Community engagement in COVID-19 responses:Evidence from qualitative interface with community opinion leaders in Enugu, Nigeria

Successful stories of community engagement existed during the Ebola disease outbreak in Liberia, indicating that a combination of government and community efforts are needed in addressing pandemics or epidemics. However, for communities to rise to the challenge of containing and combatting the spread of any disease, they must be communicated most effectively and supported by the government. Therefore, our study investigates how applicable successful community engagement has been in the charge against the Coronavirus disease 2019 (COVID-19) in Nigeria. Through telephone interviews, we sourced data from 12 community opinion leaders in Enugu State, Nigeria. After conducting a thematic analysis of responses, we discovered that the Nigerian government had several gaps in engaging the grassroots in the charge against COVID-19. These gaps comprise the lack of effective inclusion strategies of rural communities and the uneducated, weak accountability, poor database of citizens, weak accountability of security agents, weak primary healthcare system, and the dearth of grassroots-targeted communication. The effects of these gaps majorly manifested in the compromise and disregard of safety measures, which most likely put Nigeria at risk of increased cases of COVID-19 or poor response to disease outbreaks in the future. We concluded that the government must improve its accountability records while effectively interfacing with the grassroots during disease outbreaks and co-producing strategies.<br/

Community engagement in COVID-19 responses:Evidence from qualitative interface with community opinion leaders in Enugu, Nigeria

Successful stories of community engagement existed during the Ebola disease outbreak in Liberia, indicating that a combination of government and community efforts are needed in addressing pandemics or epidemics. However, for communities to rise to the challenge of containing and combatting the spread of any disease, they must be communicated most effectively and supported by the government. Therefore, our study investigates how applicable successful community engagement has been in the charge against the Coronavirus disease 2019 (COVID-19) in Nigeria. Through telephone interviews, we sourced data from 12 community opinion leaders in Enugu State, Nigeria. After conducting a thematic analysis of responses, we discovered that the Nigerian government had several gaps in engaging the grassroots in the charge against COVID-19. These gaps comprise the lack of effective inclusion strategies of rural communities and the uneducated, weak accountability, poor database of citizens, weak accountability of security agents, weak primary healthcare system, and the dearth of grassroots-targeted communication. The effects of these gaps majorly manifested in the compromise and disregard of safety measures, which most likely put Nigeria at risk of increased cases of COVID-19 or poor response to disease outbreaks in the future. We concluded that the government must improve its accountability records while effectively interfacing with the grassroots during disease outbreaks and co-producing strategies.<br/

TP53 Gene Status in the Presence of Allicin in NNK Induced Pancreatic Cancer Albino Rats

Pancreatic cancer (PC) is the fourth most lethal form of cancer in Western society, with mortalities closely mirroring incidence and an overall 5-year survival of less than 7%. Traditional medicine which involves the use of herbs has been used to treat various types of cancer and this has been found to be effective with minimal or no side effects. This ressearch was aimed at evaluating the chemo preventive effect of extract of the active ingredients of garlic (Allicine)on Nitrosamines induced pancreatic cancer in rat. Allicine was extracted from garlic by crushing the garlic in an ethanol and inject  into the HPLC column. Agarose gel electrophoresis was used to analyze deoxyribonuleic acid (DNAs) extracted from the pancreatic tissue of the experimental mice while haematoxylin and eosin staining was used for histological assay.There was a significant reduction in the weight of the experimental animals that were administered with NNK. The animals administered with extract (allicin) also show a reduction in weight. Normal control animals were seen to have gained weight. DNA bands obtained from agarose gel electrophoresis suggested a possible NNK induced damage which was prevented to a certain degree owing to the effect of the allicin. Histological assay revealed the presence of neoplastic hyperplasia which is more prominent in the histological sections of the pancreatic tissue of the rats which were not treated with allicin. This study has shown that allicin could be used as a treatment against NNK induced pancreatic cancer in white albino rats at the right concentration

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

'Vernacular Voices: Black British Poetry'

ABSTRACT Black British poetry is the province of experimenting with voice and recording rhythms beyond the iambic pentameter. Not only in performance poetry and through the spoken word, but also on the page, black British poetry constitutes and preserves a sound archive of distinct linguistic varieties. In Slave Song (1984) and Coolie Odyssey (1988), David Dabydeen employs a form of Guyanese Creole in order to linguistically render and thus commemorate the experience of slaves and indentured labourers, respectively, with the earlier collection providing annotated translations into Standard English. James Berry, Louise Bennett, and Valerie Bloom adapt Jamaican Patois to celebrate Jamaican folk culture and at times to represent and record experiences and linguistic interactions in the postcolonial metropolis. Grace Nichols and John Agard use modified forms of Guyanese Creole, with Nichols frequently constructing gendered voices whilst Agard often celebrates linguistic playfulness. The borders between linguistic varieties are by no means absolute or static, as the emergence and marked growth of ‘London Jamaican’ (Mark Sebba) indicates. Asian British writer Daljit Nagra takes liberties with English for different reasons. Rather than having recourse to established Creole languages, and blending them with Standard English, his heteroglot poems frequently emulate ‘Punglish’, the English of migrants whose first language is Punjabi. Whilst it is the language prestige of London Jamaican that has been significantly enhanced since the 1990s, a fact not only confirmed by linguistic research but also by its transethnic uses both in the streets and on the page, Nagra’s substantial success and the mainstream attention he receives also indicate the clout of vernacular voices in poetry. They have the potential to connect with oral traditions and cultural memories, to record linguistic varieties, and to endow ‘street cred’ to authors and texts. In this chapter, these double-voiced poetic languages are also read as signs of resistance against residual monologic ideologies of Englishness. © Book proposal (02/2016): The Cambridge History of Black and Asian British Writing p. 27 of 4

Forging connections: anthologies, arts collectives, and the politics of inclusion

The changing social and political landscape of twentieth-century Britain catalysed a remarkable rise in collaborative activity by artists and activists of black and Asian heritage. Creative communities began to gather in both local and regional contexts, with the aim of sharing resources and securing an audience. This chapter records some of these many activities, tracing the groups’ genesis, manifest objectives, and key contributions. It argues that anthologising should be understood as a specifically motivated activity. Literary anthologies of poetry and fiction served to showcase the diversity of contemporary writing, while also suggesting its coherence. Drawing on the concept of “strategic essentialism” elucidated by Gayatri Chakravorty Spivak, I show that the anthology acts to ensure the visibility of a group, bannered as a unified and singly-titled selection of texts, while also insisting on the differences within: the heterogeneous multiplicity of black and Asian British experiences and creative practices

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Young people and perceived achievements on social media:the needfulness of social work services in Nigerian tertiary schools

Material and non-material achievements are replete on social media, and they are perceived differently by people. We sought to provide evidence on how young undergraduates relate with these perceived achievements, the prospects and problems associated with such perceptions, and the implications for psychosocial support services in higher institutions in Nigeria. Guided by phenomenology, 30 young undergraduates across two universities in Nigeria were interviewed. Elicited data were analysed in themes, and identity theory provided the conceptual framework. Despite the positives taken from the perceived achievements on social media, there were considerable negative influences, affecting the character and esteem of young people. The students expressed interest in seeking psychosocial services, which were unavailable. Our study buttresses the need to mainstream social work and other psychosocial services in Nigerian tertiary schools for the comprehensive development of students.</p