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A Kuhnian paradigm shift in Applied/Sociolinguistics has ushered in a number of new lenses for rethinking the study of language and communication, but there has been rather limited synergy among the raft of new conceptualizations. As a consequence, the collective knowledge generated by, for instance, integrationism, multimodality, and translingualism, has not been deployed to elucidate overarching questions that arguably unite them. This chapter funnels these three scholarly directions into a synergistic framework, multisemioticity, which is then applied to a relatively understudied database of first-order and receptive communication – text annotations. As jottings of the mind, annotations bear fewer imprints of normative consciousness and activity, and therefore are an interesting source for both investigating and enhancing the explanatory adequacy of theorization around language and communication. The analysis reveals an underlying multisemiotic instinct in annotation, which in turn suggests that reading in the southern context studied unfolds through a rich communicative repertoire in which languages, colors, graphology, images, intertextuality interact to create meaning.

The proximate composition of Luffa Acutangula (sponge gourd) fruit collected from a dumpsite at Akpan Andem Market, Uyo, Akwa Ibom State was investigated. The parameters investigated were determined using standard biochemical methods. The proximate analysis of the leaves revealed that Luffa Acutangula (sponge gourd) is a poor source of protein (0.90) and lipid (0.30) but has very high carbohydrate content (68.20%), lignin (14.70%), hemicelluloses (15.80%) and cellulose (37.70%); moderate moisture (9.30%) and ash (10.40%). Results show that the plant can withstand moisture and will not deteriorate easily if used for food processing.

Background: The landscape of coronavirus disease in Nigeria is very undulating with established uncertainty due to blatant disregard to genomics research by government health care institutions. As other countries in the west are documenting Covid-19 disease genomics variations among her populace, few research efforts are made by a private university to replicate such data in Nigeria. The objective of this case study was to identify genetic variations associated with severe Covid-19 disease, by whole genome sequencing on a heathy adult Nigerian. Methods: Buccal swabs were self-collected and DNA extracted, quantified, normalised before sequencing on the high-throughput MGI DNBSEQ-T7 DNA sequencer using Nebula genomics platform. Raw sequences in FASTQ files were assembled in contigs or chromosomes using the Gene iobio pipeline. DNA sequences were aligned with integrated genome viewer (IGV) to the human reference genome GRCh38 (hg38) for single nucleotide polymorphism (SNP) variant calls, deletions and insertions. The genetic variations were compared with the recent genome wide association study (GWAS) implicating 8 genetic loci associated with critical covid-19 disease. Results: Five (5) out of the eight (8) genetic variants associated with severe covid-19 were identified in the healthy subject. The highest number of SNPs occurred in Leucine Zipper Transcription Factor Like 1 (LZTFL1) with 147 SNPs, followed by 100 SNPs observed in Oligoadenylate synthetase 1 (OAS1). Six (6) missense variants were observed in Coiled-Coil Alpha-Helical Rod Protein 1 (CCHCR1), all occurring in heterozygous pattern. The SNP in rs3131294 for variant Notch receptor 4 (NOTCH4) located at chr6:32220606 was present in 90% of the allele frequency, while the variant found in Dipeptidyl peptidase (DPP9) on rs2109069 located in chr19:4719431 implicated in GWAS and in this case study had 38% allele frequency. Conclusion: This case study has demonstrated the importance of genomics study that has the potential to play significant roles in mitigating risk factors associated with severe covid-19 disease for public health advise and personalized medicine.

Protocol for systematic review on the bacterial causes of childhood pneumonia in children in sub-Saharan Africa.

Protocol for systematic review on the bacterial causes of childhood pneumonia in children in sub-Saharan Africa.

Background: Well-trained, adequately skilled and motivated primary healthcare (PHC) workers are essential for attaining universal health coverage and the Sustainable Development Goal 3 of ensuring healthy lives and promoting well-being for all. While there is abundant literature on drivers of workforce motivation, published knowledge on the mechanisms of how motivation works within different contexts is limited, particularly from low- and middle-income countries. This paper contributes to health workforce literature by reporting on how motivation works among PHC workers in a maternal and child health (MCH) programme in Nigeria. Methods: We adopted a realist evaluation design including scoping review of literature, document review of policies and MCH programme handbook, and in-depth interviews of PHC workers (n=25), facility managers (n=16), policymakers (n=12) and programme managers (n=10) to assess the impact of the MCH programme in Anambra State, Nigeria. A realist process of theory development, testing, verification and consolidation was used to understand how and under what circumstances the MCH programme impacted on workers’ motivation and which mechanisms helped explain how motivation works. The developed programme theory drew upon Herzberg’s two-factor and Adam’s equity theories to unpack the influences of contextual conditions on worker motivation. Results: A complex and dynamic interaction between the MCH programme and organizational, societal and policy contexts triggered five mechanisms which explain PHC worker motivation: i) feeling supported, ii) feeling valued and committed to work, iii) morale and confidence to perform tasks, iv) companionship and v) feeling comfortable with work environment. Some mechanisms were mutually reinforcing while others operated in parallel. Further analysis showed that the conditions that enabled worker motivation to occur were organisational values of fairness, recognition of health workers’ contributions and a culture of task-sharing and teamwork. Conclusions: Policy designs and management strategies for improving performance of health workers, particularly in resource-constrained settings should create working environments that foster feelings of being valued and supported while enabling workers to apply their knowledge and skills to improve healthcare delivery. Future research can test the explanatory framework generated by this study and explore differences in motivational mechanisms among different cadres of PHC workers to inform cadre-related motivational interventions.

