Bivariate ordered probit modelling of motorcycle riders and pillion passengers' injury severities relationship and associated risk factors.

This study simultaneously modelled the injury severity of motorcycle riders and their pillion passengers and determine the associated risk factors. The analysis is based on motorcycle crashes data in Ashanti region of Ghana spanning from 2017 to 2019. The study implemented bivariate ordered probit model to identify the possible risk factors under the premise that the injury severity of pillion passenger is endogenously related to that of the rider in the event of crash. The model provides more efficient estimates by considered the common unobserved factors shared between rider and pillion passenger. The result shows a significant positive relationship between the two injury severities with a correlation coefficient of 0.63. Thus, the unobservable factors that increase the probability of the rider to sustain more severe injury in the event of crash also increase that of their corresponding pillion passenger. The rider and their pillion passenger injury severities have different propensity to some of the risk factors including passengers' gender, day of week, road width and light condition. In addition, the study found that time of day, weather condition, collision type, and number of vehicles involved in the crash jointly influence the injury severity of both rider and pillion passenger significantly.

Application of Hierarchical/Multilevel Models and Quality of Reporting (2010-2020): A Systematic Review.

Introduction: Multilevel models have gained immense popularity across almost every discipline due to the presence of hierarchy in most data and phenomena. In this paper, we present a systematic review on the adoption and application of multilevel models and the important information reported on the results generated from the use of these models. Methods: The review was performed by searching Google Scholar for original research articles on the application of multilevel models published between 2010 and 2020. The search strategy involved topics such as "multilevel models," "hierarchical linear models," and "mixed models with hierarchy." The search placed more emphasis on the application of hierarchical models in any discipline but excluded software methodological development and related articles. Results: A total of 121 articles were initially obtained from the search results. However, 65 articles met the inclusion criteria for the review. Out of the 65 articles reviewed, 46.2% were related to health/epidemiology, 15.4% to education and psychology, and 16.9% to social life. The majority of the articles (78.5%) were two-level models, and most of these studies modelled univariate responses. However, the few that modelled more than one response modelled them separately. Moreover, 83.1% were cross-sectional design, and 9.2% and 6.2% were longitudinal and repeated measures, respectively. Moreover, a little over half (55.4%) of articles reported on the intraclass correlation measure, and all articles indicated the response variable distribution where most (47.7%) were normally distributed. Only 58.5% of articles reported on the estimation methods used as Bayesian (20%) and MLE (18.5%). Again, model validation measures and statistical software were reported in 70.8% and 90.8% articles, respectively. Conclusion: There is an increase in the utilization of multilevel modelling in the last decade, which could be attributed to the presence of clustered and hierarchically correlated data structures. There is a need for improvement in the area of measurement and reporting on the intraclass correlation, parameter estimation, and variable selection measures to further improve the quality of the application of multilevel models. The integration of spatial effects into multilevel models is very limited and needs to be explored in the future.

Assessing the vibration perception threshold in a community sample of adult Ghanaians.

BACKGROUND: The vibration perception threshold (VPT) helps evaluate human somatosensory function and diagnose peripheral neuropathy. To optimize its use as a primary neurologic tool, it is imperative to establish its typical values in healthy subjects and assess the factors affecting its variability in an individual to ensure consistency in its application. METHODS: Demographic data and a brief medical history were collected from 391 non-diabetic adults aged 30-80 at Kpone-on-Sea in Ghana. The VPT was measured at the tip of the big toe, the medial malleolus, the tip of the middle finger, and the head of the ulna of each participant using a Horwell Neurothesiometer. The variability of VPT was assessed vis-à-vis the following factors: gender, age, fasting plasma sugar and body mass index. RESULTS: The mean age of participants was 48.4 ± 0.7 years, and the female-to-male ratio was 1.46. The overall VPT values ranged from 5.74 ± 0.14 volts to 8.55 ± 0.18 volts in the lower limbs and 3.61 ± 0.06 volts to 5.00 ± 0.08 volts in the upper limbs. Age was found to be the only factor that could predict VPT for both the lower and upper limbs (P < 0.001). One-Way Analysis of Variance with Tukey's posthoc showed that the VPT in the feet was significantly higher than that in the hands. CONCLUSIONS: Generally, the VPT was high on proximal sites and low on distal sites indicating that the vibration sensation increased from proximal to distal direction. Therefore, distal areas should be used for VPT testing with a Neurothesiomer. Age was found to be the only factor that affected VPT variability. Hence, the practical application of VPT will require age-specific reference ranges to cater for older adults.

