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Hair relaxers and skin lighteners have been commonly used by African women, with suggestions that they may have hormonal activity.To investigate the relationship of hair relaxer and skin lightener use to serum estrogen/estrogen metabolite levels.We utilized the postmenopausal population-based controls of the Ghana Breast Health Study to estimate adjusted geometric means (GM) and 95% confidence intervals of individual circulating estrogen levels by hair relaxer/skin lightener exposure categories.Of the 585 postmenopausal women included in our analysis, 80.2% reported hair relaxer use and 29.4% skin lightener use. Ever hair relaxer use was positively associated with estriol (adjusted GM 95.4 pmol/L vs. never 74.5, p value = 0.02) and 16-epiestriol (20.4 vs. 16.8, p value = 0.05) particularly among users of lye-based hair relaxers. Positive associations between scalp burns and unconjugated estrogens were observed (e.g., unconjugated estrone: 5+ scalp burns 76.9 [59.6-99.2] vs. no burns 64.0 [53.7-76.3], p-trend = 0.03). No association was observed between use of skin lighteners and circulating estrogens.This study presents evidence that circulating 16-pathway estrogens (i.e., estriol and 16-epiestriol) may be increased in users of lye-based hair relaxer products. Among hair relaxer users, unconjugated estrogen levels were elevated in women with a greater number of scalp burns.In this population-based study of hair relaxer and skin lightener use among postmenopausal women in Ghana, altered estrogen metabolism was observed with hair relaxer use, particularly among women using lye-based products or with a greater number of scalp burns. In contrast, skin lightener use was not associated with differences in estrogen metabolism in this population. Continued investigation of the potential biological impact on breast cancer risk of hair relaxer use is warranted.

Sexuality is an important part of an individual’s quality of life. Reduced sexual function is common and can be treated. People search all heights and depths for substances they could use to stimulate and increase sexual desire in themselves and others. The non-prescription procurement and use of medicines have become a major challenge in Ghana. However, it is unknown how serious this situation is with regards to aphrodisiacs. This study therefore assessed the purchase and consumption of aphrodisiacs within the Kumasi metropolis. Retail pharmacies were involved in this study. Quota sampling was used to determine the number of pharmacies to be selected from each sub-metro while stratified sampling was then used to select participating pharmacies for the study. Males between the ages of 31 and 45 years purchased aphrodisiacs from pharmacies the most (56, 38.5%) and the rate of purchase of aphrodisiacs from retail outlets (104, 70.3%) is high. Aphrodisiacs were consumed to prolong erection as well as enhance pleasure. However, this practice is seen by many as inappropriate and reported by many to be associated with very serious adverse effects, with headaches being the most dominant adverse effect reported.

Approaching academic writing as a medical student; tips and tricks No abstract - Editorial

Our study describes breast cancer risk loci using a cross-ancestry GWAS approach. We first identify variants that are associated with breast cancer at P, GWAS have enhanced our understanding for the genetic basis of breast cancer, but the majority of them were performed for European ancestry populations. Here, the authors use a cross-ancestry approach and report seven new variants associated with breast cancer risk among women of African ancestry.

This study focuses on Western medical practices in the Atiwa District of Ghana. The people of Atiwa District accessed Western medicinal practice to prevent and cure diseases. Before the advent of Western medical practice in the Atiwa District, people were unable to access Western medicine due to the challenges with travelling or trekking from rural communities to the towns where they would find limited Western oriented health centres/hospitals. Although there were challenges, the local population continued to highly embrace practitioners and also accessed the basic Western oriented medical facilities. Western medical strategies were used to combat skin diseases, stomach aches, and malaria that was prevalent in the Atiwa District. The other diseases which afflicted the people and which required urgent attention included cerebrospinal meningitis (CSM), tuberculosis and HIV/AIDS among others. Findings from the study revealed that the introduction and success of western medical practice in the Atiwa District could not have been possible without a positive reception from the indigenous people. Importantly, this study has projected the relevance of public health in the history of the people of Atiwa and the significant roles played by governments to ensure the promotion of good health at the District.

