Effect of Educational Technology Usage on Student’s Clinical Skills, Competencies and Satisfaction at School of Nursing in Sokoto State, Nigeria

Background: Technology allows the most difficult tasks to become seamlessly easy and more efficient. In education, technology has allowed the dissemination of knowledge to be dispersed instantly and it allows for quicker and more effective communication. A critical reflection on what nursing educators should consider now in order to better support the clinicians of the future is also included with a particular focus on existing informatics curricular supports. Aim: The study aimed at assessing the effect of the use of educational technology on student clinical skills, competency, and satisfaction at schools of nursing Sokoto state. Methodology: A quasiexperimental design was used for the study, A total of 239 respondents, with pre-test/post-test injection and hand hygiene clinical Competency observation checklist and a researcher developed a questionnaire for satisfaction. Results: The findings of the study revealed that the effect of educational technology on student clinical competence skills based on hand hygiene difference of 2.36 with t(186)=9.837, p<0.05, hence, the experiment group performed better than the control group in hand hygiene competencies and injection procedure with mean 1.12 with t(186)=3.556, P<0.05 The satisfaction with teaching/learning using reusable learning object, both experiment, and control groups were relatively satisfied with the reusable learning object educational technology The mean levels of satisfaction was 26.54 and 26.38 for experimental and control groups respectively r(92)=0.425, r2=0.18 (18%), P<0.05 Conclusion: The RLOs were successful in supporting the students understanding of clinical procedures such as injection and hand hygiene issues, resulting in effective ability and confidence to meet their clinical competency

Awareness and Utilization of Moodle among Students at Nursing Schools in North-Western Nigeria

Background: E-learning has been observed to enhance and support the teaching and learning processes, ranging from the way students use educational materials on the web or server and accessing course work online while following a course on campus to programs offered entirely online. Again e-learning allows for efficient transfer of knowledge anywhere and anytime, regardless of subject matter. It opens up a world of learning unavailable in most corners of the world, while at the same time empowering learners with the information technology awareness and skills crucial to succeed in today's global knowledge economy. Aim: The study aimed at assessing the awareness and utilization of moodle among students at nursing schools in North-Western Nigeria. Methodology: A cross-sectional analytic design was used for this study. Multistage sampling technique was used to select three schools; school of nursing Birnin Kudu, Jigawa state, school of nursing Katsina, Katsina state and school of nursing Gusau, Zamfara state which forms the setting for the study. A total of 307 nursing students were selected and recruited for the study. A structured Self-Administered Questionnaire was used for data collection. Descriptive statistics and the Bonferroni Post Hoc test were used in data analysis which. Results: The findings of the study revealed that most of the students (245 out of 305) have an excellent levels of awareness of e-learning with a percentage of 80.4%. The study also found out that most of the students have a high level of utilization of e-learning with 62%. The study also showed a statistically significant relationship between awareness and utilization of elearning among students at nursing schools in North-Western Nigeria with P-values of 0.001. Conclusion: Based on the findings, it was concluded from the results of the study that the students have an excellent level of awareness of e-learning and have a high level of utilization of e-learning.&nbsp

Effects of Azadirachta indica Leaf Powder on some Biochemical Parameters of the African Catfish (Clarias gariepinus)

The study investigated the alterations in biochemical parameters of African catfish (Clarias gariepinus) exposed to neem (Azadirachta indica) leaf powder during the short term experimental period in static renewable bioassay system. The fish with mean length and weight of 18.35 ± 0.60cm and 22.38 ± 1.25g respectively were exposed to 0.192, 0.096, 0.048 and 0.00mg/L concentrations of neem leaf powder for 14-day period. During the experimental period, some physicochemical parameters such as temperature, pH, dissolved oxygen and total alkalinity were monitored weekly. At the end of the experimental period, the fish were sacrificed for the test of biochemical parameters that include: total protein, glucose, triglycerides, cholesterol, uric acid and creatinine in the serum, liver and kidney of the test fish in order to ascertain the effect of the plant on these biomarkers. As the concentrations of the plant leaf powder increased, the activities of serum total protein, triglycerides, cholesterol, creatinine and glucose either significantly (p<0.05) or insignificantly (p>0.05) decreased. An increase in liver glucose and total protein were recorded while kidney total protein, cholesterol and triglycerides were also either significantly (p<0.05) or insignificantly (p>0.05) increased. However, kidney glucose decreased significantly (p<0.05) while liver cholesterol, creatinine and triglycerides insignificantly decreased. Therefore, it is an indication that the plant leaf powder has effect on the physiological activities of the test fish during the study period.Keywords: Health status, Neem leaf powder, Clarias gariepinus, Toxicity