Examining the risk factors for overweight and obesity among women in Ghana: A multilevel perspective.

Overweight/obesity prevalence is on the increase in epidemic proportions across Low- and Middle-Income countries (LMICs). The public health burden associated with obesity/overweight cannot be underestimated due to its association with chronic health outcomes. This study investigated the individual- and community level risk factors for obesity/overweight among reproductive women. The data used consist of 4393 reproductive women and form part of the 2014 Ghana Demographic and Health Survey (GDHS). Information on these women are clustered within 427 communities. A 2-tier random intercept multilevel logistic model was used to assess the effect of individual- and community level factors on the likelihood of a woman to be obese/overweight. The obesity/overweight prevalence among reproductive women was estimated to be 35.5% (95% CI: 34.04, 36.90%), which significantly differed across clusters. Most at risk were women from middle-income households (aOR = 2.85; 95% CI: 2.28, 3.56), upper-income households (aOR = 5.019, 95% CI: 3.85, 6.55), attaining secondary education (aOR = 1.74; 95% CI: 1.41, 2.16), and higher (aOR = 1.63; 95% CI: 1.14, 2.33), old age (20-29 years (aOR = 4.26; 95% CI: 3.142,5.78); 30-39 years (aOR = 8.59; 95% CI: 6.15, 12.00); 40-49 years (aOR = 12.81; 95% CI: 9.10, 18.16)). Significant differences in the probability of being overweight/obese between different communities were observed (MOR = 1.39). The high prevalence of overweight/obesity requires urgent public health interventions to prevent future public health crises. Efforts to strengthen the healthcare system, encourage lifestyle modification, and public health education are needed to solidify the gains of ensuring a healthy population by 2030 (SDG 3).

Assessment of the Clinical Presentations and Ultrasonographic Features of Uterine Fibroids in Adult Africans: A Retrospective Study.

Objectives: We sought to determine the clinical presentations and ultrasonographic features of uterine fibroids in adult Ghanaians. Methods: Between 1 January 2018 and 31 December 2021, 4279 ultrasound-confirmed cases of uterine fibroids were retrieved. The data obtained, which included age, clinical presentations, and sonographic features were analyzed. A chi-squared test was done to assess for possible associations between the clinical indications, age distribution, and ultrasonographic features of uterine fibroids. Results: The mean age of the patients diagnosed with uterine fibroids was 37.1±11.5 years (range = 16-69 years). Routine checkup (n = 1310, 28.1%), menorrhagia (n = 1104, 23.7%), and lower abdominal mass (n = 801, 17.2%) were the leading clinical indications. Dysmenorrhea, amenorrhea, menorrhagia, and routine checkup were significantly noted in the younger patients (p ≤ 0.001). The majority of the fibroid nodules had smooth regular outline (n = 4125, 96.4%) and were mostly heterogeneous (n = 3282, 76.7%). The echo pattern of the nodules was predominantly hypoechoic (n = 3358, 51.1%) followed by hyperechoic nodules (n = 2554, 38.9%). Degenerative changes accounted for less than one-third of the total fibroid nodules, with the least recorded degenerative change being nodules with cystic areas (n = 55, 5.4%) and the most observed degenerative feature being nodules with rim of calcification and areas of calcified degeneration (n = 965, 94.6%). Almost all the sonographic features were significantly seen in the 30-44 years age category. Conclusions: Sonographically, uterine fibroids were mostly hypoechoic heterogeneous nodules with a smooth regular outline with a predominant occurrence within women in the fourth to fifth decade of life.

