Effects of Different Strategies Adopted by Rural Women on their Food Security in Oyo State

The study assessed the effects of different strategies adopted by rural women on their food securityin Oyo State. Multistage sampling procedure was adopted for this research work. Data collected were analyzed using descriptive statistics and binomial logit model. Majority (93.5 percent) of the sampled women were married, while 6.5 percent of them were widowed. The mean age was 49 years. Backyard farming (= -1.000333343) had a negative but significant relationship to household food insecurity while reduction of meals (= 1.312270792) had a positive and significant relationship to household food insecurity. It was recommended that, program aimed at reducing poverty should be implemented in other to ensure that households were able to afford adequate mealsalso; backyard farming should be encouraged among rural women

Effect of Climate Change on Groundwater Resources in South West, Nigeria

This study examined the impact of climate change on groundwater resources of the south-western region of Nigeria. First, chronological climate (meteorological) and geological and hydrogeological data of Ondo State the various catchment areas within the region which spanned over a period of 30 years (1982 – 2012) were analyzed with a  view to determine whether there has been any climate change in the study area. The Meteorological data such as rainfall and temperature were obtained from the Nigerian Meteorological Agency located in Lagos, while the hydrogeological data such as borehole yield were collected from Benin-Owena river basin in Ondo state. For each location, the graphs of Rainfall versus Month and Maximum Temperature (Tmax), Minimum Temperature (Tmin) versus Month were plotted as a means of obviating the probable change in climate. It was discovered that there was a slight increase in both rainfall and the mean temperature 2% - 8% and 0.10 c – 0.70 c respectively. Thus climate change was observed as a result of increase in the average yearly rainfall and mean temperature. The effect was concluded as not pronounced or significant on the groundwater after all the analyses and studies. Keywords: groundwater, climate change, temperature, rainfall, south-western, Nigeria

A giant hydronephrotic pelvic kidney mimicking an ovarian cyst in a 34-week pregnancy

Background: A giant hydronephrosis is defined as a dilated pelvi-calyceal system with an amount of urine exceeding one Litre in the urinary tract of an adult. It can mimic several other clinical conditions including a huge ovarian cyst. An ectopic pelvic kidney with hydronephrosis in pregnancy is a rare occurrence.Aim: This study documents a case of giant hydronephrosis that was wrongly diagnosed as an ovarian cyst. Findings: A 36-year old primiparous with a giant hydronephrosis which was initially diagnosed as an ovarian cyst. She was planned for a laparotomy with caesarean section and ovarian cystectomy at 34 weeks gestation. She was delivered of a live female neonate. Further exploration was done which revealed a left ectopic kidney. She had a left simple nephrectomy because the kidney appeared totally unhealthy.Conclusion: There is a need to be careful when dealing with cystic lesions of the abdomen. A high index of suspicion is required and further imaging other than ultrasound scan such as computerized tomography or magnetic resonance imaging may be necessary to make accurate diagnosis.Keywords: Caesarean section, ectopic gestation, hydronephrosis, urinary tract, cystectomy, ovarian cyst

Physical Assets Ownership of Fisherfolk in Fishing Communities of Kainji Lake Nigeria: Implications for Climate Change

A probe was carried out to ascertain fisherfolk ownership of physical assets for fisheries activities in fishing communities’ vis-à-vis implication of climate change around Kainji Lake. Interview schedule was employed to generate primary data from 165 respondents in eleven fishing communities on western side of the lake and analysed with descriptive and inferential statistics. Information on personal characteristics revealed that most of the respondents were advanced in age, small scale artisan fisherfolk with many years of experience, self employed and married with children but had poor education. Physical assets owned fall into three categories of fishing asset (33.3%), fish processing asset (41.7%) and accessories (25%). Conspicuous assets owned were fishing net, wooden canoe, hook & line, fish drying net, improved banda and modified drum smoking kiln. Physical assets that use wood and fuelwood which impinged on climate change were fishing canoe, improved banda and modified drum smoking kiln. Correlates of improved banda and modified drum kiln were marital status and number of wives. It implies that marital family’s ownership of fish smoking processing assets contributed to climate change problems through deforestation thereby causing desertification, soil erosion, destruction of ecosystem and weather variations with serious consequences on water bodies, fisheries, and livelihood in fishery around the lake. Worrisome is zero ownership of solar tent dryer which uses renewable energy of the sun and friendly to climate change adaptation. In view of prevailing evidence, adaptation to climate change is subject to modification of solar net drier to meet fish smoking needs. In alternative is exploration of biomass energy sources that is sustainable like rice husk for fish smoking as a mitigation strategy

