Articles

<b>Background: </b>The construction industry is one of the most hazardous sectors worldwide, with workers consistently exposed to risks from prolonged contact with hazardous materials. This study evaluates the effectiveness of wearable technologies in improving safety and health monitoring among construction workers in Nigeria. <b>Methodology</b>: A quantitative cross-sectional survey was conducted among 370 construction workers, site managers, and safety officers across Nigeria using an online questionnaire hosted on Google Forms. The study employed purposive sampling to ensure representation across job roles, experience levels, and project types. Data were collected on awareness, usage, benefits, challenges, and improvements associated with wearable technology. Data was analysed using SPSS version 28. <b>Results</b>: Findings showed that awareness of wearable technology was low (32.4%), and only 34.1% reported personal utilisation. Smart vests (32.7%), noise monitoring devices (32.4%), and smartwatches (32.4%) were the most common devices used. Benefits cited included reduced accident occurrences (28.4%) and enhanced well-being (24.6%), while barriers included cultural/language issues (32.7%) and technological limitations (22.4%). Overall, 48.6% reported improvement in safety and health monitoring. Logistic regression showed that wearable technology use significantly improved safety and health monitoring (AOR = 5.937, p < 0.001), with commercial project workers reporting higher odds of improvement (AOR = 7.495, p = 0.001). <b>Conclusion</b>: Wearable technology significantly enhances safety and health monitoring in Nigeria’s construction industry, particularly for experienced workers and commercial projects. Targeted interventions addressing awareness, training, and accessibility are crucial to overcoming barriers and maximizing its impact.

This study addresses the critical challenge of material scarcity within Ghana’s creative industries by pioneering the synthesis of professional-grade stage blood from indigenous, locally-sourced materials. In the context of Ghanaian theatre and film, practitioners face significant barriers due to the high cost and limited availability of imported special effects products, often resulting in the use of inadequate substitutes that compromise aesthetic realism, safety, and narrative authenticity. This paper responds by exploring the potential of cassava starch, tapioca, kenkey dough, and fufu wax. Grounded in Schumacher’s theory of Appropriate Technology, the paper reframes indigenous resources not as inferior alternatives but as technologically and contextually appropriate solutions that align with Ghana’s economic, environmental, and social realities. The study provides detailed, reproducible recipes for both flowing and clotted blood variants, validated through practical application in simulated special effects such as gunshot wounds and deep-tissue scars. These formulations meet key performance criteria: visual fidelity under theatrical and cinematic conditions, controlled viscosity, ease of application and removal, and performer safety. Beyond technical innovation, this research contributes to shifting academic and professional discourse from dependency and scarcity toward resourcefulness, sustainability, and artistic self-reliance. It offers a practical framework for reducing production costs, enhancing the quality of visual storytelling, and fostering local value chains within Ghana’s growing creative economy.

The construction industry remains one of the most hazardous sectors globally, with Nigeria experiencing a high incidence of workplace accidents despite the adoption of Occupational Health and Safety Management (OHSM) frameworks. This study evaluated the effectiveness of OHSM practices in improving workplace safety across construction companies in Nigeria’s coastal cities. A cross-sectional design was employed, combining quantitative surveys of construction workers (n = 1,400) with qualitative interviews of 35 managers and supervisors. Quantitative data were analyzed using SPSS version 28, while thematic analysis was applied to qualitative responses. Findings revealed a generally positive perception of OHSM, with 54.4% of workers rating OHS policy effectiveness as “Good” and 52.0% rating health outcomes as “Good.” However, accident frequency remained a concern, with 46.4% reporting accidents occurred “Occasionally” and 31.9% acknowledging them as “Frequent” or “Very Frequent.” Comparative analysis showed indigenous firms were rated higher in policy effectiveness and health outcomes but also reported slightly higher accident frequencies than international firms. Thematic analysis identified five key monitoring and evaluation strategies including routine inspections, regular training, audits, behavioural reinforcement, and access control, Also, five measures of OHSM effectiveness, including compliance observation, incident tracking, KPIs, employee feedback, and benchmarking. OHSM was found to positively influence project outcomes by reducing compensation costs, enhancing reputation, and improving supervision and quality of work. OHSM practices in Nigeria’s construction sector are perceived as effective in policy and health outcomes, yet accident rates remain a critical challenge. The study underscores the importance of continuous training, stricter enforcement, behavioural reinforcement, and systematic performance evaluation.