In many countries of sub-Saharan Africa, the release of each year’s results for the end of high school examinations heralds an annual ritual of public commentary on the poor state of national education systems. However, the exoglossic/monolingual language regime for these examinations is infrequently acknowledged as contributing to the dismal performance of students. Even less attended to is the manner in which the language of examinations, through shaping students’ performances, may be exacerbating social inequalities. This article politicizes the language of examinations in the region in the hope of generating policy and research interest in what is arguably an insidious source of inequality. The article makes three arguments. Firstly, it is argued that current exoglossic/monolingual practices in these examinations constitute a set of sociolinguistic aberrations, with demonstrable negative effects on students’ performance. Secondly, it is argued that the gravity of these paradoxical sociolinguistic disarticulations is better appreciated when their social ramifications are viewed in terms of structural violence and social inequality. Thirdly, in considering how to evolve a more socially equitable examination language regime, it is argued that the notion of consequential validity in testing positions translanguaging as a more ecologically valid model of language use in examinations.

Highlights • Impacted penetrating injuries in airways of children create management challenges. • Unavailability of ideal working tools worsens situations in resource-poor settings. • Practitioners should think outside box and improvise what is available to save lives. • Parents and caregivers should be responsive and keep sharp objects away from children., Introduction Impacted penetrating foreign body (FB) in the airway especially the postnasal space presents with management challenges. The challenges are worsened by lack of modern equipment in resource-poor settings. Two suchlike cases were managed in this report. Presentation of cases Case 1: A 4-year-old girl who fell on a metal rod in her mouth while playing alone. Examination revealed an agitated child in open mouth posture, with a silvery straight metallic object impacted on the hard palate and projecting from the mouth. X-ray of the post nasal space showed a radiopaque object through the hard palate impinging on the skull base. Case 2: A 5-year-old male presented with swollen neck and difficulty in breathing following a fall on a sharp pencil while at play in school. The object which pierced through the neck was immediately removed by an attendant. Examination revealed a child in obvious respiratory distress with swollen neck, face and eyes with a slit measuring 2 cm over the crico-thyroid membrane (subcutaneous emphysema). Discussion With no available fibre-optic laryngoscope, classical Macintosh laryngoscopy was infeasible. With refusal of tracheostomy, the authors employed three-man intubation technique to successfully secure the airway for excision of the FB in first patient. The second was induced with IV ketamine since he could not tolerate the supine position and facemask. Due to falling oxygen saturation, an orotracheal intubation was done before a successful mid-level emergency tracheostomy was sited. Conclusion Penetrating airway injuries in children pose serious management challenges. Careful anticipation and quick intervention are helpful.

OBJECTIVE: To evaluate post-operative sexual activity among women who have undergone obstetric fistula repair. METHODS: The present descriptive cross-sectional study recruited married women who had undergone successful obstetric fistula repair who were attending reunion activities at Bingham University Teaching Hospital Jos Nigeria between March 13 and March 15 2014. Participants were interviewed regarding penetrative vaginal intercourse after surgery and any changes in sexual desire arousal orgasm sexual satisfaction and the presence of coital pain compared with before they experienced obstetric fistula. RESULTS: There were 102 patients who participated in interviews; 23 (22.5%) reported not being able to engage in penetrative vaginal intercourse and 12 (52%) of these patients ascribed this to a "tight" or "narrow" vagina. Compared with the pre-fistula period 63 (61.7%) patients reported reduced sexual desire 57 (55.9%) reported lack of or inadequate lubrication during intercourse 12 (11.8%) reported anorgasmia and 60 (58.8%) reported reduced attainment of orgasm. Dyspareunia was reported by 48 (47.1%) patients; 43 (90%) experienced superficial or deep dyspareunia and 5 (10%) experienced both. A lack of and lower sexual satisfaction were reported by 20 (19.6%) and 40 (39.2%) patients respectively. CONCLUSION: Following obstetric fistula repair many women experienced difficulty engaging in penetrative vaginal intercourse and reported sexual dysfunction. Management of sexual dysfunction should be part of fistula rehabilitation programs. (c) 2016 International Federation of Gynecology and Obstetrics.

Against the backdrop of poor routine immunization (RI) and high supplemental immunization activities (SIAs) coverage in Edo State, an analysis of data generated from both activities over a three year period was conducted. The data showed of coverage ,75%, 82% and 80% in 2012, 2013 and 2014 respectively, against an expected national minimum coverage of 87%. This study compared oral polio immunization plus days (IPDs) data with data generated from the district vaccine data management tool (DVD-MT) used for RI analysis in Edo State over a 3 year period; 2012-14. This is aimed at determining if there is a significant difference in the number of children vaccinated during RI and SIAs. The result showed a statistical significance at P≤ 0.05 in data generated for RI coverage compared to both rounds of SIAs for the 3 years in Edo State and in all the 18 LGAs. The annual OPV uptake was higher during the SIAs than RI for 2012-2014 in the State and in 17 LGAs except 1 LGA (Uhunmwonde) whose RI coverage was higher than the SIAs for the period under review though it was statistically insignificant at P≤ 0.05. The OPV uptake during RI was higher than both rounds of SIAs in 2014 at Ovia North East LGA; this was statistically significant at P≤ 0.05. The percentage coverage of the immunization activities and the year conducted are represented in bar diagrams