Articles

<b>Background:</b> Tuberculosis (TB) in the elderly poses significant diagnostic and therapeutic challenges due to immunosenescence, comorbidities, and atypical clinical presentation. This study evaluates the epidemiological and clinical characteristics of TB in patients aged ≥65 years. <b>Methods:</b> A retrospective descriptive study was conducted including all TB cases reported between 2020 and 2024. Data from the National Tuberculosis Program were analyzed for demographic characteristics, clinical form, bacteriological confirmation, comorbidities, and treatment outcomes. <b>Results:</b> Of 1,335 TB cases, 352 (26.4%) occurred in individuals aged ≥65 years. Pulmonary TB accounted for 80.7% of cases. Men represented 63.4% of patients, and 56.8% lived in urban areas. Bacteriological confirmation was achieved in 82% of pulmonary cases, and treatment success exceeded 85%. Diabetes mellitus (26.5%) and arterial hypertension (31%) were the most common comorbidities. An increase in TB cases was observed in the post-COVID-19 period. A significant association was found between age and clinical form of TB (p < 0.001). <b>Conclusions:</b> Elderly individuals constitute a substantial proportion of TB cases and frequently present with chronic comorbidities. Despite diagnostic challenges, favorable treatment outcomes were achieved, highlighting the need for integrated and early management strategies in this population.

Eating at home remains very much ingrained in Ghanaian culture but rapid urbanization coupled with busy lifestyle and advancement in technology has greatly changed the way of life of many Ghanaians. These changes have altered the tradition of cooking and eating at home. The study focused on the determinants of consumer patronage of street foods in the Koforidua Metropolis. The target population comprised customers that patronize the street foods in Koforidua Metropolis. From the target population, 197 consumers were selected using convenience. A structured self-administered questionnaire was utilized to gather the required data. The data collected were coded and analyzed with the help of SPSS-23. The findings revealed that food characteristics and social status determines consumers patronage of street food. It became evident that age (r=0.261, p<0.01), age (r=-0.318, P<0.01), educational level (r=0.144, P<0.05) and occupation (r=-0.477, P<0.01) of consumers has a significant influence on the decision and patronage of street food. The study concluded that food characteristics and social factors are major determinants of consumers patronage of street foods. It is recommended that Food and Drug Authority (FDA), other stakeholders, and street food vendors work cooperatively to establish laws that capture the distinctive and diverse foods sold on the street and their various preparation, storage, and sale methods in order to ensure that food preparation and sales are safe and hygienic.

Legionnaires' disease became widely known following an outbreak of pneumonia in the United States in 1976. It is often caused by infection from artificial water sources such as cooling towers, water supply and heating systems, and recirculating hot tubs. To effectively implement infection prevention measures for Legionnaires' disease, collaboration among healthcare workers, water supply and heating system managers, building hygiene personnel, and other relevant parties is essential. It is important to note that outbreaks of Legionnaires' disease continue to occur frequently both domestically and internationally. While the number of reported cases of Legionnaires' disease in Japan has increased, the mortality rate has decreased but has stabilized at a lower level. Caution is also required as reports have been made in association with disasters and travel, in addition to artificial environmental water.

The anterior collateral ligament (ACL) is one of four ligaments in the knee, connecting the tibia and femur and acting as a key stabilizer. Factors influencing these injuries include playing surface, training programs, athlete strength, technique, and gender. Female athletes are at a higher risk of ACL injuries, being four to nine times more likely than males, often due to differences in biomechanics and training patterns. It ss important that rehab focuses on both legs, as overworking the injured leg increases the risk of injuries elsewhere. Prevention training, such as proprioceptive-balance and plyometric agility training, has been shown effectiveness in minimizing ACL injuries. Despite some limitations in research, these programs highlight the importance of improved training techniques. Kinesio taping might help reduce pain but lacks strong evidence for preventing ACL tears.