<b>Background:</b> Sleep deprivation is increasingly prevalent among young adults due to academic, occupational, and social demands, making them susceptible to circadian disruption. Executive functioning—encompassing working memory, inhibitory control, and cognitive flexibility is essential for academic and professional success. This meta-analysis quantifies the effect of sleep deprivation on executive functioning in healthy young adults. Practical Implications: These findings highlight the need for evidence-based interventions such as university-level sleep education programs, flexible academic scheduling, and workplace policies promoting adequate sleep to optimize cognitive performance and productivity among young adults. <b>Methods: </b>Following PRISMA 2020 guidelines, PubMed, Scopus, PsycINFO, and Web of Science were searched (January 2000–March 2024) for studies assessing acute (<6 hours sleep or ≥24 hours total deprivation) or chronic (<6 hours/night over multiple days) sleep deprivation in young adults. Outcomes included validated executive function tests (e.g., Stroop, N-Back). Random-effects meta-analysis (Hedges’ g) was conducted using R (version 4.3.2) with metafor/meta packages. Heterogeneity (I², Q-test), sensitivity (leave-one-out), and publication bias (funnel plot, Egger’s test) were evaluated. <b>Results: </b>Out of 2,478 screened studies, 39 met inclusion criteria (n=4,578). Sleep deprivation had a moderate-to-large detrimental effect on executive functioning (Hedges’ g = -0.62, 95% CI [-0.78, -0.45], p<0.001). Subdomain analysis revealed greatest impairment in working memory (g = -0.71), followed by inhibitory control (g = -0.59) and cognitive flexibility (g = -0.49) (all p<0.001). Moderate heterogeneity was present (I² = 58%), with results robust to sensitivity analysis. Egger’s test indicated no significant publication bias (p=0.22). <b>Interpretation</b><b>: </b>Sleep deprivation significantly impairs executive functioning in young adults, especially working memory. Interventions improve sleep may enhance cognitive performance and should be integrated into public health strategies and educational policies. Future research should assess chronic restriction and individual vulnerability factors.

VAP, or Ventilator Associated Pneumonia, is a type of pneumonia that arises in patients receiving mechanical ventilation. This condition is a serious complication and can lead to the patient's decline while on a mechanical ventilator, posing a significant risk for secondary complications if not addressed promptly. In particular, VAP is a prevalent issue in intensive care units, where the healthcare team works to prevent further deterioration of the patient. VAP is associated with a notably high mortality rate, particularly in individuals with weakened immune systems, as well as in younger and older populations. Extended intubation and prolonged sedation can contribute to the onset of VAP. The previous study had found that incidence of VAP accounts for 9 % to 27 % endotracheal intubated patients, whereas VAP has a mortality rate ranging from 25 % to 50 % [1-3]. VAP increased ICU and hospital length of stay, antibiotic consumption, and healthcare cost (Zhi Mao et al, 2016) [4]. While using the subglottic suctioning could prevent and help the intubated patient to decreased the development of VAP. The study shown by Smith et al (2021) [5] SSD is a technique employed to reduce micro aspiration of oropharyngeal secretions in patients with cuffed endotracheal airways. Aspiration of oropharyngeal secretions is the accepted cause of the majority of ventilator-associated pneumonia (VAP), a complication of invasive ventilation with high associated mortality. Another study by Rahul Gujadhur et al (2005) [6], subglottic suction has also been shown to delay the onset of VAP but no benefits in terms of ventilation time, hospital stay or mortality benefit have ever been shown. This investigation into subglottic suctioning may assist the healthcare team, particularly in the intensive care unit, in preventing the development of VAP and shortening the duration of ventilation for patients. The advantages of subglottic suctioning are often debated, particularly regarding its impact on the duration of intubation. However, recent research indicates that implementing subglottic suctioning within a time frame of fewer than three days could help reduce intubation duration and lead to improved patient recovery.