Evaluation of the anatomical locations and sizes of uterine fibroids from ultrasound examination in Ghana.

Background: Uterine fibroids locations and sizes, have significant influences on the quality of life of women especially pregnant women and on live birth rate. Objectives: To determine the anatomical locations and sizes of uterine fibroids and assess any possible associations with age groups. Methods: This retrospective study reviewed the locations and sizes of a total of 3,542 patients who were ultrasonographically diagnosed with uterine fibroids from January 2019 to December 2021. The obtained data were analysed using GNU PSPP, and Python on Jupyter Notebook with statistical significance level set at p≤0.05. Results: The overall average diameter of uterine myoma was 5.50±2.60cm (95%CI=5.41-5.58, range=1.00cm-19.10cm) and the respective mean diameter of intramural, subserosal and submucosal fibroids were 5.53±2.60cm (95%CI=5.44-5.62), 5.50±2.27cm (95%CI=5.27-5.74) and 5.82±2.77cm (95%CI=5.49-6.14). Most of the fibroid nodules were small (48.36%, n=1713) and only 5.84% (n=207) were large (>10cm). Posterofundal fibroids and lower anterior myomas were mostly seen in the 35-44 years age class. Conclusion: The majority of the uterine fibroids were intramural and were mostly at the anterior uterine wall. The submucosal fibroids, even though the rarest, were averagely larger than the other types of uterine myomas. The diameter of uterine fibroids increased with age.

Structural equation modelling of COVID-19 knowledge and attitude as determinants of preventive practices among university students in Ghana.

Coronavirus disease (COVID-19) has distorted the economic development activities of many countries across continents. This undesirable tragedy has highly affected the educational system, which majorly contributes to the wellbeing of an individual and the economy as a whole. The study aims to explore the determinants of COVID-19 preventive practices among students considering their knowledge about COVID-19 and attitudes toward the disease. The data for the study were collected through an online questionnaire survey involving university students. The relationship between students' knowledge, attitude and their preventive practices towards COVID-19 were investigated using structural equation modelling. The results indicated that most students demonstrated substantial knowledge on COVID-19, moderate to strongly agree attitude towards COVID-19, and sometimes practiced COVID-19 preventive and safety protocols. In addition, a positive relationship between knowledge and attitudes towards COVID-19 was established. Also, a positive effect was established for students' knowledge about COVID-19 and preventive practices, whilst an adverse effect was confirmed for attitudes towards COVID-19 and practices to avoid spreading the COVID-19 disease.

Modelling COVID-19 incidence in the African sub-region using smooth transition autoregressive model.

Prediction of COVID-19 incidence and transmissibility rates are essential to inform disease control policy and allocation of limited resources (especially to hotspots), and also to prepare towards healthcare facilities demand. This study demonstrates the capabilities of nonlinear smooth transition autoregressive (STAR) model for improved forecasting of COVID-19 incidence in the Africa sub-region were investigated. Data used in the study were daily confirmed new cases of COVID-19 from February 25 to August 31, 2020. The results from the study showed the nonlinear STAR-type model with logistic transition function aptly captured the nonlinear dynamics in the data and provided a better fit for the data than the linear model. The nonlinear STAR-type model further outperformed the linear autoregressive model for predicting both in-sample and out-of-sample incidence.

Factors affecting motorcycle crash casualty severity at signalized and non-signalized intersections in Ghana: Insights from a data mining and binary logit regression approach.