Women have always been central concerning the provision of healthcare. The transitions into the modern world have been very slow for women because of how societies classify women. Starting from lay care, women provided healthcare for their family and sometimes to the members of the community in which they lived. With no formal education, women served as midwives and served in other specialised fields in medicine. They usually treated their fellow women because they saw ‘women’s medicine’ as women’s business. They were discriminated against by the opposite sex and by the church, which regarded it as a taboo to allow women to practice medicine. This study points to a Ghanaian context on how the charismas of women have made them excel in their efforts to provide healthcare for their people. The study also focused on the role of indigenous practitioners who are mostly found in the rural areas and modern practitioners who are mostly found in the peri-urban, urban areas and larger cities in Ghana.

To investigate subtype-specific risk of germline alleles associated with triple negative breast cancer (TNBC) in African ancestry populations.Breast cancer (BC) mortality is higher in African American (AA) compared to White American (WA) women; this disparity is partly explained by 2-fold higher TNBC incidence.We used a surgically maintained biospecimen cohort of 2884 BC cases. Subsets of the total (760 AA; 962 WA; 910 West African/Ghanaian; 252 East African/Ethiopian) were analyzed for genotypes of candidate alleles. A subset of 417 healthy controls were also genotyped, to measure associations with overall BC risk and TNBC.TNBC frequency was highest in Ghanaian and AA cases (49% and 44% respectively; P0.0001) and lowest in Ethiopian and WA cases (17% and 24% respectively; P0.0001). TNBC cases had higher West African ancestry than non-TNBC (P0.0001). Frequency of the Duffy-null allele (rs2814778; an African ancestral variant adopted under selective pressure as protection against malaria) was associated with TNBC-specific risk (P0.0001), quantified West African Ancestry (P0.0001) and was more common in AA, Ghanaians, and TNBC cases. Additionally, rs4849887 was significantly associated with overall BC risk, and both rs2363956 and rs13000023 were associated with TNBC-specific risk, although none as strongly as the Duffy-null variant.West African ancestry is strongly correlated with TNBC status, as well as germline variants related to BC risk. The Duffy-null allele was associated with TNBC risk in our cohort.

Background Malaria is one of the leading causes of morbidity in the world. It is a significant health concern in most developing countries, including Ghana. Even though there are several orthodox medications used for decades in treating malaria effectively, a substantial number of individuals in developing countries are resorting to the use of herbs in the treatment of malaria. The study aim at exploring the practices of herbal management of malaria among trading mothers in Shai Osudoku District, Accra. Methods A qualitative approach with an exploratory, descriptive design was adopted in analyzing the research problem. Purposive sampling technique was used to select twenty (20) participants to partake in a face-face interview, guided by a semi-structured interview guide. The data were transcribed verbatim and analysed by adopting content analysis. Results Two significant themes and seven subthemes were generated following the analysis of this study. The main themes were; preferences for herbal malaria treatment and the practices and effectiveness of herbal medicine used for malaria treatment. It was worth noting that the women’s cultural beliefs did not influence their preference for herbal malaria treatment. The main challenge associated with the herbal malaria treatment was inappropriate dosage specification. Conclusion This study discovered that several factors influenced participants’ preferences for malaria treatment. Participants further listed some traditional ways of treating malaria which implies that there is herbal malaria practice. However, literature in this area is inadequate, and most herbs lack specifications for use. It is therefore recommended that future research focus on scientific herbal malaria treatment. Also, regulating bodies should ensure that quality herbal drugs are sold for consumption.

The gut microbiota may play a role in breast cancer etiology by regulating hormonal, metabolic, and immunologic pathways. We investigated associations of fecal bacteria with breast cancer and non-malignant breast disease in a case-control study conducted in Ghana, a country with rising breast cancer incidence and mortality. To do this, we sequenced the V4 region of the 16S rRNA gene to characterize bacteria in fecal samples collected at the time of breast biopsy (N=379 breast cancer cases, N=102 non-malignant breast disease cases, N=414 population-based controls). We estimated associations of alpha diversity (observed amplicon sequence variants [ASVs], Shannon index, and Faith’s phylogenetic diversity), beta diversity (Bray Curtis and unweighted/weighted UniFrac distance), and presence and relative abundance of select taxa with breast cancer and non-malignant breast disease using multivariable unconditional polytomous logistic regression. All alpha diversity metrics were strongly, inversely associated with odds of breast cancer and for those in the highest vs. lowest tertile of observed ASVs, the odds ratio (95% confidence interval) was 0.21 (0.13-0.36; Ptrend