<b>Background:</b> Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. <b>Aims:</b> This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and adverse outcomes, including suicide attempt, major depressive disorder (MDD), nicotine use, and marijuana use. <b>Methods:</b> Participants were children from the Adolescent Brain Cognitive Development (ABCD) study. SGM identity was reported at baseline, while outcomes included past MDD and suicide attempts as well as future nicotine and marijuana use. Structural equation modeling (SEM) was used to test both direct and indirect pathways linking SGM identity to mental health and behavioral outcomes. <b>Results:</b> No significant mediation was found through family conflict, discrimination, or trauma. Instead, effects of SGM identity were primarily direct: SGM youth had higher odds of past suicide attempts and MDD, as well as future marijuana use, but not future nicotine use. Stressor variables, however, were independently associated with outcomes. Discrimination predicted all outcomes; trauma was positively associated with suicide, nicotine, and marijuana use but not MDD; and family conflict predicted all outcomes except MDD. <b>Conclusion:</b> Family conflict, discrimination, and trauma did not mediate SGM disparities in mental health and substance use, but each emerged as an independent predictor of risk. These findings highlight the complexity of mechanisms underlying SGM-related disparities and suggest the need for future research to explore additional pathways and contextual influences.

<b>Objective:</b> This systematic review aimed to identify, synthesize, and critically analyze the available evidence on clinical protocols used for the prevention and treatment of prosthetic joint infection (PJI) in total hip arthroplasty (THA), based on studies published between 2000 and 2025. <b>Methods:</b><b> </b>The review was conducted according to PRISMA guidelines. Electronic searches were performed in PubMed (MEDLINE), Scopus, Web of Science, and Embase between January and April 2025. Eligible studies included clinical trials, cohort studies, case-control studies, systematic reviews, and meta-analyses published in English that addressed either preventive or therapeutic strategies for PJI in THA. Study selection, data extraction, and quality assessment were carried out independently by two reviewers. Due to the heterogeneity of the included studies, a qualitative synthesis was performed. <b>Results:</b><b> </b>A total of 32 studies were included. Preventive measures identified in the literature comprised combined antibiotic prophylaxis (cefazolin and gentamicin), multimodal perioperative protocols such as ACERTO, nasal decolonization for <i>Staphylococcus aureus</i>, silver-impregnated dressings, and structured post-discharge surveillance. Treatment strategies included DAIR (Debridement, Antibiotics, and Implant Retention), the DAPRI technique, one-stage and two-stage revision surgeries, muscle flap reconstructions, and protocols without spacers. These interventions were associated with significantly reduced infection rates and improved clinical outcomes when applied appropriately and in accordance with patient-specific factors. <b>Conclusion:</b><b> </b>Effective prevention and treatment of PJI in total hip arthroplasty require a systematic and evidence-based approach. Integrated protocols—spanning preoperative optimization, meticulous intraoperative techniques, and rigorous postoperative monitoring—have proven effective in reducing infection incidence. In cases of established infection, surgical management must be tailored to the timing of infection, microbial profile, and host conditions. Two-stage revision remains the gold standard for complex infections, while one-stage revision and emerging techniques like DAPRI offer promising results in selected cases. This review contributes to the standardization of clinical practice and supports improved patient outcomes.

Effective infection control requires a close fit between the mask and face to minimize gaps. This study investigated whether surgical mask performance varies with face shape and mask size. Three facial models were 3D-printed using head-related transfer function data. Two mask sizes were tested on each model, and 3D measurements were taken at five facial points: the nose, cheeks, and chin to assess mask-to-face gaps. To simulate droplet emission, an aqueous sodium chloride solution was released from a pseudo-oral cavity in the models, and air leakage was measured using a mask-fitting tester. A two-way analysis of variance (ANOVA) was used to examine the effects of face and mask size on leakage. Small face models showed significantly higher leakage than medium and large ones (p < 0.001), and S-sized masks leaked more than M-sized masks regardless of face size (p = 0.038).<b> </b>Linear regression showed a positive correlation between chin gaps and leakage when using S-sized masks (p < 0.05). These results suggest that medium-sized masks offer better overall performance. However, for small faces, fit—especially at the chin, requires particular attention.

