Effect of Smallholders Socio-Economic Characteristics on Farming Households’ Food Security in Northern Nigeria

Food security is indispensable prerequisite for the continued existence of mankind and his economic activities including adequate food production.  The study examined the effect of smallholder socio-economic characteristics on farming households’ food security in Northern Nigeria. Data for this study were obtained from 120 randomly selected farming households, using a structured questionnaire. The results revealed that 81.7% of the households considered themselves food insecure.  Furthermore, the majority of households have low incomes and low educational attainment which usually affects food security. There was also a significant negative association between food security and education as well as government policies. The analysis shows that low levels of education and government policies affected rural households. The paper therefore recommended that government and other development agencies should enhance food security among smallholders’ farmers and rural communities through farmer education, promoting labour-saving technologies and facilitating access to market information.  In the same vein, the paper infers that Nigeria needs to come up with results oriented food policy which for now it lacks.  The public policy makers must as a matter of urgency see food as an essential component of welfares and as such develop sufficient political will to achieve food increase in food production and eventually attain food security for all. Keywords: household food security; household food insecure; smallholder farmers; Nigeria DOI: 10.7176/JESD/11-4-16 Publication date: February 29th 202

Role of Information and Communication Technologies (ICTs) in Enhancing Food Utilization among Smallholder Farmers’ Households in Northern Nigeria

Information and Communication Technologies (ICTs) are attracting global attention because of their unprecedented potential to bring about astounding improvement. The numerous advantages presented by ICTs can be employed towards the enhancement of rural households’ capabilities in attaining sufficient, safe and nutritious food.  This paper seeks to establish the potency of ICTs in enhancing the food utilization among smallholder households in Northern Nigeria.  Data were collected through a structured questionnaire administered to 120 smallholders.  The results show that smallholders consider that food utilization was inadequate (80.9%); however, they acknowledged that ICTs could play a significant role in enhancing food utilization.  The findings further reveal that the following were ranked first to fifth by household heads: disseminating appropriate information about food crops (98.6%), improving purchasing power and market price (94.1%), enhancing decision-making regarding food (89.5%), improving food distribution practices (81.1%) and improving cultural and individual food choice (77.6). Keywords: ICTs, Food utilization, Smallholder farmer households, Nigeria DOI: 10.7176/IKM/10-1-05 Publication date: January 31st 202

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine