Residential energy expenditures and the relevance of financial inclusion across location, wealth quintiles and household structures.

This paper examines the relative role of financial inclusion in enhancing households' ability to spend on energy consumption across rural and urban locations. It uses comprehensive household data from Ghana and employs the ordinary least square (OLS) as well as an instrumental variable estimation technique. Endogeneity of financial inclusion is instrumented using distance to the nearest bank. Our findings suggest that a standard deviation increase in financial inclusion contributes to an improvement in residential energy expenditure by 1.2835 standard deviations. This finding is robust to different methods for resolving endogeneity and alternative weighting schemes in the financial inclusion construct. Among the different sources of energy for lighting and cooking, financial inclusion increases expenditure on LPG and electricity more than the others. Financial inclusion increases the ability to spend more on residential energy in urban, poorest, and female-headed dual-parent households. Household net income is a key pathway through which financial inclusion affects residential energy expenditure.

Views of Service Users, Their Family or Carers, and Health Care Professionals on Telerehabilitation for People With Neurological Conditions in Ghana: Qualitative Study.

BACKGROUND: Up to 50% of people in low- and middle-income countries do not receive the rehabilitation they require. Telerehabilitation has the potential to improve access to neurorehabilitation services especially in low- and middle-income countries. Although there are reports of the barriers and facilitators to telerehabilitation in such settings, almost all are anecdotal. Furthermore, family or carers have a significant influence on the adoption and success of telerehabilitation, but their views have not been reported. OBJECTIVE: This study aimed to investigate the views of service users, their family or carers, and health care professionals (HCPs) on telerehabilitation for people with neurological conditions in Ghana. METHODS: Two focus groups were held at Komfo Anokye Hospital in Kumasi, Ghana: one in person for service users (n=11) and their family or carers (n=9), conducted in the Ghanaian language of Twi, and one hybrid for HCPs (n=18) conducted in English. The mean (SD) age of the service users was 59.8 (8.6) years; 5 users had a stroke and 6 had Parkinson disease. The HCP group consisted of 7 speech and language therapists, 3 physiotherapists, 3 occupational therapists, 3 medical staff, 1 nurse, and 1 industry representative. Focus groups were semi-structured and explored previous experiences of telerehabilitation, perceived benefits and challenges, and solutions to overcome these challenges. Focus groups were audio transcribed, and the service user transcript was translated into English. The resulting transcripts were analyzed using thematic analysis. RESULTS: Overall, participants were positive about the role of telerehabilitation but recommended hybrid delivery, with in-person rehabilitation in the early stages and telerehabilitation in the later stages. In relation to telerehabilitation in Ghana, there were 3 main themes: benefits, challenges or barriers, and implementation. Benefits included the convenience and lower cost for service users, the higher dose of therapy possible, and increased access for people in remote areas. However, challenges included lack of a stable internet connection, cost of phones and data packages, and low levels of literacy. Implementation issues included cultural relevance, information governance, and the platform used to deliver telerehabilitation, with most participants being familiar with WhatsApp. CONCLUSIONS: Telerehabilitation has the potential to be a useful method of delivering rehabilitation to people with neurological conditions in Ghana, especially in a hybrid rehabilitation model with telerehabilitation augmenting in-person sessions. However, many people were unaware of telerehabilitation, and challenges such as a reliable internet connection, cultural relevance, and costs need to be addressed. Clinical trials of low-cost telerehabilitation interventions contextualized to the specific user group are required.

Energy justice, democracy and deforestation.

This paper contributes to the debate on the determinants of deforestation, a menace that is posing threat to sustainable development particularly in tropical developing regions. Specifically, the paper focuses on the effect of energy justice and democratization. The main contribution to the literature hinges on the emphasis on energy justice - operationalized as rural-urban equality in access to electricity and clean fuels and technologies for cooking - and its interaction with democracy. Using a panel data of 47 sub-Saharan African countries over the period 2000-2020 and the dynamic two-step generalized method of moment estimator, the results generally indicate that improvement in rural-urban equality in access to electricity and clean fuels and technologies for cooking is associated with a reduction in deforestation. Democracy is similarly found to be associated with reduction in deforestation. The conditional effect analysis largely depicts an intensified reducing effect of energy justice on deforestation in the presence of improved democratic practices. The results though robust to an alternative estimator, the Driscoll-Kraay estimator, differ when sub-regional analysis is considered. The paper aligns with the Sustainable Development Goals, particularly Goals 7, 13, 15 and 16.

Surveillance for potentially zoonotic viruses in rodent and bat populations and behavioral risk in an agricultural settlement in Ghana.