<b>Background</b><b>:</b><b> </b>Electronic cigarette (e-cigarette) use is increasingly prevalent among youth and young adults, particularly college and university students. This is a population for whom e-cigarette use is not recommended due to potential health risks, including nicotine addiction and long-term respiratory effects. Social networks play a crucial role in shaping attitudes toward e-cigarettes and influencing use behaviors. However, the relative influence of different social ties—parents, siblings, and friends—on e-cigarette attitudes and use remains unclear. <b>Objective</b><b>:</b><b> </b>This study utilizes data from the SMOKES study to compare the influence of e-cigarette use within different social network sections—parents, friends, and siblings—on personal e-cigarette attitudes and use among college and university students. <b>Methods</b><b>:</b><b> </b>Using a cross-sectional survey of college and university students, we examined the associations between e-cigarette use within different social networks and individual e-cigarette attitudes and use. Multivariate regression models assessed the strength of these associations, adjusting for key demographic and behavioral covariates. <b>Results</b><b>:</b><b> </b>Findings indicate that among college and university students, the strongest influence on both e-cigarette attitudes and use comes from friends who use e-cigarettes. In contrast, parental and sibling e-cigarette use showed weak or non-significant effects. These results suggest that peer influence, rather than family influence, plays a dominant role in shaping e-cigarette-related behaviors and perceptions in young adults. <b>Conclusion</b><b>:</b><b> </b>This study underscores the importance of peer influence in e-cigarette uptake and attitudes among college and university students. Public health interventions aimed at reducing e-cigarette use in this population should consider targeting peer networks rather than focusing solely on family-based influences.

<b>Background: </b>Nicotine pouches, gummies, and candies have emerged as popular alternatives to traditional tobacco products among U.S. adolescents. While parental educational attainment is generally associated with youth substance use, marginalization-related diminished returns (MDRs) suggest that this effect may be weaker in marginalized populations, including non-Latino White communities. In particular, place-based marginalization—such as neighborhood economic disadvantage and school-level poverty—may attenuate the benefits of parental education. This study examines MDRs in the relationship between parental educational attainment and nicotine pouch/gummy/candy use among non-Latino White 12th graders in the 2024 Monitoring the Future (MTF) study. <b>Methods: </b>This study analyzed nationally representative data from the 2024 MTF study, focusing on non-Latino White 12th graders who reported parental education levels and adolescents’ use of nicotine pouch/gummy/candy. Structural equation modeling (SEM) was used to estimate the effects of parental education on adolescents’ use of nicotine pouches, gummies, and candies, while adjusting for demographic covariates. Place-based marginalization was operationalized using rural vs urban /suburban residence. Interaction terms tested whether the effect of parental education varied based on place of residence. <b>Results: </b>Higher parental educational attainment was associated with lower use of nicotine pouches, gummies, and candies. However, this effect was significantly weaker in rural areas. <b>Conclusion: </b>Public health interventions should account for place-based disparities rather than assuming a uniform effect of SES factors. This study highlights the need for policy responses that address structural inequities beyond individual family SES.