<b>Introduction:</b> Pain is considered as the fifth vital sign that should be considered in assessing patients. For clinicians to evaluate and determine the right pain interventions, there should be parameters such as pain scale. Our objective in this study is to determine factors affecting pain scale preferences in suburban and rural populations. The pain scales used in this study are FPS-R (Faces Pain Scale-Revised), VRS (Verbal Rating Scale), VAS (Visual Analogue Scale), and NRS (Numering Rating Scale). <b>Method:</b> This study uses observational design with an interview approach and a cross-sectional study. Areas covered are within Indonesia, which are marginal areas of Tangerang district border, and two rural areas in Serukam, West Kalimantan, and Soe, East Nusa Tenggara. Data collected will be analyzed using SPSS 25 software. <b>Result:</b> Populations within the suburban areas prefer NRS (52.08%) as their pain scale, and populations in rural areas prefer FPS-R 76.92%). Factors affecting pain scale preferences are location areas, as well as last education, with statistical significance of p<0.05. <b>Discussion:</b> Our study showed that the choice of several pain scales is not appropriate for specific demographics due to the complexity of these scales. Factors that should be considered are the location areas and education level, as some population in remote areas have better understanding of simpler pain scales. <b>Conclusion:</b> Complexity or simpler components may be an underlying reason for the preference of score selection to assess pain scales in some population. Therefore, the selection of pain scales should be adjusted to specific demographics so that clinicians can provide appropriate management with appropriate pain scales.

<b>Background: </b>The dual use of e-cigarettes and combustible cigarettes poses significant public health concerns due to the compounded risks associated with the use of both products. Understanding the predictors of dual use can inform targeted interventions and tobacco control strategies aimed at reducing nicotine dependence and health risks among adults.<b> </b><b>Objective: </b>This study aims to identify the sociodemographic predictors of dual use of e-cigarettes and combustible cigarettes among U.S. adults using baseline data from the Population Assessment of Tobacco and Health (PATH) Study.<b> </b><b>Methods: </b>We analyzed baseline data from the PATH Study, focusing on adult participants who reported the use of both e-cigarettes and combustible cigarettes. Logistic regression models were used to identify the associations between dual use and key sociodemographic variables, including age, gender, race/ethnicity, and education level.<b> </b><b>Results: </b>The analysis revealed that dual use of e-cigarettes and combustible cigarettes was predominantly observed among young, female, non-Latino, White, and highly educated adults. Younger adults were more likely to engage in dual use compared to older age groups. Females showed higher rates of dual use compared to males. Non-Latino White individuals were more likely to be dual users than individuals from other racial/ethnic backgrounds. Additionally, higher educational attainment was associated with increased dual use, contrary to traditional smoking patterns.<b> </b><b>Conclusion: </b>The findings highlight specific demographic groups that are at higher risk of dual use of e-cigarettes and combustible cigarettes, particularly younger, highly educated, non-Latino White females. These insights suggest the need for tailored public health interventions that address the unique needs and behaviors of these populations. Future research should explore the underlying motivations and contextual factors contributing to dual use to enhance the effectiveness of tobacco control policies and cessation programs.

This study examines the influence of socio-demographic factors on work-family conflict among management staff in star-rated hotels in the Accra Metropolis. The research aims to explore how variables such as gender, age, marital status, and educational background impact the experiences of work-family conflict among hotel managers. A quantitative research design was employed, and data were collected through structured questionnaires distributed to a purposive sample of hotel managers. The findings reveal significant associations between socio-demographic characteristics and work-family conflict, highlighting the complexities of balancing work responsibilities with family obligations in the hospitality industry. The implications of the study underscore the importance of tailored interventions to support the well-being of hotel managers, while the recommendations emphasise the implementation of work-life balance programs, support for family obligations, promotion of diversity and inclusion, and continuous training and development. It is recommended that hotel organisations create a supportive work environment that enhances the job satisfaction and productivity of their management staff. This study contributes valuable insights to the existing literature on work-family conflict in the hospitality sector and provides a foundation for future research endeavours in this area.

Background: </b>Vitamin D plays an important role in the development of bone health and possibly non-communicable diseases. Arab countries had made their own national studies to assess serum vitamin D level among women, yet in Egypt there is no national survey<b> </b>done. The aim of the current study was to identify risk factors affecting vitamin D level among Egyptian females during the child-bearing period.<b> Subjects and methods: </b>A total of 100 healthy adult females in their childbearing period who were attending a Family Medicine Center were included in our study. The age of the included women ranged from 19 to 49 years old with a mean age of 34 (SD 8.47) years. The majority of participants had deficiency (43%) and insufficiency (13%) of vitamin D level. <b>Results: </b>Unemployed women were more likely to have vitamin D deficiency than employed women (P<0.05). Participants who were exposed to sun ˃30 minutes/day were more likely to have sufficient vitamin D level (P<0.05). All participants who consume fish ≥3 times/week had sufficient vitamin D level. Therefore, there was a statistically significance association between a number of consuming fish/week and vitamin D3 level groups. Also, there was statistically significant association between number of consumed milk cups/day and vitamin D3 level groups. All participants who drink 2 cups of milk have sufficient vitamin D level.<b> </b>No statistically significance association was found between using multivitamins and vitamin D3 level groups.<b> Conclusion: </b>Unemployment, low fish consumption and infrequent sun exposure were significant risk factors for vitamin D deficiency. Future research on the role of multivitamins supplements in improving vitamin D nutrition is warranted.