BACKGROUND: In Ghana, the conversion of land to agriculture, especially across the vegetative belt has resulted in fragmented forest landscapes with increased interactions among humans, domestic animals, and wildlife. METHODS: We investigated viruses in bats and rodents, key reservoir hosts for zoonotic viral pathogens, in a small agricultural community in the vegetation belt of Ghana. We also administered questionnaires among the local community members to learn more about people's awareness and perceptions of zoonotic disease risks and the environmental factors and types of activities in which they engage that might influence pathogen transmission from wildlife. RESULTS: Our study detected the RNA from paramyxoviruses and coronaviruses in rodents and bats, including sequences from novel viruses with unknown zoonotic potential. Samples collected from Epomophorus gambianus bats were significantly more likely to be positive for coronavirus RNA during the rainy season, when higher numbers of young susceptible individuals are present in the population. Almost all community members who responded to the questionnaire reported contact with wildlife, especially bats, rodents, and non-human primates in and around their homes and in the agricultural fields. Over half of the respondents were not aware or did not perceive any zoonotic disease risks associated with close contact with animals, such as harvesting and processing animals for food. To address gaps in awareness and mitigation strategies for pathogen transmission risks, we organized community education campaigns using risk reduction and outreach tools focused around living safely with bats and rodents. CONCLUSIONS: These findings expand our knowledge of the viruses circulating in bats and rodents in Ghana and of the beliefs, perceptions, and practices that put community members at risk of zoonotic virus spillover through direct and indirect contact with bats and rodents. This study also highlights the importance of community engagement in research and interventions focused on mitigating risk and living safely with wildlife.

What are the barriers and facilitators to polio vaccination and eradication programs? A systematic review.

Global efforts to eradicate polio by the Global Polio Eradication Initiative agency partners and country-level stakeholders have led to the implementation of global polio vaccination programs. This study presents the findings of existing studies regarding the barriers and facilitators that countries face when implementing polio interventions. A comprehensive search was conducted in OVID Medline, OVID Embase, EBSCO CINAHL Plus, and Web of Science. Eligible studies underwent quality assessment. A qualitative evidence synthesis approach was conducted and aligned to the Consolidated Framework for Implementation Research (CFIR). The search identified 4147 citations, and following the removal of duplicates and screening according to our inclusion/exclusion criteria, 20 articles were eligible for inclusion in the review. Twelve countries were represented in this review, with India, Nigeria, Pakistan, Ethiopia, and Afghanistan having the most representation of available studies. We identified 36 barriers and 16 facilitators. Seven themes emerged from these barriers and facilitators: fear, community trust, infrastructure, beliefs about the intervention, influential opinions, intervention design, and geo-politics. The most frequently cited CFIR constructs for the facilitators and barriers were knowledge and beliefs about the intervention, followed by available resources. This study identified a wide range of barriers and facilitators to polio vaccination implementation across the globe, adding to the scarce body of literature on these barriers and facilitators from an implementation perspective and using a determinant framework. The diversity of factors among different groups of people or countries highlights the relevance of contexts. Implementers should be conversant with the contexts within which polio eradication programs boost intervention coverage and capacity. This study provides policymakers, practitioners, and researchers with a tool for planning and designing polio immunization programs. Trial registration: A protocol for this systematic review was developed and uploaded onto the PROSPERO international prospective register of systematic reviews database (Registration number: CRD42020222115).

Exploring the transition from student to health professional by the first cohort of locally trained occupational therapists in Ghana.

INTRODUCTION: The transition from student to occupational therapist for new graduates has been described as a period of extreme stress and anxiety; novice therapists enter a world that is new and complex upon starting clinical practice. The first locally-trained occupational therapists in Ghana worked autonomously and in a self-directed manner from their first year of practice in a country where occupational therapy had not been established. The study sought to explore the transition from student to clinician, made by the first cohort of locally trained occupational therapists in Ghana. METHODS: An interpretive phenomenology approach was used to explore participants' experiences of their transition from occupational therapy students to clinicians in Ghana. Six participants were selected using purposive, maximum variation, sampling. Data were collected by means of in-depth interviews and analysed using an iterative, inductive approach. RESULTS: Four themes emerged: Being 'new' in a new profession, introducing occupational therapy into a new environment, Personal and professional competence, and 'The future is bright'. New graduates found continued professional development activities, such as additional reading, seminars and conferences, essential for successful transition into practice. CONCLUSION: The importance of supervision and mentorship was highlighted in the study. Explicit attention to factors that support assimilation of new graduates within health care facilities were highlighted. The importance of continued professional development in development of practice competencies was foregrounded. Strategies to facilitate multi-professional work were demonstrated.