<b>Background:</b> Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical evidence to confirm these mechanisms. <b>Aims:</b> This study aimed to investigate potential mechanisms underlying gender differences in quit rates in a tobacco cessation program, testing whether demographic, socioeconomic, health, or behavioral factors explain the observed disparities. <b>Methods:</b> Participants were assigned to one of three smoking cessation interventions: an in-person program (CEASE), a self-help approach, or an online/hybrid program. The main outcome measured was smoking abstinence, evaluated three months after the intervention. Secondary analyses explored whether demographic, socioeconomic, health, or tobacco use-related factors mediated the association between gender and quit rates. <b>Results:</b> Women had significantly lower quit rates than men (p < 0.01). This association remained significant after adjusting for demographic, socioeconomic, health, and addiction-related factors. While women reported higher social support and a higher prevalence of chronic cardiometabolic conditions, these factors did not explain the gender disparity in quit rates. <b>Conclusions:</b> Gender differences in quit rates persist despite controlling for known factors that could influence cessation success. Although women had higher social support, they had lower quit rate. Future research should explore unmeasured variables, such as psychological, biological, and structural influences, to develop more effective cessation strategies tailored for women.

<b>Background:</b> Scapulohumeral periarthritis commonly afflicts individuals in their middle age. Its etiology is multifaceted, and treatment presents a challenge with a high risk of recurrence. The main symptoms include shoulder pain and limited joint mobility, seriously affect the quality of life of the patients. Recent research indicate that acupuncture combined with bloodletting cupping can significantly improve the function of activity of shoulder joint and the pain in individuals with scapulohumeral periarthritis. However, these studies have typically been limited in scope, therefore additional research to substantiate the efficacy and safety of these intervention. <b>Methods:</b> To evaluate the efficacy of acupuncture combined with bloodletting cupping for treating patients with scapulohumeral periarthritis. We conducted an online search of databases in both Chinese and English, including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wangfang Data, China Science and Technology Journal Database (VIP) and Chinese BioMedical Literature Database (CBM), to collect randomized controlled trials (RCTs) concerning the use of acupuncture combined with bloodletting cupping in scapulohumeral periarthritis patients. We also examined the references within the identified literature. Search utilised subject headings and free-text terms in both languages, without racial restrictions, for records up to April 3, 2024. Two researchers independently screened the literature, extracted data, and evaluated their qualities. RevMan 5.3 software was used for meta-analysis of the included studies. The protocol of this review was recorded in the International Platform of Registered Systematic Review and Meta-analysis Protocols (PROSPERO). Its registration number is CRD42023454614. <b>Results:</b> This review incorporated 22 RCTs involving a total of 1,774 patients. The results of meta-analysis showed that the clinical effective rate (RR=1.25, 95%CI [1.20, 1.30], P＜0.00001) of treating scapulohumeral periarthritis with acupuncture combined with bloodletting cupping was higher in the experimental group than in the control group. The all of Visual Analogue Scale (VAS) score (MD=-1.70, 95% CI [-2.17, -1.22], P＜0.00001). Melle score (SMD=-2.45, 95% CI [-2.55, -2.34], P=0.007]) and recurrence rate (RR=0.23, 95% CI [0.07, 0.77], P=0.02) were lower in the experimental group than in the control group with statistical significance (P<0.05). <b>Conclusion:</b> The acupuncture combined with bloodletting cupping for the treatment of shoulder impingement syndrome demonstrates definite efficacy and safety, with superior clinical effectiveness, pain relief, improvement in shoulder joint mobility, and reduction in recurrence compared to acupuncture alone. Therefore, it is worthy of being promoted and applied clinically.

<b>Background:</b><b> </b>Menthol-flavored tobacco products are disproportionately used in low-income African American communities, a result of decades of targeted marketing and systemic inequities. Menthol use has been associated with lower quit rates, often compounded by factors such as lower trust in healthcare systems, reduced access to cessation programs, and other structural barriers. Despite this, few studies have systematically examined the explanatory mechanisms that might clarify why menthol-flavored tobacco is linked to poorer cessation outcomes among participants in tobacco cessation programs. <b>Aims:</b><b> </b>This study aimed to investigate the potential mechanisms by which menthol tobacco use is associated with lower quit rates across three types of smoking cessation interventions. <b>Methods:</b><b> </b>Participants were randomized into one of three smoking cessation interventions: in-person (CEASE), self-help, or online/hybrid programs. Smoking abstinence was assessed three months post-intervention as the primary outcome. Secondary analyses explored whether demographic, socioeconomic, or behavioral factors mediated the association between menthol use and quit rates across the intervention arms. <b>Results:</b><b> </b>Menthol tobacco use was significantly associated with lower quit rates (p < 0.01). This association was not explained by demographic, socioeconomic, health, or addiction-related factors. While menthol use was associated with lower education and employment levels, demographic characteristics, physical or mental health, or addiction did not explain the effect of menthol on tobacco cessation. These findings suggest that the lower quit rates observed among menthol users cannot be attributed to any third factors assessed in this study. <b>Conclusions:</b><b> </b>Menthol tobacco use independently predicts lower quit rates, and the mechanisms behind this disparity remain unclear. The consistent findings across different intervention types highlight the need for further research to uncover the underlying pathways and to design targeted strategies to improve cessation outcomes for menthol users.