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950–2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2•72 (95% uncertainty interval [UI] 2•66–2•79) in 2000 to 2•31 (2•17–2•46) in 2019. Global annual livebirths increased from 134•5 million (131•5–137•8) in 2000 to a peak of 139•6 million (133•0–146•9) in 2016. Global livebirths then declined to 135•3 million (127•2–144•1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2•1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27•1% (95% UI 26•4–27•8) of global livebirths. Global life expectancy at birth increased from 67•2 years (95% UI 66•8–67•6) in 2000 to 73•5 years (72•8–74•3) in 2019. The total number of deaths increased from 50•7 million (49•5–51•9) in 2000 to 56•5 million (53•7–59•2) in 2019. Under-5 deaths declined from 9•6 million (9•1–10•3) in 2000 to 5•0 million (4•3–6•0) in 2019. Global population increased by 25•7%, from 6•2 billion (6•0–6•3) in 2000 to 7•7 billion (7•5–8•0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58•6 years (56•1–60•8) in 2000 to 63•5 years (60•8–66•1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019. Interpretation: Over the past 20 years, fertility rates have been dropping steadily and life expectancy has been increasing, with few exceptions. Much of this change follows historical patterns linking social and economic determinants, such as those captured by the GBD Socio-demographic Index, with demographic outcomes. More recently, several countries have experienced a combination of low fertility and stagnating improvement in mortality rates, pushing more populations into the late stages of the demographic transition. Tracking demographic change and the emergence of new patterns will be essential for global health monitoring. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global burden of 87 risk factors in 204 countries and territories, 1990�2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk�outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk�outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk�outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95 uncertainty interval UI 9·51�12·1) deaths (19·2% 16·9�21·3 of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12�9·31) deaths (15·4% 14·6�16·2 of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253�350) DALYs (11·6% 10·3�13·1 of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0�9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10�24 years, alcohol use for those aged 25�49 years, and high systolic blood pressure for those aged 50�74 years and 75 years and older. Interpretation: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Diversity of Bacteria and Fungi Associated with Freshwater Fishes from Mijawal River, Nasarawa, Nigeria

Understudying the presence of bacteria and fungi population on freshwater fishes, provides the knowledge and understanding of their diversity and potential roles they may play in the health of the aquatic and terrestrial ecosystems. The present study was conducted to evaluate the diversity of bacteria and fungi species of identified fish samples from River Mijawal, Nasarawa State. The fishes were sampled from the only landing for three months (October to December, 2019) for this study. During the sampling periods, thirteen (13) different fish species were identified; they were  swabbed with sterilized swab stick from the skin surface for bacteria and fungi identification. The Dominant fish species were Tilapia zillii, Labeo senegalensis, Mormyrus rume and Mormyrus tapines. The total number of thirteen (13) bacterial and five (5) fungi species were isolated and  identified. Eight (8) of the bacteria isolates, were gram negative bacteria (Pseudomonas sp, Aeromonas sp, Serratia mercescenes, Proteus sp, Salmonella spp, Escherichia coli, Klebsiella sp, and Enterobacter sp.); whilst the other five (5) were gram positive bacteria (Bacillus sp, Micrococcus sp, Staphylococcus sp, Enterococcus sp and Listeria monocytogenes).The five isolated fungi species were Aspergillus niger, Rhizopus sp, Penicillium  sp, Trichoderma viridae and Geotrichum candidum. The frequency of occurrence of the isolated bacteria indicated that Staphylococcus sp had the highest frequency of occurrence (16.67%) while Serratia mercescens had the least occurrence (2.78%). The highest number of occurrence of the isolated fungi species was observed in Rhizopus sp while the least was recorded in Geotricum candidum. It was observed that Tilapia zillii and  Mormyrus rume had the most frequent bacteria and fungi isolates. It can therefore be deduced from the results that fish samples identified from River Mijawal has high bacteria and fungi diversity that may be pathogenic to man. The occurrence of these microbes may be attributed of human  and animal faeces in the River  Keywords: Freshwater fishes, Microbes, River Mijawal, Nasarawa &nbsp