Both crucial success and critical failure factors are included in the current review work. The method relies on creating surveys to collect optional data. It describes the terms that are used to obtain research papers on the ERP deployment in Enterprise Business from databases and scholarly research. In order to enhance the quality of papers, it also includes the consideration and restriction criteria. At that time, a thorough audit of the available papers is conducted to determine the impact of ERP use in Enterprise Business. Important elements are found that determine whether ERP deployments are successful or unsuccessful, as well as how they actually affect Enterprise Business (insert actual success and failure variables here aside from impact). The time span during which research publications have been evaluated limits the scope of the study presented in this paper. One implicit drawback is that it only considers the state of the art in the field of study, without taking into account an empirical investigation. Nevertheless, its findings may prove advantageous, and the directions for future research aid in expanding the field of study. This work advances the body of knowledge regarding the potential benefits and drawbacks of ERP adoption for small and medium-sized enterprises. It uses a secondary data collection strategy to identify important success factors, important failure factors, and their impact. The insights will assist Enterprise Business, Enterprise Business' stakeholders, and ERP service providers in understanding the causes of success or failure and in taking the appropriate action.

The technologies for cloud ERP (Enterprise Resource Planning) have revolutionized the field of information technologies. Any kind of business can benefit from their flexibility, affordability, scalability, adaptation, availability, and customizable data. An advancement of classic ERP, cloud enterprise resource planning (C-ERP) provides the benefits of cloud computing (CC), including resource elasticity and ease of use. The rise of cloud computing affects on-premise ERP systems in terms of architecture and cost. Cloud-based ERP systems make the claim to be appropriate for digital corporate settings. System quality, security, vendor lock-in, and data accessibility are recognized as the technological issues. Industry 4.0 refers to the re-engineering and revitalization of modern factories through the integration of cloud-based operations, industrial internet connectivity, additive manufacturing, and cybersecurity platforms. One of the four main pillars of Industry 4.0, cloud-based Enterprise Resource Planning (Cloud ERP), is a component of cloud operations that aids in achieving greater standards of sustainable performance.

Fertility control is crucial to achieving improved health and socio-economic status of women. The main objective of the study was to explore fertility control behaviours among educated urban women in the Cape Coast Metropolis. The study adopted the interpretivist (qualitative) philosophy in social research. The population for the study comprised women who have at least secondary-level education, are married or in a stable union and are between the ages of 18 and 49 years. A snowball sampling technique was used to select thirty-two (32) respondents for the study. The respondents constituted the number that provided the required information at saturation. The main instrument for data collection was a semi-structured interview guide. Data was collected from educated women within the Cape Coast Metropolis. Five items open-ended questions under the heading <i>Factors influencing fertility control</i><i> among highly-educated urban women in the Cape Coast Metropolis</i>. All transcribed data were then imported into NVivo 11, a computer-aided qualitative data analysis package with each transcript coded sentence by sentence. The codes were determined and constructed based on the content of the data. After the coding process, each code was described and memos attached as ideas about the themes emerged from social-cultural, economic to educational factors. The study underscores the adequate involvement of male partners in women’s fertility control practices, especially women’s contraceptive preferences. This demonstrates the authority of men over women in the domain of the family. Recognising that men have enormous powers regarding fertility issues tend to appreciate the need to promote and advance family needs and welfare. Also, the results indicate that other close associates or relatives are involved in women’s contraceptive lives. These close relations are what describes as a social network in Bronfenbrenner social-ecological framework. Besides, there are multiple socio-cultural and economic obstacles that could work against achieving desired fertility levels. It is recommended that family planning programmes should not focus on only women, but include male partners to enhance a change in behaviour and norms regarding power and gender roles that do not make them supportive partners. There is a need for a high-level promotion through civil society to encourage men to get involved in family planning matters. This will help women or couples to freely adopt their desired fertility control methods without hindrance.