Despite the countless benefits derived from motorcycle usage, it has become a significant public health concern, particularly in developing countries, due to the plateauing number of fatal/serious injuries associated with them. Although it has been well documented that the frequency and fatality rates of intersection-related motorcycle crashes are high, little research efforts have been made to explore the contributory factors influencing motorcycle-involved crashes at these locations. Interestingly, no study has investigated the latent patterns and chains of factors that simultaneously contribute to the injury severity sustained by motorcycle crash casualties at intersections under different traffic control conditions in developing countries. Since motorcycles are mostly used as taxis in developing countries, it is imperative to consider the injury severity sustained by all crash casualties in the motorcycle safety analysis. This study bridges the research gap by employing a plausible data mining tool to explore hidden rules associated with motorcycle crash casualty injury severity outcomes at both signalized and non-signalized intersections in Ghana's most densely populated region, Accra, using three-year crash data spanning 2016-2018. Besides, a binary logit regression model was also employed to explore the impact of crash factors on casualty severity outcomes using the same dataset. The results from both analysis techniques were consistent; however, the data mining technique provided chains of factors which provided additional insights into the groups of factors that collectively influence the casualty injury severity outcomes. From the rule discovery results, while full license status, daytime/daylight, and shoulder presence increased the risk of fatal injuries at signalized intersections, factors such as inattentiveness, good road surface, nighttime, shoulder absence, and young rider were highly likely to increase casualty fatalities at non-signalized intersections. By controlling all or some of these risk factors, the level of injury severity on the roadways could be reduced. Based on the findings, we provide enforcement, education, and engineering-based recommendations to help improve motorcycle safety.

Geographically weighted principal component analysis for characterising the spatial heterogeneity and connectivity of soil heavy metals in Kumasi, Ghana.

The use of principal component analysis (PCA) for soil heavy metals characterization provides useful information for decision making and policies regarding the potential sources of soil contamination. However, the concentration of heavy metal pollutants is spatially heterogeneous. Accounting for such spatial heterogeneity in soil heavy metal pollutants will improve our understanding with respect to the distribution of the most influential soil heavy metal pollutants. In this study, geographically weighted principal component analysis (GWPCA) was used to describe the spatial heterogeneity and connectivity of soil heavy metals in Kumasi, Ghana. The results from the conventional PCA revealed that three principal components cumulatively accounted for 86% of the total variation in the soil heavy metals in the study area. These components were largely dominated by Fe and Zn. The results from the GWPCA showed that the soil heavy metals are spatially heterogeneous and that the use of PCA disregards this considerable variation. This spatial heterogeneity was confirmed by the spatial maps constructed from the geographically weighted correlations among the variables. After accounting for the spatial heterogeneity, the proportion of variance explained by the three geographically weighted principal components ranged between 85% and 89%. The first three identified GWPC were largely dominated by Fe, Zn and As, respectively. The location of the study area where these variables are dominated provides information for remediation.

Evaluation of the Clinical and Imaging Findings of Breast Examinations in a Tertiary Facility in Ghana.

Breast diseases have been one of the major battles the world has been fighting. In winning this fight, the role of medical imaging cannot be overlooked. Breast imaging reveals hidden lesions which aid physicians to give the appropriate diagnosis and definitive treatment, hence this study, to determine the clinical and imaging findings of breast examinations to document the radiologic features in our setting. This cross-sectional retrospective study reviewed the sociodemographics, imaging reports (mammography and ultrasonography with BI-RADS scores and their features), and the clinical data of 425 patients from September 2017 to September 2020 in the Cape Coast Teaching Hospital. 72 solid lesions with their histology reports were also reviewed. Data obtained were organized, coded, and analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 20.0. The results obtained were presented in appropriate tables and charts. A chi-squared test was employed for associations and statistical significance was specified at p ≤ 0.05. 63.29% of the patients were married, but only 18.59% had a positive family history of breast cancer. BI-RADS scores 1(57.46%) and 2(27.99%) were the most recurrent findings. The most common BI-RADS 2, 3, 4, and 5 imaging features were benign-looking axillary lymph nodes (66.33%), well-defined solid masses (61.54%), ill-defined solid masses (42.86%), and ill-defined solid masses with suspicious-looking axillary lymph nodes (100.00%), respectively. The most frequent indications were routine screening (49.18%), mastalgia (26.59%), and painless breast masses (19.77%). There was significant association between duration of symptoms and breast cancer (p value = 0.007). In conclusion, routine breast screening and mastalgia were the topmost indications for breast imaging. BI-RADS 1 and 2 were the commonest BI-RADS scores, and benign-looking axillary lymph nodes and simple cysts were the most frequent imaging features for BI-RADS 2 and ill-defined solid masses and suspicious-looking axillary lymph nodes for BI-RADS 4 and 5.

