backgrounding phase. Carcasses were sampled at slaughter for intramuscular fat (IMF) content, fat melting point (FMP) and FA composition analyses. Increasing the proportion of desmanthus in the diet led to a linear increase in docosanoic acid (p = 0.04) and omega-6/omega-3 polyunsaturated FA ratio (n-6/n-3 PUFA; p = 0.01), while docosahexaenoic acid decreased linearly (p = 0.01). Feedlot finishing increased hot carcass weight, subcutaneous fat depth at the P8 site and dressing percentage (p ≤ 0.04). The n-6/n-3 PUFA ratio was within the recommended < 5 for human diets. IMF was within the consumer-preferred ≥3% level for palatability. The hypothesis that steers backgrounded on isonitrogenous diets augmented with incremental proportions of desmanthus will produce similar carcass characteristics and FA composition was accepted. These findings indicate that a combination of tropical beef cattle backgrounding on desmanthus augmented forage and short-term feedlot finishing produces healthy and highly palatable meat.

Perceptions and Experiences of Orthodox Health Practitioners and Hospital Administrators towards Integrating Traditional Medicine into the Ghanaian Health System.

The government of Ghana has been piloting traditional medicine (TM) integration in 17 health facilities across the country. However, the nature of current practice of integrated healthcare has not been thoroughly explored. This paper sought to explore the experiences and recommendations of orthodox health practitioners and hospital administrators in the Ashanti region regarding the practice of integrated healthcare in Ghana. The study adopted a qualitative, phenomenological approach involving 22 interviews. Purposive sampling technique was used in selecting study participants. Framework analysis was used to draw on the experiences of participants relating to TM integration. Participants were knowledgeable about the existence of integrated health facilities and stated that TM integration has created options in health services. However, participants deemed the integrated system ineffective and attributed the inefficiency to poor processing and certification of TM products, opposition of medical doctors to TM usage, absence of a protocol to guide the integration process, and inadequate publicity. Professional training of TM practitioners and inclusion of TM in medical school curriculum could improve collaboration between the health practitioners. Future research should focus on assessing the opinions and involvements of TM practitioners regarding the integration of traditional therapies into national health systems.

Haematological, Biochemical and Hormonal Biomarkers of Heat Intolerance in Military Personnel.

Heat intolerance is the inability to withstand heat stress and this may occur due to exertional heat stroke (EHS). However, it is unknown if heat intolerance is associated with immune and hormonal disturbances. This study investigates haematological, biochemical and hormonal biomarkers related to heat intolerance and EHS in military and civilian volunteers. A quasi-experimental pre-and post-test design was used, with participants drawn from the Australian Defence Force (ADF) and the general populace. Blood samples were collected and analysed for biomarkers. Inferential statistics compared the biomarkers between the groups. Changes in alanine amino transaminase (p = 0.034), creatine kinase (0.044), cortisol (p = 0.041) and creatinine (p < 0.001) differed between the heat-intolerant and heat-tolerant groups. Participants with a history of EHS showed significant changes in creatinine (p = 0.022) and urea (p = 0.0031) compared to those without EHS history. Predictors of heat intolerance were increasing post-HTT creatinine and cortisol (OR = 1.177, p = 0.011 and OR = 1.015, p = 0.003 respectively). Conclusively, EHS history is associated with changes in creatinine and urea concentrations, while the predictors of heat intolerance are creatinine and cortisol. However, further exploration of other biomarkers, such as genetic polymorphism, is needed.

Australian School Stakeholders' Perceived Strategies for Preventing Adolescent Obesity.

Adolescent obesity is a complex multifactorial disease with a combination of environmental, behavioral, psychosocial, biological, cultural and genetic determinants. It remains a global public health issue that presents a major challenge to chronic disease prevention and health into adulthood. Schools have a rich opportunity to improve youth health and tackle obesity, yet they face barriers in fulfilling this function. This study investigated school stakeholders' beliefs and perceptions of the barriers and enablers currently experienced by schools, as well as their recommendations towards preventing adolescent obesity. A sequential explanatory mixed-methods study design was utilised with surveys administered for the quantitative phase and individual interviews for the qualitative phase. Descriptive statistics and inductive thematic analyses were utilised for the survey and interview data, respectively. Triangulation of findings from the quantitative and qualitative phases aided in the better understanding and integration of the overall results. In total, 60 school stakeholders (52 subject teachers, 3 senior teachers and 5 heads of department) from both independent and public high schools in Queensland, Australia responded to the survey, while 14 respondents participated in the interviews. The main perceived causes of obesity were poor eating habits and sedentary lifestyle. Highlighted barriers were busy timetables, shortage of trained staff and funding, lack of robustness in the introduction and implementation of school interventions and insufficient motivation of learners to participate in obesity prevention programs. Enabling factors included parental support, easy access to fitness equipment during recess, supportive government policies, provision of healthier school tuck shop menu options and elimination of sugary drinks from vending machines. A model for the prevention of adolescent obesity was developed based on participants' perceptions. Tripartite collaboration between the school, government and parents was perceived as fundamental to preventing adolescent obesity. Strategies targeting nutrition, physical activity and overall health, including parental education on health, formal health talks in schools by health professionals and better-targeted advertisement encouraging healthy lifestyle choices, were identified as essential for improved adolescent health outcomes.