Physical Assets Ownership of Fisherfolk in Fishing Communities of Kainji Lake Nigeria: Implications for Climate Change

A probe was carried out to ascertain fisherfolk ownership of physical assets for fisheries activities in fishing communities’ vis-à-vis implication of climate change around Kainji Lake. Interview schedule was employed to generate primary data from 165 respondents in eleven fishing communities on western side of the lake and analysed with descriptive and inferential statistics. Information on personal characteristics revealed that most of the respondents were advanced in age, small scale artisan fisherfolk with many years of experience, self employed and married with children but had poor education. Physical assets owned fall into three categories of fishing asset (33.3%), fish processing asset (41.7%) and accessories (25%). Conspicuous assets owned were fishing net, wooden canoe, hook & line, fish drying net, improved banda and modified drum smoking kiln. Physical assets that use wood and fuelwood which impinged on climate change were fishing canoe, improved banda and modified drum smoking kiln. Correlates of improved banda and modified drum kiln were marital status and number of wives. It implies that marital family’s ownership of fish smoking processing assets contributed to climate change problems through deforestation thereby causing desertification, soil erosion, destruction of ecosystem and weather variations with serious consequences on water bodies, fisheries, and livelihood in fishery around the lake. Worrisome is zero ownership of solar tent dryer which uses renewable energy of the sun and friendly to climate change adaptation. In view of prevailing evidence, adaptation to climate change is subject to modification of solar net drier to meet fish smoking needs. In alternative is exploration of biomass energy sources that is sustainable like rice husk for fish smoking as a mitigation strategy

Understanding data and information needs for palliative cancer care to inform digital health intervention development in Nigeria, Uganda and Zimbabwe: protocol for a multicountry qualitative study

Introduction: Palliative care is a clinically and cost‐effective component of cancer services in sub-Saharan Africa (SSA). Despite the significant need for palliative cancer care in SSA, coverage remains inadequate. The exploration of digital health approaches could support increases in the quality and reach of palliative cancer care services in SSA. However, there is currently a lack of any theoretical underpinning or data to understand stakeholder drivers for digital health components in this context. This project addresses this gap through engaging with key stakeholders to determine data and information needs that could be supported through digital health interventions. Methods and analysis: This is a multicountry, cross-sectional, qualitative study conducted in Nigeria, Uganda and Zimbabwe. In-depth interviews will be conducted in patients with advanced cancer (n=20), caregivers (n=15), health professionals (n=20) and policy-makers (n=10) in each of the three participating countries. Data from a total of 195 interviews will transcribed verbatim and translated into English before being imported into NVivo software for deductive framework analysis. The analysis will seek to understand the acceptability and define mechanisms of patient-level data capture and usage via digital technologies. Ethics and dissemination: Ethics approvals have been obtained from the Institutional Review Boards of University of Leeds (Ref: MREC 18–032), Research Council of Zimbabwe (Ref: 03507), Medical Research Council of Zimbabwe (Ref: MRCZ/A/2421), Uganda Cancer Institute (Ref: 19–2018), Uganda National Council of Science and Technology (Ref: HS325ES) and College of Medicine University of Lagos (Ref: HREC/15/04/2015). The project seeks to determine optimal mechanisms for the design and development of subsequent digital health interventions to support development, access to, and delivery of palliative cancer care in SSA. Dissemination of these findings will occur through newsletters and press releases, conference presentations, peer-reviewed journals and social media. Trial registration number: ISRCTN1572771

