Exploring strategies for including visually impaired students in online learning.

Online learning has gained prominence in higher education institutions globally. Its actual and potential benefits are linked to improving access to and quality of education. It is also considered as a vital strategy for contributing to the UN SDG 4 agenda which aims at ensuring inclusive, equal and equitable lifelong education for all by the year 2030. Unfortunately, not much has been documented on how visually impaired students (VIS) have been included in online learning. To extend our understanding of this neglected but significant topic, this qualitative developmental phenomenographic study engages 14 faculty and six Administrators from two Ghanaian higher education institutions to explore challenges and possible strategies for the inclusion of VIS in online learning. The findings indicate that general policy frameworks are available in the studied universities but they are limited in salience and significance as they do not consider the inclusion of VIS in online learning. Some forms of digital technology are also available in the studied institutions but their accessibility and usability remain a challenge to the VIS. Besides, the universities have specialized units to support students with special needs generally but their practices to support VIS in online settings have remained a challenge. Consequently, universities need to develop adaptive and agile policies through inclusive and participatory approaches. Additionally, higher education institutions should strategically build the capacities of their faculty and staff to better serve VIS in online learning settings. The creation of strategic partnerships with civil society, intergovernmental and non-governmental organizations and the private sector generally is deemed vital for the mobilization of resources to support VIS in online learning spaces.

Echoing the voices of SWVIs under Covid-19 inspired online learning.

With the kind of interruption caused by the COVID-19 pandemic, many higher institutions, including the University of Ghana, swiftly shifted their engagements online which might have come with its setbacks. In view of that, this phenomenographic design study sought to investigate and document the qualitatively different perspectives of thirteen students with visual impairments (SWVIs) as they transitioned and studied fully in an online space. The experiences of the SWVIs were captured in five themes that emerged from the analysis of the field data. The five themes are pre-COVID-19 academic experiences, [initial] reaction to online shift, preparation towards online shift, coping mechanisms in fully online learning spaces and preferred post-COVID-19 learning space. In the end, the SWVIs expressed more challenges with online learning than benefits and opted for a switch to the face-to-face mode post-COVID-19. Consequently, the study recommends inter alia, training for students and faculty to build sustainable online relationships; deployment of participatory technologies to build learner autonomy; and the need for the University to craft a policy of inclusiveness which embeds 'ubuntu' (common humanity) and human awareness to reverse inequalities among its students.

Nutritional status of children with cerebral palsy in Ghana.

Background: Limited knowledge on nutritional epidemiology in Ghanaian children with Cerebral Palsy (CP) necessitates a comprehensive investigation for an improved understanding of malnutrition in this population. Objectives: We aimed to describe the epidemiology of malnutrition among children with CP in Ghana. Methods: The study used data collected as part of the Ghana CP Register (GCPR). The GCPR is an institution-based surveillance of children with CP aged < 18 years in Ghana. Between October 2018 and April 2020, N = 455 children with CP were registered. Data were collected on (i) weight, length or height, mid-upper-arm-circumference of children with CP; (ii) socio-demographic characteristics; (iii) motor type and topography, gross motor function classification system level (GMFCS); (iv) associated impairments; (v) educational and rehabilitation status for each child. Descriptive and bivariate analyses were performed. Results: Mean and standard deviation age of the registered children at assessment was 5.9 ± 4.1 years, and 42.1% were female. Two-thirds of the children had ≥ one form of undernutrition (underweight or severely underweight: 38.9%, stunted or severely stunted: 51.2%, thin or severely thin: 23.8%). In the adjusted analysis, low maternal education, GMFCS-IV, speech impairment and epilepsy significantly increased the odds of undernutrition among participating children (aOR: 2.6 [95% CI:1.3-5.4]; 2.2 [95% CI:1.0-4.8]; 2.0 [95% CI:1.1-3.6]; 2.9 [95% CI:1.1-7.5] respectively). Conclusions: The high malnutrition rate indicates an urgent need for nutrition interventions and translational research to improve nutritional status and prevent adverse outcomes among children with CP in Ghana. Contribution: Our study contributes important data and a framework to develop guidelines and evidence-based interventions for children with CP in Ghana.