Glutamate receptors in brain development.

Brain development encompasses a number of processes including synaptogenesis, migration and synaptic plasticity. These activities are regulated by neurotransmitter receptors such as glutamate receptors. The development, activation and expression of these receptors vary during foetal and neonatal brain development. In this review, it has been shown that the stage or age of brain development, which correlates with the functional activities ongoing in the neonatal brain, determines the cellular distribution and the expression of glutamate receptors in the neonatal brain. Additionally, environmental factors including stress and alcohol may trigger the dysregulation of glutamate receptors during development. This deficit or dysregulation of glutamate receptors may result in developmental neuropathology, some of which may affect later development and normal functioning of the individual.

Incidence rate and age of onset of first stroke from CT scan examinations in Cape Coast metropolis.

INTRODUCTION: The trends in the incidence and age of onset of first stroke is lacking in Ghana and with an increasing elderly population, such trends are projected to increase in developing countries. Through the review of Computed Tomography (CT) scan examinations and patients' records; we assessed the incidence rate and age of onset of first stroke in Cape Coast Metropolis. METHODS: This study retrospectively reviewed all imaging records and clinical data of all stroke patients referred for CT scans in the radiology department of the Cape Coast Teaching Hospital (CCTH) between January 2017 and December 2019. All CT confirmed cases of stroke were classified as either hemorrhagic stroke or ischemic stroke. Age adjusted annual incidence rate with 95% Confidence Intervals (CIs) were calculated assuming a Poisson distribution. Mean difference were tested using one way Analysis of Variance (ANOVA). RESULTS: 840 patients with first onset of stroke were identified, comprising 417 (49.6%) males and 423 (50.4%) females. There was a statistically significant difference in the mean age of onset of first stroke in males (61.47 ± 13.36 years) and in females (63.41 ± 15.41 years), p = 0.049. The incidence of first stroke for the entire age categories were higher in males compared to the same age categories in females, except for patients aged 35-44 years in 2017, 25-34 years in 2018, 15-24 years and 75 years or older age groups in 2019. Males had hemorrhagic stroke at an older age (64.41 ± 15.31 years) compared to ischemic stroke (60.40 ± 12.42 years) in this study. This difference was statistically significant (p = 0.014). There was no significant difference in the mean age of onset of first stroke for the respective years under study: F (3, 836) = 0.693, P = 0.500. CONCLUSION: The findings of this study imply that the incidence rate of stroke is higher in males than in females and increases with age. The majority of the strokes were ischemic.

The relationship between driver and passenger's seatbelt use: a bivariate probit analysis.

Vehicle seatbelt has been shown to have a beneficial impact on occupants. However, some occupants do not use the seatbelt when inside a moving vehicle. Despite the numerous investigation on the risk factors associated with seatbelt use by occupants, little is known about the relationship between driver and passenger seatbelt use. This gap is analyzed with road side observational survey data on driver and front-right seat passenger's seatbelt use behaviour using bivariate probit model. The use of the bivariate probit model is based on the premise that the front-right passenger's seatbelt use is endogenously related to that of the driver. Out of the 5,433 vehicles observed, the prevalence rate of driver and front-right passengers' seatbelt use were 81% and 33%, respectively. In addition, there is a positive relationship between driver and passenger's seatbelt use with correlation coefficient of 0.53. Thus, the unobserved factors that influence the probability of a driver seatbelt use also influence their front-right passenger's seatbelt use propensity.