For conducting advanced analytics initiatives to acquire in-depth data into usage habits, regional access, sales, and promotional success, etc., unique identification of packaged pharmaceuticals will be a fantastic enabler. The main objective of this study is to prevent and reduce the production of erroneous and counterfeit drugs using the enterprise system, which has become a serious threat because it damages the reputation of legitimate drug manufacturers by trying to produce and market placebo medications that are identical to the real thing. Due to federal government procedures and priorities that frequently change over time, the majority of implementation takes time. To achieve compliance with numerous federal regulatory authorities, including drug traceability for patient safety, the pharmaceutical industry must implement a systematic procedure in an ERP environment. The goals would be to guarantee medical drug traceability and provide real-time warnings to supply chain stakeholders and regulatory bodies to maximize the benefit of integrating a drug traceability system into an ERP environment. Additionally, manufacturers are compelled to maintain product costs on the higher side due to a heavy burden of unchecked manufacturing cost spikes. As a result, innovative marketing schemes must be introduced in order to increase the reach to consumers by putting into practice successful strategies.

The decision to choose between onsite and offsite construction is important in the effort toward sustainable construction. Offsite construction is often promoted as an environmentally friendly approach to construction operations. However, previous studies have shown that there is a lack of clarity on the environmental trade-offs between onsite and offsite construction. Factors that can affect the decision to build onsite or offsite include the availability of a local offsite manufacturing facility, the distance of the offsite factory to the final place of use, the proximity of the site to the local supply of material and labor, etc. This study provides a framework to apply the system dynamic modeling technique to evaluate how various factors can affect the environmental impact of the building construction phase (for onsite or offsite construction methods). The system dynamic model (using Vensim software) that was developed provides a platform that allows users to input variables such as the distance that is expected for transportation of labor, material, and equipment to both the onsite facility and the offsite construction location, factors associated with the use of equipment for construction, the distance needed for transportation of building panels or modules from the offsite facility to the final site, etc. Among other things, the model showed that an increase in the distance from the offsite yard to the final construction site increases the total impacts of transportation of completed modules. An increase in the number of trips for the transportation of material to the onsite construction location increases the total impact of onsite construction. In terms of the environmental impact of construction, none of the two methods of construction gives an absolute superiority over the other. The environmental performance of offsite and onsite depends on various associated factors. It is recommended that building practitioners review various factors that are peculiar to their projects to make an informed decision on the best construction methods.

<b>Objective</b>: The study investigated the biological effects and molecular mechanisms of platelet-rich plasma (PRP) on periodontal bone regeneration. <b>Methods:</b> Electronic and manual searches were searched up to 1 October 2022 in the following databases: Pubmed, Scopus, Cochrane Library and Embase. [Platelet rich plasma or platelet or growth factors] and [periodontal] or [bone regeneration or bone defect or bone reconstruction] were used for searching. This study reviewed and analyzed published papers associated with PRP and periodontal bone defect restoration or bone regeneration or bone reconstruction. <b>Results:</b> Different growth factors exhibited varied biological characteristics and function. In-vitro studies, animal experiments and clinical studies confirmed that PRP displayed assorted role in periodontal bone defects repair. The growth factors secreted from PRP can promote new bone formation, soft tissue regeneration and wound healing. The fiber three-dimensional structure in PRP is conducive to the growth and migration of cells and provides strong support for the regeneration of periodontal soft and hard tissues. The anti-inflammatory characteristics of PRP are also closely related to the repair of periodontal bone defects. <b>Conclusion:</b> PRP played an important biological effect on periodontal bone regeneration. The mechanism is closely related to PRP promoting the growth, proliferation, differentiation and migration of periodontal ligament cells and osteoblasts, and the fiber stereo configuration of PRP and the anti-inflammatory effect of leukocytes.