Epidemiology of Malnutrition among Children with Cerebral Palsy in Low- and Middle-Income Countries: Findings from the Global LMIC CP Register.

BACKGROUND: This study aimed to describe the epidemiology of malnutrition among children with cerebral palsy (CP) in low- and middle-income countries (LMICs). METHODS: Data from children with confirmed CP aged <18 years registered into the Global LMIC CP Register (GLM CPR) from Bangladesh, Indonesia, Nepal, and Ghana were included. Anthropometric measurements were collected, and nutritional status was determined following the WHO guidelines. Descriptive statistics and adjusted logistic regression were used to describe the nutritional status and identify predictors of malnutrition. RESULTS: Between January 2015 and December 2020, 3619 children with CP were registered into the GLM CPR (median age at assessment: 7.0 years, 39% female). Overall, 72-98% of children from Bangladesh, Indonesia, Nepal, and Ghana had at least one form of undernutrition. The adjusted analysis showed, older age, low maternal education, spastic tri/quadriplegia, and Gross Motor Functional Classification System (GMFCS) levels III-V were significant predictors of underweight and stunting among children with CP in Bangladesh. In Nepal, female children, GMFCS III-V had higher odds of underweight and stunting. In Ghana, low maternal education was significantly associated with underweight, whereas older age and the presence of associated impairments were the significant predictors of stunting among children with CP. Having a GMFCS of III-V increased the odds of being underweight among children in Indonesia; however, no predictors were identified for stunting, as nearly all children with CP registered from Indonesia were stunted. CONCLUSION: Most children with CP in GLM CPR had undernutrition. Maternal education and moderate-to-severe motor impairment (GMFCS III-V) were significant predictors. Practical nutrition education to mothers/caregivers and management guidelines according to the motor severity using local resources could improve the nutritional outcome of children with CP in LMICs.

Composition of nutrients, heavy metals, polycyclic aromatic hydrocarbons and microbiological quality in processed small indigenous fish species from Ghana: Implications for food security.

The triple burden of malnutrition is an incessant issue in low- and middle-income countries, and fish has the potential to mitigate this burden. In Ghana fish is a central part of the diet, but data on nutrients and contaminants in processed indigenous fish species, that are often eaten whole, are missing. Samples of smoked, dried or salted Engraulis encrasicolus (European anchovy), Brachydeuterus auritus (bigeye grunt), Sardinella aurita (round sardinella), Selene dorsalis (African moonfish), Sierrathrissa leonensis (West African (WA) pygmy herring) and Tilapia spp. (tilapia) were collected from five different regions in Ghana. Samples were analyzed for nutrients (crude protein, fat, fatty acids, several vitamins, minerals, and trace elements), microbiological quality (microbial loads of total colony counts, E. coli, coliforms, and Salmonella), and contaminants (PAH4 and heavy metals). Except for tilapia, the processed small fish species had the potential to significantly contribute to the nutrient intakes of vitamins, minerals, and essential fatty acids. High levels of iron, mercury and lead were detected in certain fish samples, which calls for further research and identification of anthropogenic sources along the value chains. The total cell counts in all samples were acceptable; Salmonella was not detected in any sample and E. coli only in one sample. However, high numbers of coliform bacteria were found. PAH4 in smoked samples reached high concentrations up to 1,300 µg/kg, but in contrast salted tilapia samples had a range of PAH4 concentration of 1 µg/kg to 24 µg/kg. This endpoint oriented study provides data for the nutritional value of small processed fish as food in Ghana and also provides information about potential food safety hazards. Future research is needed to determine potential sources of contamination along the value chains in different regions, identify critical points, and develop applicable mitigation strategies to improve the quality and safety of processed small fish in Ghana.

Probabilistic quantitative microbial risk assessment model of norovirus from wastewater irrigated vegetables in Ghana using genome copies and fecal indicator ratio conversion for estimating exposure dose.