Exploring the factors that affect the transition from student to health professional: an Integrative review.

BACKGROUND: The nature of a new health professional's transition from student to health professional is a significant determinant of the ease or difficulty of the journey to professional competence. The integrative review will explore the extent of literature on the factors that impact the transition of new health professionals into practice, identify possible gaps and synthesise findings which will inform further research. The aim was to identify research conducted in the last two decades on the barriers, facilitators and coping strategies employed by new health professionals during their transition into practice. METHODS: Whittemore and Knafl's methodological framework for conducting integrative reviews was used to guide this review. Sources between 1999 and 2019 were gathered using EBSCOhost (including CINAHL, Medline, Academic Search Premier, Health Science: Nursing and Academic Edition), PubMed, Scopus, Cochrane and Web of Science, as well as hand searching and follow-up of bibliographies followed. The Covidence platform was used to manage the project. All studies were screened against a predetermined selection criteria. Relevant data was extracted from included sources and analysed using thematic analysis approach. RESULTS: Of the 562 studies identified, relevant data was extracted from 24 studies that met the inclusion criteria, and analysed to form this review. Thematic analysis approach was used to categorise the findings into theme areas. Four overarching themes emerged namely: systems and structures, personal capacities, professional competence and mediating processes. Each theme revealed the barriers, facilitators and coping strategies of transition into practice among new health graduates. CONCLUSION: The transition into practice for new health practitioners has been described as complex and a period of great stress. Increasing clinical and practical experiences during education are required to support new health professionals in the process of closing the gap between learning and practice. Continued professional development activities should be readily available and attendance of these encouraged.

Investigating the environmental effect of globalization: Insights from selected industrialized countries.

Despite the burgeoning literature on the globalization-environmental degradation nexus, this area of empirical interest is still riddled with ambiguity. Thus, based on an extended Stochastic Impacts by Regression on Population, Affluence and Technology (STIRPAT) model, we re-investigate the effect of globalization on environmental degradation for 27 selected industrialized countries over the period 1991-2016. More specifically, we shed light into how overall globalization and its various components - economic, social and political globalization - affect environmental degradation. We advance existing literature by considering a measurement approach which disaggregates overall, economic, social and political globalization into their de facto and de jure aspects. Using the augmented mean group estimator, we find that overall and economic globalization reduce environmental degradation while social and political globalization do not exert any significant effect on globalization. With respect to the de facto and de jure aspects, we observe that, while only de facto economic globalization mitigates environmental degradation, de jure overall, economic and social globalization also dampen environmental degradation. We provide some policy implications in the end.

Trade and environmental pollution in Africa: accounting for consumption and territorial-based emissions.

This paper employs a recently constructed consumption-based carbon dioxide emissions data in which emissions computations are made based on fossil fuel usage domestically, in addition to emissions emanating from imports minus exports. We contrast this measure with the commonly measured territory-based carbon dioxide emissions data and examine how trade performance (split into imports, exports, and total trade) impacts these two measures of carbon dioxide. We focus on 22 sub-Saharan African countries over the period 1995-2014. Employing the system generalized method of moments, we find trade to generally have positive effect on emissions. The results are consistent across the different measures of trade and carbon dioxide emissions. The results of the paper allow us to give some policy suggestions regarding carbon dioxide emissions in sub-Saharan Africa.

Exploring the factors that affect new graduates' transition from students to health professionals: a systematic integrative review protocol.

INTRODUCTION: To become a competent health professional, the nature of new graduates' transition plays a fundamental role. The systematic integrative review will aim to identify the existing literature pertaining to the barriers during transition, the facilitators and the evidence-based coping strategies that assist new graduate health professionals to successfully transition from students to health professionals. METHODS AND ANALYSIS: The integrative review will be conducted using Whittemore and Knafl's integrative review methodology. Boolean search terms have been developed in consultation with an experienced librarian, using Medical Subject Heading terms on Medline. The following electronic databases have been chosen to ensure that all relevant literature are captured for this review: PubMed, EBSCOhost (including Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier, Health Science: Nursing and Academic Edition), Scopus and Web of Science. A follow-up on the reference list of selected articles will be done to ensure that all relevant literature is included. The Covidence platform will be used to facilitate the process. ETHICS AND DISSEMINATION: Ethical approval is not required for this integrative review since the existing literature will be synthesised. The integrative review will be published in a peer-reviewed journal once all the steps have been completed. The findings will also be presented at international and national conferences to ensure maximum dissemination.