Large-scale efforts to identify breast cancer (BC) risk alleles have historically taken place among women of European ancestry. Recently, there are new efforts to verify if these alleles increase risk in African American (AA) women as well. We investigated the effect of previously reported AA breast cancer and triple-negative breast cancer (TNBC) risk alleles in our African-enriched International Center for the Study of Breast Cancer Subtypes (ICSBCS) cohort. Using case–control, case-series and race-nested approaches, we report that the Duffy-null allele (rs2814778) is associated with TNBC risk (OR = 3.814, p = 0.001), specifically among AA individuals, after adjusting for self-indicated race and west African ancestry (OR = 3.368, p = 0.007). We have also validated the protective effect of the minor allele of the ANKLE1 missense variant rs2363956 among AA for TNBC (OR = 0.420, p = 0.005). Our results suggest that an ancestry-specific Duffy-null allele and differential prevalence of a polymorphic gene variant of ANKLE1 may play a role in TNBC breast cancer outcomes. These findings present opportunities for therapeutic potential and future studies to address race-specific differences in TNBC risk and disease outcome.

The United Nations (UN) sustainable development goals (SDGs) that became effective at the commencement of January 2016 constitute a global community agreement calling for action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity. This chapter looks at the nexus between real estate (RE) and SDGs by investigating the extent to which Ghana's RE sector incorporates, especially, environmental sustainability principles from the design and construction stages to occupation, operation and activities aimed at helping to solve the problem of climate change, thereby, contributing to achieving the SDGs. The chapter is theoretical and, therefore, heavily reliant on critical review of relevant extant literature. The chapter has shown that RE cuts across virtually all the sectors that contribute greenhouse gas (GHG) emissions, which over the years have generally been increasing. Only a few buildings in both the private and public sectors (six located in three of the 16 administrative regions in the country) are officially classified as green based on three sustainability-rating systems currently used in the country, which suggests that the uptake of green building technologies (GBTs) is rather low leading to the conclusion that at the moment, the RE sector is not contributing much towards the attainment of the SDGs. However, it may be the case that there are buildings, which are sustainable in one form or the other, but because they have not been officially certified, they are not regarded as green – employing the services of the sustainability-rating agencies to certify buildings involve significant costs that might serve as a barrier in accessing their services. Thus, there is the need for country-wide, large-scale studies that systematically investigate the uptake of GBTs in the private and public RE sectors (not necessarily based on using the rating systems) as that may reveal the actual uptake of GBTs and what can be done policy-wise based on the outcomes of such studies.

Progress under sustainability principles is now widely accepted as the goal that every society should pursue. Whilst the built environment has imbibed these sustainability principles just like many other sectors, scholarly works that bring together experiences of real estate and sustainability are limited. Contributors to this book in accordance with the aim of the book examine real estate and sustainability in the developing world drawing on experiences from several countries. This conclusion chapter summarises the discussions in the book highlighting implications and prospects. The chapter notes that the threat to the destruction of the environment in the developing world is real and the real estate and urban development sector is at the forefront of this threat. Furthermore, although adoption of sustainability principles is seen as very relevant to abate the threat, progress in uptake of the principles within the real estate and urban development sector has rather been slow due to lack of incentives, funding, technology and robust policies; inadequate knowledge and awareness; and poor planning among others. Changes in practices from business as usual to ones which promote effective planning, building knowledge and databases through research and increase in funding for sustainable projects and education among other things as ways to improve uptake are proposed with the recognition of huge prospect for developing countries to overcome the current situation given recent initiatives and available knowledge.

Although a basic need, housing and its development activities impinge on the environment. As part of efforts to promote sustainability, there have been several initiatives since the Brundtland Commission's work in 1987 to minimise the adverse impact of housing development activities on the environment in the developing world such as sub-Saharan Africa (SSA). This chapter explores housing development activities in Ghana within the context of environmental sustainability based on the extant literature. The aim is to examine the state and promotion of environmental sustainability in the housing development sector. The chapter establishes that although there are some efforts to promote environmental sustainability within the housing development sector, uptake of environmental sustainability practices has been less satisfactory due to lack of incentives as stakeholders perceive that environmentally sustainable homes are more expensive than conventional ones. The chapter, therefore, recommends further investigations into the cost and benefit of environmentally sustainable homes as well as other drivers in Ghana to give additional insights to provide the appropriate doses of incentives both contrived and instinctive to drive uptake.

