Implementing an E-Democracy System in Nigeria

E-democracy basically comprises the use of electronic communications technologies such as the internet, in enhancing and advancing the democratic process within a democratic republic. E-democracy is an innovation still in its infant stage; and is still subject to much debate and activity within government, civic oriented groups and societies around the world. In most developing countries including Nigeria, there exists a low attitude of participation of the citizens in governance. Social, political, insecurity, Corruption and other forms of electoral manipulation discourage the electorate from getting involved in government From the various elections conducted since independence, about half the number of registered voters actually voted during elections. In addition, less than half of those who voted were involved in participatory governance. The objective is of this paper is development of a web-based system that will foster and encourage active citizenship participation by implementing democratic practices like voting and election campaign. The system was developed using PHP as front end, Apache as web server and MySQL as Database. The benefits of having an e-Democracy system are numerous: It reduces the success of rigging during elections. It is time saving because it reduced some undue electoral processes. It allows for easy communication between the citizens and their elected candidates

Implementing an E-Democracy System in Nigeria

E-democracy basically comprises the use of electronic communications technologies such as the internet, in enhancing and advancing the democratic process within a democratic republic. E-democracy is an innovation still in its infant stage; and is still subject to much debate and activity within government, civic oriented groups and societies around the world. In most developing countries including Nigeria, there exists a low attitude of participation of the citizens in governance. Social, political, insecurity, Corruption and other forms of electoral manipulation discourage the electorate from getting involved in government From the various elections conducted since independence, about half the number of registered voters actually voted during elections. In addition, less than half of those who voted were involved in participatory governance. The objective is of this paper is development of a web-based system that will foster and encourage active citizenship participation by implementing democratic practices like voting and election campaign. The system was developed using PHP as front end, Apache as web server and MySQL as Database. The benefits of having an e-Democracy system are numerous: It reduces the success of rigging during elections. It is time saving because it reduced some undue electoral processes. It allows for easy communication between the citizens and their elected candidates. Keywords:  Citizen, e-Democracy, Election, e-Governance, Voting and Participatio

The current pattern of facility-based perinatal and neonatal mortality in Sagamu, Nigeria

Background: Perinatal and neonatal mortality rates have been described as sensitive indices of the quality of health care services. Regular audits of perinatal and neonatal mortalities are desirable to evaluate the various global interventions. Objective: To describe the current pattern of perinatal and neonatal mortality in a Nigerian tertiary health facility. Methods: Using a prospective audit method, the socio-demographic parameters of all perinatal and neonatal deaths recorded in a Nigerian tertiary facility between February 2017 and January 2018 were studied. Results: There were 1,019 deliveries with stillbirth rate of 27.5/1000 total births and early neonatal death (END) rate among in-born babies of 27.2/1000 live births. The overall perinatal mortality rate for in-facility deliveries was 53.9/1000 total births and neonatal mortality (till the end of 28 days) rate of 27.2/1000 live births. Severe perinatal asphyxia and prematurity were the leading causes of neonatal deaths while obstructed labour and intra-partum eclampsia were the two leading maternal conditions related to stillbirths (25.0% and 21.4% respectively). Gestational age < 32 weeks, age < 24 hours and inborn status were significantly associated with END (p = 0.002, p <0.001 and p = 0.002 respectively). Conclusion: The in-facility perinatal mortality rate was high though stillbirth rate was relatively low. There is a need to improve the quality of emergency obstetric and neonatal services prior to referral to tertiary facilities

Determinants of outcome in newborns with respiratory distress in Osogbo, Nigeria

Background: Respiratory distress is one of the commonest presentations necessitating hospital admission in newborn unit. Regardless of the cause, if not recognized and managed quickly, respiratory distress can escalate to apnoea, respiratory failure, cardiopulmonary arrest and death.Methods: A cross-sectional and descriptive study of newborns with respiratory distress admitted into the SCBU of LAUTECH Teaching Hospital, Osogbo, Nigeria. Respiratory distress was diagnosed by grunting, inspiratory stridor, nasal flaring and tachypnea (more than 60 breaths per minute), retractions in the intercostal, subcostal, or supracostal spaces and cyanosis. At admission, every neonate had a complete physical examination.Results: Of 625 babies admitted, 384 (61.4%) were males while 241 (38.6%) were females and 164 (26.2%) had respiratory distress. Respiratory distress was commoner among the preterms than term newborns. c2 = 44.7, p = 0.001. Leading causes of respiratory distress among the preterms were hyaline membrane disease, septicaemia, while among the term babies were perinatal asphyxia, transient tachypnoea of newborn and meconium aspiration. Sixty (36.6%) of the 164 babies with respiratory distress died. While 40.2% of the preterms died mainly from causes like hyaline membrane disease and septicaemia, 31.3% of term babies died from causes like perinatal asphyxia and meconium aspiration. Mortality from hyaline membrane disease was 46.9%, while perinatal asphyxia and meconium aspiration accounted for 38.9% and 40.0% respectively.Conclusions: Respiratory distress is therefore, a very common neonatal problem and it causes death of more than third of those affected. Emphasis should be geared towards reduction of preterm delivery, control of asphyxia and neonatal sepsis in order to reduce neonatal mortality in our environment

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

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

Abstract 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