The effects of weather on the spread of COVID-19: evidence from Ghana.

BACKGROUND: Climatic factors have been shown to influence communicable disease dynamics especially in tropical regions where temperature could swing from extreme heat and dryness to wet and cold within a short period of time. This is more pronounced in the spread of airborne diseases. In this study, the effect of some local weather variables (average temperature, average relative humidity, average wind speed and average atmospheric pressure) on the risk of Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Ghana is investigated. The daily confirmed new COVID-19 cases were compiled from the Ghana Health Service and the weather data extracted from Weatherbase. The type of relationship between the climatic variable and risk of spread were explored using the Generalized Additive Model (GAM). RESULTS: Results obtained showed that wind speed and atmospheric pressure have positive linear relationship with the spread of infection an increase in the risk of COVID-19 spread. In addition, the risk of spread fluctuates for temperature between 24 and 29 °C but sharply decreases when average temperature exceeds 29 °C. The risk of spread of COVID-19 significantly decrease for relative humidity between 72 and 76% and leveled afterwards. CONCLUSION: The results indicate that wind speed and pressure have a positive linear relationship with the risk of spread of COVID-19 whilst temperature and humidity have a non-linear relationship with the spread of COVID-19. These findings highlight the need for policy makers to design effective countermeasures for controlling the spread as we are still within the low temperature season.

Computed tomography features of spontaneous acute intracranial hemorrhages in a tertiary hospital in Southern Ghana.

INTRODUCTION: spontaneous acute intracranial hemorrhage (SICH) accounts for approximately 10-15% of all stroke cases. Early detection by computed tomography (CT) and early treatment are key. Hence this study to examine the CT features of SICH. METHODS: this retrospective cohort study reviewed all 435 patients diagnosed with SICH from 1st March, 2017 to 1st January, 2021 in a tertiary facility in Southern Ghana. Data collected (age, sex, SICH type and the CT scan features) were organized and analyzed using GNU PSPP and Libre Office Calc. Statistical significance level was pegged at p≤0.05. RESULTS: the SICH types were acute intracerebral hemorrhage (97.93%), acute subarachnoid/intraventricular hemorrhage (1.15%), acute epidural hemorrhage (0.46%) and acute subdural hemorrhage (0.46%). Acute intracerebral hemorrhage was more common in those >60 years (57.75%, p<0.001). The commonest CT feature for acute intracerebral hemorrhage was hyperdense lesion with perilesional edema (40.98%), with smoking (OR=2.24, 95% CI: 1.14-4.41, p=0.019) and anticoagulants intake (OR=2.56, 95% CI: 1.15-5.72, p=0.022) as the predictive factors; followed by hyperdense lesion extending to the edge of the brain (25.03%), also predictable by smoking (OR=0.23, 95% CI: 0.11-0.47, p<0.001); and hyperdense lesion with mass effects (22.70%) was not predictive with any risk factor. Type 2 diabetes mellitus (60.00%, p<0.001) and smoking (97.83%, p<0.001) were more common in males. CONCLUSION: hyperdense lesion with perilesional edema was the most frequent CT feature for acute intracerebral hemorrhage and was predictable by smoking and anticoagulants intake. Smoking was a predictive factor to the development of most of the features of acute intracerebral hemorrhage.

Modelling risk factors for red light violation in the Kumasi Metropolis, Ghana.