<b>Background: </b>Chronic medical conditions are major drivers of healthcare spending, morbidity, and mortality in the United States, as well as critical indicators of health disparities. The disproportionately high rates of chronic medical conditions among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino Whites highlight the urgent need to examine the factors contributing to these disparities. While higher socioeconomic status is generally associated with better health outcomes, this benefit may be diminished for racialized and minoritized populations. <b>Objective:</b> This study investigates the protective effects of educational attainment and income-to-poverty ratio on the prevalence of chronic medical conditions and examines whether these effects vary across racial and ethnic groups, specifically among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino White adults. <b>Methods:</b> Using data from the 2023 National Health Interview Survey (NHIS), this cross-sectional study analyzed the association between educational attainment and chronic medical conditions across racial and ethnic groups. Logistic regression models were employed to assess whether the strength of the relationship between education and chronic medical conditions differed by racial/ethnic group, controlling for key demographic and socioeconomic covariates. Sample size was 29,373 which was reflective of 256,566,689 US population. <b>Results:</b> Consistent with the theory of Minorities' Diminished Returns, findings showed that the protective effects of higher educational attainment on chronic medical conditions were significantly weaker for Black, Latino, and American Indian and Alaska Native adults than for their non-Latino White counterparts. Even among individuals with higher education, Black, Latino, and American Indian and Alaska Native adults faced elevated risks of chronic medical conditions. <b>Conclusion:</b> While educational attainment generally reduces the prevalence of chronic medical conditions, this protective effect is moderated by racial and ethnic background. Structural barriers limit the health benefits of educational attainment. This underscores the need for policies that address structural inequities—such as low-quality education and occupational segregation—that constrain the protective health effects of educational attainment for minoritized groups.

Foods rich in phytochemicals are well recognized for their role in the prevention of chronic disease development, in addition to fulfilling the nutrient requirements. However, different processing methods employed during preparation may affect their levels and functionality as they are sensitive to different processing parameters such as temperature and light. This study aimed to evaluate the effects of three common processing methods; boiling, fermentation, and drying (sun and solar drying, with and without blanching), on total phenolic content and total flavonoid content in cassava (<i>Manhot</i><i> esculenta </i><i>Crantz</i>), black jack (<i>Bidens</i><i> </i><i>pilosa</i>) and bitter lettuce leaves (<i>Launaea</i><i> </i><i>cornuta</i>) grown in Mkuranga District in the Eastern part of Tanzania. Total phenolic content and total flavonoid content were analyzed by using the spectrophotometric method with the use of Folin-Ciocalteu and Aluminum Chloride reagents, respectively. Total phenolic content ranged from 0.9±0.14 to 85.7 ± 0.56 mg Gallic Acid Equivalent (GAE)/100g and flavonoids ranged from 0.03±0.00 to 3.9±0.03 mg/100g across the treatments. Both parameters were adversely affected by fermentation and boiling, while solar and sun drying only reduced the flavonoid content. Results showed that direct solar and sun drying appear to be effective processing methods, for the retention and maintenance of total phenolic content in all samples while, none proved to be effective for flavonoid content.