Mavis Baffoe,1 George Koffuor1 ,† Agyapong Baffour-Awuah,1 Lorraine Sallah2 1Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; 2Department of Physiology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana†Prof. George Koffuor passed away on February 5, 2021.Correspondence: George KoffuorDepartment of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaTel +233 27-740-0312Email gkoffuor@yahoo.comPurpose: Male sexual dysfunction negatively affects an individual’s quality of life and thus its of prime public concern, hence the need to boost reproductive abilities in such individuals. This study assessed the effect of hydroethanolic root extracts of Caesalpinia benthamiana (CBRE), Sphenocentrum jollyanum (SJRE), and Paullinia pinnata (PPRE), commonly used as aphrodisiacs in Ghana, using male Sprague-Dawley rats.Methods: Plasma testosterone, follicle-stimulating hormone, and luteinizing hormone were assayed in grouped rats treated orally with 1 mL/kg normal saline, 50 mg/kg monosodium glutamate (MSG), and 100, 300, or 1000 mg/kg CBRE, SJRE, and PPRE, respectively, for 60 days. Epididymis and testis weights were determined. Semen was assessed on spermatozoa count, motility, and morphology. Malonyladehyde formation in lipid-peroxidation assay and histological examinations were performed to assess pathological changes in testes. Testicular testosterone was also assayed.Results: While MSG, CBRE, SJRE, and PPRE treatments did not result in significant reduction (p> 0.05) in plasma testosterone, there was significant reduction (p≤ 0.05 − 0.0001) in plasma luteinizing hormone, and follicle-stimulating hormone. The combined mean wet weights of epididymides and testes of all treated groups did not vary significantly (p> 0.05) from the control. There was significant reduction (p≤ 0.0001) in sperm motility and count, with significant morphological changes (p≤ 0.05– 0.001), ie, bent necks, tails, and midpieces, and multiple anomalies in the spermatozoa in extract and MSG-treated groups. There was also significant (p≤ 0.0001) reduction in testicular testosterone among all treatment groups.Conclusion: Hydroethanolic CBRE, SJRE, and PPRE were found to have detrimental effects on reproductive function with prolonged usage and thus may not be safe to use in healthy males who intend to reproduce.Keywords: plasma follicle-stimulating hormone, plasma luteinizing hormone, sperm anomalies, sperm motility, testicular testosterone, monosodium glutamate, herbal aphrodisiacs

Pressure to reduce the environmental impact of construction activities has increased, such that a paradigm shift is required. This paper presents stakeholder opinions of environmental management systems as a means for the construction industry to respond to these issues. Using a previous approach, the views of small and medium construction companies were sought, using questionnaires to ask respondents to reveal their perceived benefits of and barriers to implementing the ISO 14000 suite of environmental management standards in the UK. Detailed statistical analysis showed that environmental management systems can sometimes produce quantifiable benefits to organisations in terms of cost reduction. However, from a contractor’s view, the greatest benefit was a reduction in environmental impact outweighing financial benefits. Findings also demonstrated numerous barriers to an organisation exist, both internal and external, regarding adoption and use of environmental management systems. The most critical barrier was that cost savings do not always balance with the expense of implementation. Furthermore, waste minimisation at the design stage is viewed as most important. In general, the opinions gauged in this study indicated that short-term profits are normally considered more imperative than long-term gains. Therefore, despite a need to focus on developing strategies for removing or reducing the challenges of environmental management systems, the reality is that they may not be the panacea to sustainable development, as is often touted.