Addressing adolescent and sexual reproductive healthcare is essential to providing young patients with the resources they need to navigate and empower themselves with. However, there is limited data about how often this occurs. Several studies have previously indicated that there is a large gap in accessing this gap in low-income neighborhoods. Our study aims to identify the establishment of gynecologic care among adolescent cisgender women and elucidate potential reasons for seeking or not seeking out care. We approached women in the pediatric emergency room that matched the inclusion criteria set out. Qualitative surveys were conducted until thematic saturation was reached and a cross-section study design was employed. Interviews were analyzed through modified ground theory. The study was conducted at the pediatric emergency department at University Hospital located in Newark, NJ. In 2018 estimates, the Newark population consists of 47.0% Black and 39.2% Hispanic or Latinos. Semi-structured interviews were conducted with 27 cisgendered, English-speaking females between ages 18 to 25 presenting to the pediatric emergency room who may or may not have previously established primary care with a gynecologist. Transcriptions were analyzed using modified grounded theory and themes were identified using inductive coding of patient interviews.

Qualitatively the study adopted a case study research design to examine the parental factors that motivate female students to complete formal education in Tolon District. The population for this study comprised of all females in the Tolon District who have successfully completed formal education. A purposive sampling technique was used to select ten (10) females who have successfully completed formal education and are now working in the Tolon District. The main instrument used for data collection was interview. Data were analysed by the use of the Interpretive Method based on the themes arrived at during the data collection. The themes were related to the research question and interpreted on the number of issues raised by respondents. The study revealed that, financial support of parents was vital to enrolment, sustenance and ultimate completion of the education of females. The study also indicated that parents give support in the form of guidance and counseling as well as moral support through encouragement of the Girl-Child played a key role to their successful education. It is recommended that, parents still need more advocacies on the importance of educating the girl child in order to enhance their interest in sending or motivating the girl child in school. It is also recommended that parents should discouraged early marriages to help girls to fully complete their formal education.

<b>Introduction:</b> Measuring patient satisfaction with health services in recent decades has been an important tool for assessing the quality of specific services. <b>Purpose</b><b>:</b> The investigation of the degree of satisfaction of patients attending the Regular Outpatient Clinics of a General Hospital as well as the effect of socio-demographic factors on their satisfaction. <b>Method</b><b>:</b> For the gathering of research data, a structured questionnaire with "closed" questions was used regarding the patients' satisfaction with the reception - environment, speed of service, clinical and laboratory examinations, impressions from the medical care, impressions from the nursing care, the administrative services and the general service. <b>Results</b><b>:</b> The study involved 36 men (57.1%) and 27 women (42.9%) with a mean age of 56.78 years. The majority of them were insured (79.4%), Greek citizens (90.5%) and high school graduates (36.5%). Also, most outpatients evaluated very satisfactorily the services provided by the Regular Outpatient Clinics of the Hospital. Finally, there was a statistically significant correlation between socio-demographic variables (age, insurance and nationality) and patient satisfaction level (p <0.05).<b>Conclusions:</b> Based on the findings of this research, there is a clear effect of socio-demographic factors on the degree of satisfaction of outpatients.

Caesarean section is the most common surgical procedure in obstetrics, but also in pregnant women with dystocia. The purpose of this study is to identify factors that contribute to post-caesarean complications in emergency of gynecology-obstetrics service of Saint Joseph Hospital in Kinshasa. This is a descriptive cross-sectional study and was conducted at Saint Joseph Hospital in Kinshasa city for a month (1^st and 30^th July 2021). A questionnaire was used to collect different data namely socio-demographic characteristics and different variables important for the study. Independent variables were factors related to the parturient and the current pregnancy, the surgical procedure and the operational room. While the dependent variable was post-caesarean complications in gynecology-obstetrics service.<b> </b>Descriptive statistical analyses namely frequency and percentage were done to describe the sample profile. To measure the strength of association between different variables were estimated using Pearson's Chi-Square (X²) test and the p-value was 0.05. Data analysis was performed using SPSS version 20 software. The majority of participants are over 33 years of age, have secondary school skills, married and have 3 to 4 children. It was observed that 88.2% of participants have acute respiratory distress prior to caesarean section, 76.6% have a personal history of thromboembolic disease prior to caesarean section. All the participants who underwent caesarean section were victims of external ventilation through the windows of the operating room, which remained open before, during and after the surgery and benefited from antibiotic treatment without any para-clinical analysis before the caesarean section. Furthermore, 82.4% of participants had benefited from the caesarean section with sterilized care materials 48 hours before and after the intervention. While 47.1% of participants had caesarean sections with defective equipment for the operation (use of dry heat sterilization etc.). A better identification of these risk factors can reduce significantly rate of complications and can consequently improve the maternal-infantile prognosis. The obstacles to effective management are related to the provision of quality services.