Stakeholder perspectives and requirements to guide the development of digital technology for palliative cancer services: a multi-country, cross-sectional, qualitative study in Nigeria, Uganda and Zimbabwe

Introduction: Coverage of palliative care in low and middle-income countries is very limited, and global projections suggest large increases in need. Novel approaches are needed to achieve the palliative care goals of Universal Health Coverage. This study aimed to identify stakeholders’ data and information needs and the role of digital technologies to improve access to and delivery of palliative care for people with advanced cancer in Nigeria, Uganda and Zimbabwe. Methods: We conducted a multi-country cross-sectional qualitative study in sub-Saharan Africa. In-depth qualitative stakeholder interviews were conducted with N = 195 participants across Nigeria, Uganda and Zimbabwe (advanced cancer patients n = 62, informal caregivers n = 48, health care professionals n = 59, policymakers n = 26). Verbatim transcripts were subjected to deductive and inductive framework analysis to identify stakeholders needs and their preferences for digital technology in supporting the capture, transfer and use of patient-level data to improve delivery of palliative care. Results: Our coding framework identified four main themes: i) acceptability of digital technology; ii) current context of technology use; iii) current vision for digital technology to support health and palliative care, and; iv) digital technologies for the generation, reporting and receipt of data. Digital heath is an acceptable approach, stakeholders support the use of secure data systems, and patients welcome improved communication with providers. There are varying preferences for how and when digital technologies should be utilised as part of palliative cancer care provision, including for increasing timely patient access to trained palliative care providers and the triaging of contact from patients. Conclusion: We identified design and practical challenges to optimise potential for success in developing digital health approaches to improve access to and enhance the delivery of palliative cancer care in Nigeria, Uganda and Zimbabwe. Synthesis of findings identified 15 requirements to guide the development of digital health approaches that can support the attainment of global health palliative care policy goals

Project OPUS: Development and evaluation of an electronic platform for pain management education of medical undergraduates in resource-limited settings

Introduction Pain is a very frequent symptom that is reported by patients when they present to health professionals but remains undertreated or untreated, particularly in low-resource settings including Nigeria. Lack of training in pain management remains the most significant obstacle to pain treatment alongside an inadequate emphasis on pain education in undergraduate medical curricula, negatively impacting on subsequent care of patients. This study aimed to determine the effect of a 12-week structured e-Learning course on the knowledge of pain management among Nigerian undergraduate medical students. Methods Prospective, multisite, pre-post study conducted across five medical colleges in Nigeria. Structured modules covering aspects of pain management were delivered on an e-Learning platform. Pre- and post-test self-assessments were carried out in the 12-week duration of the study. User experience questionnaires and qualitative interviews were conducted via instant messaging to evaluate user experiences of the platform. User experience data was analysed using the UEQ Data Analysis Tool and Framework Analysis. Results A total of 216 of 659 eligible students completed all sections of the e-Learning course. Participant mean age was 23.52 years, with a slight female predominance (55.3%). Across all participants, an increase in median pre- and post-test scores occurred, from 40 to 60 (Z = 11.3, p<0.001, effect size = 1.3), suggestive of increased knowledge acquisition relating to pain management. Participants suggested e-Learning is a valuable approach to delivering pain education alongside identifying factors to address in future iterations. Conclusion e-Learning approaches to pain management education can enhance traditional learning methods and may increase students’ knowledge. Future iterations of e-Learning approaches will need to consider facilitating the download of data and content for the platform to increase user uptake and engagement. The platform was piloted as an optional adjunct to existing curricula. Future efforts to advocate and support integration of e-Learning for pain education should be two-fold; both to include pain education in the curricula of medical colleges across Nigeria and the use of e-Learning approaches to enhance teaching where feasible. Methods: Prospective, multisite, pre-post study conducted across five medical colleges in Nigeria. Structured modules covering aspects of pain management were delivered on an e-Learning platform. Pre- and post-test self-assessments were carried out in the 12-week duration of the study. User experience questionnaires and qualitative interviews were conducted via instant messaging to evaluate user experiences of the platform. User experience data was analysed using the UEQ Data Analysis Tool and Framework Analysis. Results: A total of 216 of 659 eligible students completed all sections of the e-Learning course. Participant mean age was 23.52 years, with a slight female predominance (55.3%). Across all participants, an increase in median pre- and post-test scores occurred, from 40 to 60 (Z=11.3, p<0.001, effect size=1.3), suggestive of increased knowledge acquisition relating to pain management. Participants suggested e-Learning is a valuable approach to delivering pain education alongside identifying factors to address in future iterations. Conclusion: e-Learning approaches to pain management education can enhance traditional learning methods and may increase students’ knowledge. Future iterations of e-Learning approaches will need to consider facilitating the download of data and content for the platform to increase user uptake and engagement. The platform was piloted as an optional adjunct to existing curricula. Future efforts to advocate and support integration of e-Learning for pain education should be two-fold; both to include pain education in the curricula of medical colleges across Nigeria and the use of e-Learning approaches to enhance teaching where feasible