Background Previous work has evaluated the effect of remote ischaemic conditioning (RIC) in a number of clinical conditions (e.g. cardiac surgery and acute kidney injury), but only one analysis has examined blood pressure (BP) changes. While individual studies have reported the effects of acute bouts and repeated RIC exposure on resting BP, efficacy is equivocal. We conducted a systematic review and meta-analysis to evaluate the effects of acute and repeat RIC on BP. Methods A systematic search was performed using PubMed, Web of Science, EMBASE, and Cochrane Library of Controlled Trials up until October 31, 2020. Additionally, manual searches of reference lists were performed. Studies that compared BP responses after exposing participants to either an acute bout or repeated cycles of RIC with a minimum one-week intervention period were considered. Results Eighteen studies were included in this systematic review, ten examined acute effects while eight investigated repeat effects of RIC. Mean differences (MD) for outcome measures from acute RIC studies were: systolic BP 0.18 mmHg (95%CI -0.95, 1.31; p = 0.76), diastolic BP -0.43 mmHg (95%CI -2.36, 1.50; p = 0.66), MAP -1.73 mmHg (95%CI -3.11, −0.34; p = 0.01) and HR -1.15 bpm (95%CI -2.92, 0.62; p = 0.20). Only MAP was significantly reduced. Repeat RIC exposure showed non-significant change in systolic BP -3.23 mmHg (95%CI -6.57, 0.11; p = 0.06) and HR -0.16 bpm (95%CI -7.08, 6.77; p = 0.96) while diastolic BP -2.94 mmHg (95%CI -4.08, −1.79; p, Highlights • Question: Does acute or repeat remote ischaemic conditioning (RIC) lower blood pressure? • Findings: Acute RIC significantly reduced MAP. Repeat RIC significantly reduced DBP and MAP by around 3mmHg. This is clinically meaningful. • Meaning: Repeat RIC is effective in reducing diastolic and mean arterial blood pressures.

The Carnegie Corporation of New York has embarked on a revitalisation programme of some African public libraries. The Corporation has made grants to those public library systems targeting previously disadvantaged communities. Those aspects of the programmes that the grantees have drawn up which could impact school library development in the recipient countries are highlighted here. The selected public libraries of Botswana, Kenya and five provinces within South Africa, as grantees of revitalisation awards are the objects of focus here. Seven other African countries that have benefited to a relatively lesser extent are mentioned as issues emerge that relate to them. Suggestions are made as to the impact some of these public library programmes could make on school libraries and school pupils.

The Carnegie Corporation of New York has embarked on a revitalisation programme of some African public libraries. The Corporation has made grants to those public library systems targeting previously disadvantaged communities. Those aspects of the programmes that the grantees have drawn up which could impact school library development in the recipient countries are highlighted here. The selected public libraries of Botswana, Kenya and five provinces within South Africa, as grantees of revitalisation awards are the objects of focus here. Seven other African countries that have benefited to a relatively lesser extent are mentioned as issues emerge that relate to them. Suggestions are made as to the impact some of these public library programmes could make on school libraries and school pupils.

BackgroundVasectomy is an effective contraceptive method that has been approved worldwide and proven to be an effective method of contraception among males in the perspective of controlling a population. Although safer, simpler, less expensive and equally as effective as female sterilization, throughout the world, it is one of the least used and least known methods of contraception. It is perceived to be a form of castration, which can make men weak and incapable, thereby unable to satisfy their wives sexually, leading to marital conflicts. The study aimed at determining perceptions and experiences regarding vasectomy among vasectomized men at Larterbiokorshie. MethodsThis study adopted a qualitative method utilizing Phenomenological research design. The sample consisted of 18 vasectomized men selected through purposive sampling method. Face-face interviews were conducted with participants using a semi-structured interview guide. ResultsThe study discovered that the vasectomized men have a positive perception about vasectomy in terms of promoting couples sexual Health. Nevertheless, public perception regarding vasectomy was found to be poor. Socio-cultural and religious factors were also found to influence vasectomy uptake. In addition, several reasons were cited for motivating men regarding their decision on vasectomy and finally, participants shared their experiences following their vasectomy. ConclusionConclusively, despite all the misconceptions and concerns raised about vasectomy, the study revealed a positive perception among the vasectomized men. The study recommends that the government should formulate policies which will improve the utilization of vasectomy through ongoing monitoring and evaluation of services.

The impact of digital technologies to the domain of cultural heritage has increased the speed and automation of the processes and practices that involve processing and presentation of digital heritage data. Heritage Building Information Modelling (HBIM) and Virtual Reality (VR) can play a key role towards the conservation, preservation, and management of architectural heritage. This includes the preservation of both tangible and intangible cultural heritage at multiple levels. The purpose of this study is to explore the potential of digital storytelling through digital technologies by integrating intangible data and information to the tangible heritage in the scan-to-BIM process. The paper builds on few works that have begun to investigate the classification of intangible qualitative heritage data within a BIM and VR context for heritage assets. This exploration demonstrates that the incorporation of both qualitative and quantitative information about a heritage-built asset has value in the (re)interpretation, documentation and preservation of cultural heritage. The development of HBIM and VR in this paper is to bring together heterogeneous data that has the potential to provide a model for future work in the field of heritage conservation and digital technologies. The city of Surat is used as a case study for exploring the potential of digital storytelling for the city’s urban heritage. Indeed, this holistic integration can enhance the awareness of urban cultural heritage to support the processes of local urban heritage conservation for key stakeholders such as local Government, heritage conservation experts, urban planners and local communities.

Background: Breast cancer risk estimates for women carrying germline mutations in breast cancer susceptibility genes are mainly based on studies of European ancestry women, with limited data for women in West African. Methods: We investigated associations between pathogenic variants in 34 putative susceptibility genes with breast cancer risk in 871 cases (307 estrogen receptor (ER)-positive, 321 ER-negative, and 243 ER-unknown) and 1,563 controls in a population-based study in Ghana, and estimated lifetime risk for mutation carriers in the general population. We compared results to those for European, Asian and African-American women. Findings: The frequency of pathogenic mutations in nine breast cancer genes (BRCA1, BRCA2, PALB2, TP53, ATM, BARD1, CHEK2, RAD51C, RAD52D) was 8·38% in cases and 1·22% in controls from GBHS. Mutations in BRCA1, BRCA2, PALB2, and TP53 were significantly associated with breast cancer risk at P

The rich architectural and urban heritage of Jordan is under continuing threat not only through means of physical attack but also physical disaster, increasing urbanization and a diminishing value from multiple stakeholders such as owners and users. This research study explores the potential of digital technologies in documenting and preserving urban architectural heritage in Jordan. Data was collected from diverse stakeholders on heritage conservation in Jordan. The findings evidence that Building Information Modelling (BIM) has the potential to create a classification system for heritage buildings under threat and set forth the application of legislation and regulations about heritage . The study demonstrated that the collection of data information needs to be understood through the context of cultural sensitivity. Lack of awareness in the value of cultural heritage from local communities exacerbates the diminishing efforts in preserving cultural assets. In collecting information for the documentation of this heritage, this study categorizes the challenges of preserving urban heritage as either hierarchical or cultural. The collection, management and storing of data for digital heritage requires an awareness of the issues of time and the power structures that are involved in their collection and upon which they have a profound effect.

The informal land development system in Sub-Saharan Africa (SSA) is perceived to promote equity and could be leveraged to support sustainable urban development and management. However, scanty empirical evidence exists on the extent of the system’s provision of equity to support policy formulation and practice in the region. Based on stakeholder workshops, focus group discussions and questionnaire surveys, this study analyses the system’s provision of equity in Nigeria. The study finds all categories of people undertake informal developments. Consistent with literature, this finding reflects wide patronage of the informal land development system and its relevance. Nevertheless, contrary to the existing perception, the system’s provision of equity is low. The study recommends for the institution of pro-poor and gender sensitive land development and management policies and programmes to increase the levels of equity to support the achievement of the country’s sustainable urban development and management agenda.