Background. </b>Although youth from high socioeconomic status (SES) backgrounds are generally protected against tobacco use, this protection is weaker for racialized and marginalized families, particularly Black youth. While Minorities' Diminished Returns (MDRs) of household income on tobacco use have been documented for Black youth, the mechanisms underlying these effects are not well understood. <b>Objective. </b>This study investigates whether school poverty and associated peer deviance and delinquent behaviors explain the disproportionately higher tobacco use among Black youth from high-income backgrounds, using data from the Adolescent Brain Cognitive Development (ABCD) study. <b>Methods. </b>We conducted a longitudinal analysis of Black youth from high-income families within the Adolescent Brain Cognitive Development (ABCD) study. A total of 8,777 youth was included in our analysis. We examined the associations between household income and tobacco use, with school poverty and associated peer deviance and delinquent behaviors as mediators. Race was considered as a moderator. <b>Results. </b>Compared to their high-income White counterparts,<b> </b>Black youth from high-income backgrounds were more likely to live in areas with higher school poverty, which exposed them to increased levels of peer deviance and delinquent behaviors compared to their White counterparts. These exposures, in turn, were associated with higher rates of tobacco use among Black youth. Thus, higher school poverty, along with the related peer deviance and delinquent behaviors, contributed to the elevated tobacco use observed among Black adolescents from high-income backgrounds. <b>Conclusion. </b>The study suggests that residing in areas with school poverty, peer deviance, and youth delinquency may explain Minorities' Diminished Returns, which are defined as the weaker protective effects of socioeconomic status on tobacco use among Black youth. Interventions aiming to prevent tobacco use need to include structural components addressing these broader social determinants of health.

This study aimed to explore the relationship between teacher training and challenges in delivering effective sex education in the Sagnarigu district in the Northern region of Ghana. The Social-cultural theory underpins the study. A descriptive survey research design was adopted for the study. The population of this study comprises teachers, head teachers and a School Improvement Support Officer (SiSo) in basic schools in the Gumani/Nyanshegu circuit in the Sagnarigu district of the Northern Region. This study adopted multi-sampling methods to select respondents. Random and purposive sampling techniques were used to select the study's 10 basic schools and 83 respondents. The main tools used for the data collection were the questionnaire and interview. The data was analysed using Statistical Package for Social Scientists (SPSS) software version 23 tools. Descriptive Statistical tools such as frequencies were used to gauge the number of occurrences of the studied variables. The qualitative data was also further analysed in line with the research questions to establish patterns of similarities and variations. These were then validated with the quantitative data for any possible contradictions in the findings. The study concludes that people's socio-cultural and religious beliefs and practices affect the teaching of sex education in school. It was observed that sex education could be misconstrued as an encouragement to young people to engage in early sexual promiscuity. Finally, the study concludes that there cannot be effective sex education without the appropriate logistics such as T.L.M.s, syllabus and time allocation for the subject. The study also acknowledges that the availability of these materials must go along with appropriate capacity building for teachers to be well-positioned to teach the subject. It is recommended that Sexuality education should be included in the curricular and academic calendar of basic schools, along with the provision of adequate T.L.M.s and the proper collaboration with appropriate agencies for the effective teaching of the subject. Sex education needs to be given maximum attention, just as any of the life skills subjects, with adequate investment and motivation to both teachers and pupils to ensure a meaningful impact. There should be regular monitoring, supervision, and assessment of the training of teachers and its influence on the teaching of the subject, as well as ensuring that ethical considerations regarding cultural and religious sensitivities and individual privacy issues are upheld.

The study aimed to establish the effect of Multicultural Teaching Competency (MTC) on the Culturally Responsive Teaching (CRT) of RME teachers in Cape Coast. The cross-sectional survey design was used. All 150 RME teachers in the 54 schools in Cape Coast were involved in the study through the census method and a 33-item close-ended structured questionnaire was used for the data collection exercise. Data were analysed using descriptive and inferential (Factorial ANOVA and PLS-SEM) statistics. Results revealed that RME teachers have a high level of MTC and CRT even though the students seem not to show interest in the subject leading to them failing in their final examinations. There was a statistically significant effect of RME teachers’ sex, academic qualification, teaching experience, and professional qualification on their MTC <i>F (30, 4) = 7.142, p = .000, partial </i><i>ƞ</i><i>2 =.643 and CRT, F (30, 4) = 3.874, p = .000*, partial </i><i>ƞ</i><i>2 = .494</i>. The result showed that RME teachers' MTC substantially explained 61.2% of the variation in their CRT. It was recommended that GES and the Metropolitan Education office should provide ongoing professional development opportunities specifically focused on translating MTC principles into actionable strategies.