<b>Background:</b> Everyone, irrespective of age, sex, colour, ethnicity, or present overall fitness level, can benefit from regular exercise. To improve one's health, one must engage in regular physical activity. People with underlying illnesses like long-term impairment can benefit from regular physical activity at the individual level, especially young women. Thus, the current study aimed to assess the prevalence and determinants of physical activity among female school-aged adolescents in the West Coast Region of The Gambia. <b>Methods: </b>The present study used an institutional-based cross-sectional analytical study to collect quantitative data from 384 female high school students in The Gambia. The study used a content-validated, pretested structured questionnaire that consisted of both open and closed-ended questions on physical activity. The data were processed and analyzed using IBM SPSS version 26.0. Descriptive statistics and Chi-square and/or Fisher exact test were used with a p-value <0.15 for inclusion in the logistic regression model. Adjusted odds ratios (aORs) and 95% confidence intervals were calculated, while p-value <0.05 was considered for statistical significance. <b>Results: </b>The proportion of female students involved in physical activity was 37.5%.<b> </b>The mean age of students was 18.8 years with a standard deviation of 1.7 years. Factors such as female students between 17 – 20 years (aOR:3.05, 95% C.I. (1.807 – 5.138)), father never been to school (aOR: 2.82, 95% C.I. (1.495 – 5.334)), primary education (aOR: 2.15, 95% C.I. (1.027 – 4.493)), upper basic school (aOR: 2.31, 95% C.I. (1.055 – 5.074)) and science major students (aOR: 2.21, 95% C.I. (1.203 – 4.047)) had increased odds of involving in PA. Furthermore, students who knew that exercise would strengthen bones (aOR: 2.62, 95% C.I (1.444 – 4.739)), do a planned brisk walking (aOR: 19.16, 95% C.I. (6.698 – 54.811)), basketball/football (aOR: 29.76, 95% C.I. (10.004 – 88.512)) and skipping with rope (aOR: 29.15, 95% C.I. (9.726 – 87.333)) had increased odds to involved in PA after controlling for confounders. Other factors such as students whose mother never been to school (aOR: 0.31, 95% C.I. (0.140 – 0.674)), primary level (aOR: 0.25, 95% C.I. (0.123 – 0.518)), senior secondary level (aOR: 0.42, 95% C.I. (0.189 – 0.935)), nuclear family (aOR: 0.23, 95% C.I. (0.119 – 0.458)) and extended family (aOR: 0.45, 95% C.I. (0.225 – 0.915)) had reduced odds of involving in PA. <b>Conclusion: </b>There is low physical activity among female adolescents in schools. For this, it is imperative that suitable interventions be implemented to raise the level of physical activity among secondary school students. A future intervention for school-aged adolescents could benefit from these findings.

The objective of the study was to examine the school-related factors that contribute to the academic achievements of low- social economic – status of students in the Aboom Circuit of the Cape Coast Metropolis during 2015-2016 academic years. The study adopted descriptive survey research design. Purposive and random sampling techniques were used to select teachers, schools and students. The five junior high schools (St Nicholas, St. Monica, Aboom Methodist B, Aboom Zion A and Aboom Zion C) were randomly selected from the ten schools in the circuit. A proportional allocation was used to determine and allocate the total number of students from the population to each school. The main instrument for data collection was questionnaire. The data were entered in a pre-designed template in the Statistical Package for Social Science (SPSS) software, version 21. The data were analysed using descriptive (frequency and percentages, mean and standard deviation) and inferential statistics (correlation). The research hypothesis was also analysed using Pearson Product Moment Correlation. The hypothesis was tested at 0.05 level of significance. The study indicated that school-related factors such as school time schedule, resources, school climate, guidance and counselling, school-parents’ relationship may significantly contribute to students’ academic achievement. It is also concluded that when the right atmosphere or conditions are created, students can perform well irrespective of their socio-economic statuses or backgrounds. It is recommended that the Ministry of Education (MOE)/Ghana Education Service (GES) in partnership with school administrators should provide adequate teaching and learning resources and facilities for effective teaching and learning at the school. It is also recommended that in other to ensure effective teaching and learning, the Ministry of Education (MOE) and the Ghana Education Service (GES) should collaborate to implement a class size reduction policy effectively as expected. This means that the student-to-teacher ratio should strictly be adhered to.