Estimates from the World Health Organization (WHO) reveal that perinatal loss is a threat in sub-Saharan Africa. It has been established that half of all stillbirths and neonatal deaths occur around the onset of labour to delivery. Approximately 75% of these deaths occur in sub-Saharan Africa, giving the region the highest level of perinatal loss in the world. There are limited studies that have investigated the experiences of and support for women who experience perinatal loss. This article reports on a scoping review that aimed to explore and summarise the existing literature about the experiences of perinatal loss among couples in sub-Saharan Africa, and to identify the relevant support health professionals and the community give to improve the well-being of parents experiencing perinatal loss. Electronic databases were used to search comprehensively peer-reviewed articles and grey literature between 2005 and 2019. Two independent reviewers screened and analysed the selected articles through a data charting procedure. Eight articles met the inclusion criteria for the study. They were all qualitative studies: seven of them were peer-reviewed articles and one was a master’s thesis. The findings were categorised under two themes: (1) emotional experiences of perinatal loss among sub-Saharan African women; and (2) support systems available for these women. The literature review highlighted the limited research and lack of literature about the emotional experiences of bereaved couples in sub-Saharan Africa. Furthermore, the literature review revealed that bereaved couples need more support to reduce psychological trauma. The study findings demonstrated the need for more research to enhance understanding of and improve the services provided to bereaved couples and their families.

Master's thesis in Literacy Studies Abstract Pertinent discussions and arguments have surfaced on the topic of hegemonic masculinities and patriarchy as themes in most African novels. Focus has been thrown on the representation of biased power structures between gender typical of patriarchies. The consistent marginalisation of female characters by male characters and society at large in works by male authors has spearheaded a feminist movement where contemporary female authors have tried to redeem the image of the female character. This study seeks to review the strategies that male dominance is manifested and preserved in the African novel, using Chimamanda Ngozi Adichie’s Purple Hibiscus (2003) as a yardstick. Religion has been overlooked and undermined in these discussions compared to the scholarly works have named culture and tradition as social institutions that have been used to construct these masculinities. Others have blamed femininity calling it the fuel that enables and enhances patriarchy. A few other works have linked patriarchy to religious beliefs and practices in the African society, suggesting that religion plays a vital role in creating gender inequality in different regions of Africa. Religion has received little attention. This thesis seeks to argue that religion has indeed had an influence on gender inequalities and hegemonic masculinity portrayed in African literary texts. This paper to adds to the growing investigation on patriarchy portrayed in the African novel adding yet another aspect of religion’s position in upholding and justifying the conjectures of patriarchy and hegemonic masculinity and their symbolic representation in the literary text. Using Purple Hibiscus (2003) by Nigerian novelist and playwright, Chimamanda Ngozi Adichie, I will investigate how religion, and in this case Christianity, is used to fuel and maintain the survival of behaviour in male characters, illuminating nuances where religion has assisted the successes of patriarchy.

Circulating tumor DNA (ctDNA) sequencing studies could provide novel insights into the molecular pathology of cancer in sub-Saharan Africa. ctDNA was readily detected in 15 blood samples collected in Ghana at the time of suspected breast cancer. Genomic alterations previously associated with unfavorable prognostic outcomes were observed in the majority of patients. This supports the use of liquid biopsies for diagnosis, surveillance and clinical management of breast cancer in Ghana.

Background Polygenic risk scores (PRSs) have been demonstrated to identify women of European, Asian, and Latino ancestry at elevated risk of developing breast cancer (BC). We evaluated the performance of existing PRSs trained in European ancestry populations among women of African ancestry. Methods We assembled genotype data for women of African ancestry, including 9241 case subjects and 10 193 control subjects. We evaluated associations of 179- and 313-variant PRSs with overall and subtype-specific BC risk. PRS discriminatory accuracy was assessed using area under the receiver operating characteristic curve. We also evaluated a recalibrated PRS, replacing the index variant with variants in each region that better captured risk in women of African ancestry and estimated lifetime absolute risk of BC in African Americans by PRS category. Results For overall BC, the odds ratio per SD of the 313-variant PRS (PRS313) was 1.27 (95% confidence interval [CI] = 1.23 to 1.31), with an area under the receiver operating characteristic curve of 0.571 (95% CI = 0.562 to 0.579). Compared with women with average risk (40th-60th PRS percentile), women in the top decile of PRS313 had a 1.54-fold increased risk (95% CI = 1.38-fold to 1.72-fold). By age 85 years, the absolute risk of overall BC was 19.6% for African American women in the top 1% of PRS313 and 6.7% for those in the lowest 1%. The recalibrated PRS did not improve BC risk prediction. Conclusion The PRSs stratify BC risk in women of African ancestry, with attenuated performance compared with that reported in European, Asian, and Latina populations. Future work is needed to improve BC risk stratification for women of African ancestry.