Red light running places the violator and other road users at risk of road traffic crash. The aim of this research was to undertake a baseline study to establish the current rate of red light running in the Kumasi Metropolis, Ghana and to determine the associated risk factors. An uninterrupted road side observational survey was conducted at 10 signalized intersections using pro-forma checklist. A binary logit model was employed to determine the risk factors associated with traffic light violations. Overall, drivers were observed running the red light in 35% of all the red phases studied. From the statistical model, red light running was found to be influenced by the age and gender of the driver, presence of a passenger in the vehicle, vehicle type, junction type, cycle length of the signal and queue length. There is a need for targeted public awareness campaigns on the dangers of red light running. The education on red light violation must be accompanied by sustained Police enforcement of the traffic law to reduce the rate of violation. Automatic surveillance cameras should be installed at all critical signalized intersections to supplement Police efforts to enforce traffic safety laws and regulations.

A bivariate probit analysis of child passenger's sitting behaviour and restraint use in motor vehicle.

Motor vehicle injuries are a leading cause of death among children worldwide, though many of these deaths are preventable. Buckling young children in age- and size-appropriate car seats, booster seats, or seat belts and also seating them in appropriate position can lead to a significant reduction of serious and fatal injuries. This study investigated sitting behaviour and restraint use among child passengers through cross-sectional observational surveys conducted in Kumasi, Ghana. A bivariate probit model was developed for simultaneous determination of the contributing factors influencing child passenger's sitting behaviour and restraint use. The results showed that 26% of the child passengers observed were occupying the front seat and the prevalence rate of restraint use was 4.5%. The developed bivariate probit model clearly highlights the existence of interrelationship between child passenger's sitting position and restraint use. The key factors simultaneously influencing child passenger's sitting position and restraint use include vehicle type, driver's gender, driver's belt use, child's age, and the presence of other child or adult passenger. Furthermore, time of day and day of week also influence child passenger sitting behaviour but not their restraint use. These findings provide insight for better understanding of child transporting practices and the contributing factors influencing their sitting behaviour and restraint use. The findings also highlight the need for policy makers to design effective countermeasures to promote rear sitting and restraint use among child passengers.

Prevalence rate of helmet use among motorcycle riders in Kumasi, Ghana.

OBJECTIVES: This study investigated the prevalence rate and identified the associated factors influencing helmet use in Kumasi, Ghana. METHODS: The data used in this study were collected from motorcycle riders in the Kumasi metropolis through questionnaire survey. The contributing factors influencing helmet use were determined using a logistic regression model. RESULTS: The results show that the rate of helmet use was about 47% and the influential factors include rider's gender, marital status, educational attainment, ownership of a helmet, and motorcycle license. The most important reasons influencing noncompliance with helmet use as reported by the riders include discomfort, distance traveled, not owning a helmet, and forgetfulness. CONCLUSION: The findings highlight the need for policymakers to set up policy guidelines to enforce compliance with helmet use. For instance, any effort seeking to increase helmet use may first have to deal with helmet ownership, which also relates to the cost of helmet. In addition, helmet producers should conform to high quality standards in order to avoid discomfort while wearing a helmet.

The effect of natural and built environmental characteristics on pedestrian-vehicle crash severity in Ghana.

Despite the benefits of walking as a means of travelling, walking can be quite hazardous. Pedestrian-vehicle crashes remain a major concern in Ghana as they account for the highest percentage of fatalities. The objective of this study is to determine the effect of both natural and built environmental features on pedestrian-vehicle crash severity in Ghana. The study is based on an extensive pedestrian-vehicle crash dataset extracted from the National Road Traffic Accident Database at the Building and Road Research Institute (BRRI) of the Council for Scientific and Industrial Research (CSIR), Ghana. Using a multinomial logit modelling framework, possible determinants of pedestrian-vehicle crash severity were identified. The study found that fatal crashes are likely to occur during unclear weather conditions, on weekends, at night time where there are no lights, on curved and inclined roads, on untarred roads, at mid-blocks and on wider roads. The developed model and its interpretations will make important contributions to road crash analysis and prevention in Ghana with the possibility of extension to other developing countries. These contributing factors could inform policy makers on road design and operational improvements.