Review Article : A review of the distribution, nutritional value and conservation status of wild harlequin quails (Coturnix delegorguei delegorguei) in Kenya

Wild harlequin quails are a traditional source of protein in many parts of Sub-Saharan Africa. Nonetheless, they are greatly underutilized to combat malnutrition and ensure food security. The current status of quail populations in Kenya is mostly unknown, especially after introducing numerous exotic quails during the quail ‘bubble’ of years 2013-2015. Besides, the ongoing uncontrolled harvesting of wild harlequin quails and its effect on wild quail populations has not been examined either. The aim of this review is to discuss and reveal the emerging issues associated with the opportunities, utilization challenges and conservation status of wild harlequin quails in Kenya. This review will focus on peer-reviewed research articles, published books, review articles and internet resources on wild quails and commercial quail farming. It is essential to point out that quails are already considered as emerging poultry, and increased consumption of their products is highly encouraged, thus contributing to food security in Kenya. However, wild harlequin quail conservation concerns need to be addressed regarding their uncontrolled harvesting, destruction of their habitats, and climate change

It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened

It is time to define an organizational model for the prevention and management of infections along the surgical pathway : a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.Peer reviewe

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

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

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

Molecular pilot study on peripheral populations of Kenyan greenbul in an afromontane fragmented forest

We provide a molecular study on peripheral populations of three closely related species of African forest-dependent greenbuls: the generalist Eurillas latirostris and the specialists Phyllastrephus cabanisi and Arizelocichla nigriceps. These species co-occur within their range limits in the Kenyan Afromontane forest, Cherangani Hills. This forest has experienced drastic deforestation, which began about 50years ago, that is causing habitat fragmentation. The aims of this study, using the analyses of molecular tools, are twofold: (i) to provide evidence that functional traits (i.e., ecological attributes) may shape different genetic structure in peripheral populations and (ii) to identify the possible effects of forest fragmentation. Blood and plucked feathers were sampled from a total of 124 birds analysed using two molecular approaches: (i) sequencing of cytochrome b mtDNA and (ii) genotyping nuclear DNA at eight microsatellite loci. Molecular diversity indices, minimum spanning network and mismatch distribution analysis of mtDNA results indicated that the peripheral populations showed different demographic trends: a highly variable and bimodal pattern in forest specialist P.cabanisi, a less variable and unimodal pattern in forest generalist E.latirostris and in the montane specialist A.nigriceps. Although this is a pilot study on the Cherangani forest fragmentation, the nuclear results may not exclude the hypothesis of reduced connectivity in all forest-dependent greenbuls.Resume Nous apportons une etude moleculaire des populations peripheriques de trois especes de bulbuls etroitement liees, dependantes de la foret africaine: l'espece generaliste Eurillas latirostris et les especes specialistes Phyllastrephus cabanisi et Arizelocichla nigriceps. Ces especes coexistent, au sein de leur aire de repartition, dans la foret afromontagnarde kenyane des Cherangani Hills. Cette foret subit une deforestation dramatique, qui a commence il y a quelque 50ans et qui provoque une fragmentation de l'habitat. Le but de cette etude, qui utilise une analyse d'outils moleculaires, est double: i) apporter la preuve que des caracteristiques fonctionnelles (c. a d. ecologiques) peuvent modeler differentes structures genetiques dans des populations peripheriques et ii) identifier les effets possibles de la fragmentation forestiere. Du sang et des plumes ont ete preleves sur un total de 124 oiseaux analyses suivant deux approches moleculaires: 1) le sequencage de l'ADN mitochondrial (cytochromeb) et 2) le dechiffrage du genotype de l'ADN nucleaire de huit loci microsatellites. Les resultats des Indices de diversite moleculaire, du Reseau de recouvrement minimum, et de l'Analyse des ecarts de la distribution de l'ADNmt ont montre que les populations peripheriques presentaient des tendances demographiques differentes: un schema tres variable et bimodal chez l'espece specialiste de la foret P. cabanisi, un schema moins variable et unimodal chez la generaliste de la foret E.latirostris et chez la specialiste de montagne A. nigriceps. Bien que ceci soit une etude pilote de la fragmentation de la foret de Cherangani, les resultats nucleaires ne permettent pas d'exclure l'hypothese d'une connectivite reduite entre tous les bulbuls dependant de la foret

The status of flora and fauna in the Nzoia River drainage basin in western Kenya

The species richness of flora and fauna in the Nzoia River drainage basin is documented through a study of museum specimens,  catalogues and databases. The catchment area and basin covers 2.2% (12900/580367 km2) of Kenya’s total land area with an altitudinal range of 1140 to 4300 m and varied ecosystem and land uses. We recorded approximately 9.3% (3239/34677) of Kenya’s current known species of vascular plants, invertebrates (insects and spiders), fish, amphibians, reptiles, birds and mammals. Bird species made up the highest proportion 58.3% (650/1114) of the national total followed by amphibians 37.3% (41/110), reptiles 45.0% (86/191), mammals 31.3% (122/390), vascular plants 17.9% (1251/7000), fish 6.7% (58/872) (32.2% (58/180) for freshwater fish only) and invertebrates (insects and spiders) 4.1% (1031/25000). Ninety-five species recorded in this area are endemic to Kenya and 42 globally threatened. The species recorded contribute to several ecosystem services including pest control, pollination, bio-indicators, medicine and cosmetics, building materials, ecotourism, research and education. Data available differed substantially across counties and taxon groups with gaps apparent in five counties (Bungoma, Busia, Elgeyo Marakwet, Siaya and Usain Gishu) and four taxa plants, invertebrates, fungi and bacteria where a dearth of information exists. To fill these gaps we recommend prioritisng future survey effort on taxa and counties with fewer than 10% of the total numbers of records