A standard set of person-centred outcomes for diabetes mellitus: results of an international and unified approach

AIMS To select a core list of standard outcomes for diabetes to be routinely applied internationally, including patient-reported outcomes. METHODS We conducted a structured systematic review of outcome measures, focusing on adults with either type 1 or type 2 diabetes. This process was followed by a consensus-driven modified Delphi panel, including a multidisciplinary group of academics, health professionals and people with diabetes. External feedback to validate the set of outcome measures was sought from people with diabetes and health professionals. RESULTS The panel identified an essential set of clinical outcomes related to diabetes control, acute events, chronic complications, health service utilisation, and survival that can be measured using routine administrative data and/or clinical records. Three instruments were recommended for annual measurement of patient-reported outcome measures: the WHO Well-Being Index for psychological well-being; the depression module of the Patient Health Questionnaire for depression; and the Problem Areas in Diabetes scale for diabetes distress. A range of factors related to demographic, diagnostic profile, lifestyle, social support and treatment of diabetes were also identified for case-mix adjustment. CONCLUSIONS We recommend the standard set identified in this study for use in routine practice to monitor, benchmark and improve diabetes care. The inclusion of patient-reported outcomes enables people living with diabetes to report directly on their condition in a structured way

Sulforaphane-enriched extracts from glucoraphanin-rich broccoli exert antimicrobial activity against gut pathogens in vitro and innovative cooking methods increase in vivo intestinal delivery of sulforaphane

Purpose Studies on broccoli (Brassica oleracea var. italica) indicate beneficial effects against a range of chronic diseases, commonly attributed to their bioactive phytochemicals. Sulforaphane, the bioactive form of glucoraphanin, is formed by the action of the indigenous enzyme myrosinase. This study explored the role that digestion and cooking practices play in bioactivity and bioavailability, especially the rarely considered dose delivered to the colon. Methods The antimicrobial activity of sulforaphane extracts from raw, cooked super broccoli and cooked super broccoli plus mustard seeds (as a source myrosinase) was assessed. The persistence of broccoli phytochemicals in the upper gastrointestinal tract was analysed in the ileal fluid of 11 ileostomates fed, in a cross-over design, super broccoli soup prepared with and without mustard seeds. Results The raw super broccoli had no antimicrobial activity, except against Bacillus cereus, but cooked super broccoli (with and without mustard seeds) showed considerable antimicrobial activity against various tested pathogens. The recovery of sulforaphane in ileal fluids post soup consumption was < 1% but addition of mustard seeds increased colon-available sulforaphane 6-fold. However, when sulforaphane was extracted from the ileal fluid with the highest sulforaphane content and tested against Escherichia coli K12, no inhibitory effects were observed. Analysis of glucosinolates composition in ileal fluids revealed noticeable inter-individual differences, with six “responding” participants showing increases in glucosinolates after broccoli soup consumption. Conclusions Sulforaphane-rich broccoli extracts caused potent antimicrobial effects in vitro, and the consumption of sulforaphane-enriched broccoli soup may inhibit bacterial growth in the stomach and upper small intestine, but not in the terminal ileum or the colon