The need to replace the commonly applied fecal indicator conversions ratio (an assumption of 1:10-5 virus to fecal indicator organism) in Quantitative Microbial Risk Assessment (QMRA) with models based on quantitative data on the virus of interest has gained prominence due to the different physical and environmental factors that might influence the reliability of using indicator organisms in microbial risk assessment. The challenges facing analytical studies on virus enumeration (genome copies or particles) have contributed to the already existing lack of data in QMRA modelling. This study attempts to fit a QMRA model to genome copies of norovirus data. The model estimates the risk of norovirus infection from the intake of vegetables irrigated with wastewater from different sources. The results were compared to the results of a corresponding model using the fecal indicator conversion ratio to estimate the norovirus count. In all scenarios of using different water sources, the application of the fecal indicator conversion ratio underestimated the norovirus disease burden, measured by the Disability Adjusted Life Years (DALYs), when compared to results using the genome copies norovirus data. In some cases the difference was >2 orders of magnitude. All scenarios using genome copies met the 10-4 DALY per person per year for consumption of vegetables irrigated with wastewater, although these results are considered to be highly conservative risk estimates. The fecal indicator conversion ratio model of stream-water and drain-water sources of wastewater achieved the 10-6 DALY per person per year threshold, which tends to indicate an underestimation of health risk when compared to using genome copies for estimating the dose.

Obesity and Cardio-Metabolic Risk Factors in an Urban and Rural Population in the Ashanti Region-Ghana: A Comparative Cross-Sectional Study.

There is a surge in chronic diseases in the developing world, driven by a high prevalence of cardio-metabolic risk factors. This study described differences in prevalence of obesity and cardio-metabolic risk factors between urban and rural settlements in the Ashanti Region of Ghana. This comparative cross-sectional study included 672 participants (median age 50 years), of which 312 were from Kumasi (urban) and 360 from Jachie-Pramso (rural). Demographic, anthropometric and other cardio-metabolic risk factors were gathered and venous blood samples were drawn for biochemical assays. Results suggested significant differences in diastolic blood pressure (80.0 mmHg vs 79.5 mmHg; p = 0.0078), and fasting blood sugar (5.0 mmo/l vs 4.5 mmol/l; p < 0.0001) between the two groups. Further differences in anthropometric measures suggested greater adiposity amongst participants in the urban area. Participants in the urban area were more likely than rural participants, to have high total cholesterol and LDL-c (p < 0.0001 respectively). Risk factors including BMI ≥ 25 (p < 0.0001), BMI ≥ 30 (p < 0.0001), high waist circumference (p < 0.0001), high waist-to-height ratio (p < 0.0001) and alcohol consumption (p = 0.0186) were more prevalent amongst participants in the urban area. Markers of adiposity were higher amongst females than males in both areas (p < 0.05). In the urban area, hypertension, diabetes and lifestyle risk factors were more prevalent amongst males than females. Differences in risk factors by urban/rural residence remained significant after adjusting for gender and age. Obesity and cardio-metabolic risk factors are more prevalent amongst urban settlers, highlighting an urgent need to avert the rise of diet and lifestyle-related chronic diseases.

Comparison of municipal solid waste management systems in Canada and Ghana: a case study of the cities of London, Ontario, and Kumasi, Ghana.

Integrated waste management has been accepted as a sustainable approach to solid waste management in any region. It can be applied in both developed and developing countries. The difference is the approach taken to develop the integrated waste management system. This review looks at the integrated waste management system operating in the city of London, Ontario-Canada and how lessons can be drawn from the system's development and operation that will help implement a sustainable waste management system in the city of Kumasi, Ghana. The waste management system in London is designed such that all waste generated in the city is handled and disposed of appropriately. The responsibility of each sector handling waste is clearly defined and monitored. All major services are provided and delivered by a combination of public and private sector forces. The sustainability of the waste management in the city of London is attributed to the continuous improvement strategy framework adopted by the city based on the principles of integrated waste management. It is perceived that adopting a strategic framework based on the principles of integrated waste management with a strong political and social will, can transform the current waste management in Kumasi and other cities in developing countries in the bid for finding lasting solutions to the problems that have plagued the waste management system in these cities.