<b>Background:</b> Recent research has identified structural racism—systemic policies and practices that perpetuate racial inequalities—as a significant social determinant of population health. Studies utilizing data from the Adolescent Brain Cognitive Development (ABCD) study have shown an association between higher levels of state-level structural racism and increased tobacco use among youth in the United States. However, there has been limited exploration of the psychosocial mediators of this relationship, particularly in the context of youth aged 10-16 years. <b>Objective: </b>This study aimed to assess the roles of socioeconomic status (SES), tobacco susceptibility, and perceived discrimination as potential mediators in the relationship between state-level structural racism and youth tobacco initiation rates. <b>Methods:</b> We analyzed data from the ABCD study, a nationally representative longitudinal survey of 11,698 youth followed from ages 9/10 to 15/16. These data were combined with state-level indicators of structural racism. We employed structural equation modeling (SEM) to investigate the mediators of the association between structural racism and self-reported initiation of tobacco use, while controlling for individual and state-level covariates. <b>Results:</b> Our findings indicate that higher levels of structural racism were associated with increased rates of tobacco initiation among youth. This relationship was partially mediated by lower SES, but not by perceived discrimination or tobacco susceptibility. <b>Conclusion:</b> The association between structural racism and youth tobacco initiation appears to be influenced in part by the lower SES prevalent in states with higher levels of racism. These results highlight the need for addressing both racism and SES inequalities as key strategies for reducing tobacco disparities among youth.

<b>Background:</b> Racial discrimination remains a significant issue in the United States, particularly affecting Black individuals. Understanding how beliefs about the persistence of racial discrimination are shaped by race and parental education among college students is crucial for developing strategies to address these inequities. <b>Objectives:</b> This study aims to examine the multiplicative effects of race and parental education on beliefs about the persistence of racial discrimination among Black and White college students. We hypothesize that Black students, particularly those with highly educated parents, will exhibit stronger beliefs in the persistence of racial discrimination as a significant issue compared to their White peers. <b>Methods:</b> Data were drawn from the Higher Education Research Institute (HERI) study, which includes a national sample of Black and White young adults on college campuses across the United States. We conducted statistical analyses to explore the influence of race and parental education on students' beliefs about racial discrimination. <b>Results:</b> Black students demonstrated stronger beliefs in the persistence of racial discrimination compared to White students. Additionally, students with higher parental education levels were more likely to recognize racial discrimination as a significant issue than those with lower parental education. The impact of parental education on these beliefs was more pronounced for Black students compared to White students. <b>Discussion:</b> Black college students, especially those from higher SES backgrounds, exhibit a heightened awareness of racial discrimination due to their lived experiences and educational exposure. High SES Black individuals often face increased visibility and prejudice in predominantly White environments, further reinforcing their beliefs about the persistence of discrimination. These findings highlight the need for targeted interventions to support Black students in higher education and promote awareness of racial discrimination. Policy solutions should include comprehensive anti-discrimination policies, increased diversity and inclusion efforts, and educational curricula that address systemic racism and social justice. The cross-sectional nature of the data limits causality inference, and self-reported measures may be subject to bias. Despite these limitations, the study's large and diverse sample enhances the generalizability of the findings. Race and parental education have multiplicative effects on college students' beliefs about the persistence of racial discrimination. Black students, particularly those from high SES backgrounds, are more likely to perceive racial discrimination as a continuing problem. Addressing these disparities through targeted policies and interventions is essential for creating equitable and inclusive educational environments.