ASSESSMENT OF THE PHYSICOCHEMICAL AND BACTERIOLOGICAL QUALITIES OF NONO – A FERMENTED COW MILK

Nono is a spontaneously fermented yoghurt-like milk product consumed is a staple food commodity in parts of the Sub- Saharan West Africa. Nono is usually consumed along with ‘ Fura ’ as ‘ Fura da Nono ’ in Nigeria. Studies on physicochemical and bacteriological qualities were carried out on samples of Nono obtained from 5 different sources in Ado-Ekiti, Nigeria. The Nono samples were found to be nutritious, containi ng moderate levels of ash, crude fat, crude protein and carbohydrate. The pH of the Nono samples was relatively low (4.04 ±0.04), while the density and specific density were close to that of distilled water at room temperature. Total aerobic p late count of Nono samples was 1.8 ±0.02 × 106 CFU. mL -1 . A total of 15 bacteria species namely Eubacterium nodatum , Bacillus subtilis , Chromobacterium violaceum , Propionibacterium acnes , Amycolatopsis benzotilytica , Tropheryma whipplei, Moraxella catarrhalis, Campylobacter gracilis, Neisseria sicca, Vibrio natiensis, Photob acterium damselae, Corynebacterium kutsceri, Corynebacterium xerosis, Lactobacillus fermentum and Lactobacillus casei were isolated from the Nono samples. The gram-positive bacterial isolates were resistant to all antibiotics tested with the exceptio n of Erythromycin where 40% susceptibility was obtained, while the gram-negative bacteria showed high resista nce to the tested antibiotics, but with 80% susceptibility to Ofloxacin. The nono samples were observed to exhibit antibac terial activity against cultures of Salmonella typhimurium ATCC 14028, Escherichia coli ATCC 29929 and Staphylococcus aureus ATCC 29293. Most of the bacteria isolated were of less public health importance, but the high prevalence of m ulti-drug resistance is of great concer

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways