Trends of Zambia’s tuberculosis burden over the past two decades

Objectives:  To study trends in Zambia’s TB notification rates between 1990 and 2010 and to ascertain progress made towards TB control. Methods:  Retrospective review of TB notification returns and TB programme reports for the period from 1990 to 2010. Results:  Two distinct TB trend periods were identified: a period of rising trends up to a peak between 1990 and 2004 and a period of moderately declining trends between 2004 and 2010. Treatment outcomes improved over the two decades. Data on trends in paediatric TB, TB in prisoners and TB in pregnant women remain scanty and unreliable owing to poor diagnostic capability. There were no data available on trends on drug-resistant TB because of the lack of laboratory services to perform drug sensitivity testing. Conclusions:  The period of increasing TB between 1990 and 2000 coincided with an increase in HIV/AIDS. The period of slightly decreasing TB between 2004 and 2010 can be attributed to improved TB care, sustained DOTS implementation and improvement in TB diagnostic services. Newer diagnostics technologies for the rapid diagnosis of active TB cases and for drug-resistant testing, recently endorsed by the WHO, need to be implemented into the national TB programmes to detect more cases and to provide epidemiological and surveillance data from which to obtain an evidence base for guided investments for TB control. Alignment of TB and HIV services is required to achieve improved management outcomes

Food production and consumption in Bamyan Province, Afghanistan: the challenges of sustainability and seasonality for dietary diversity

In Asia, high levels of malnutrition threaten the health and livelihoods of millions of households. This paper concentrates on linkages between agriculture and nutrition in Afghanistan where food and nutrition insecurity are increasing and agricultural sustainability is increasingly compromised by climate change. We explore seasonal patterns of food production and consumption in the remote and robust ecological environment of Shah Foladi, Bamyan Province. Analysis of qualitative data from household interviews in eight villages has provided a wealth of insights into the seasonality of diets. Even within a broadly homogeneous environment, households were found to be markedly heterogeneous in respect of their assets, production, market, finance and employment strategies. The so-called ‘lean season’ was found to vary accordingly. Nevertheless, a general lack of dietary diversity during much of the year is likely to cause micronutrient malnutrition, especially for the vulnerable groups of children, adolescent girls and women. Potential interventions are proposed which need to account for the local context in order to overcome the natural and political constraints. These strategies include agricultural innovation and multi-sectoral policy approaches. In the end, reducing national insecurity is a pre-requisite for sustainable improvement in nutrition-sensitive agricultural development

The Ambivalent Role of Mimetic Behaviors in Proximity Dynamics: Evidences on the French “Silicon Sentier”

This articles examines the peculiar role of mimetic behaviors in co-location processes. We start showing that geographical proximity between agents and/or firms is not a sufficient nor necessary condition for the collective performance of clusters. Other types of socio-economic proximities characterize clusters, and our purpose is to show that, among the several ways to analyze the complex links between proximities and clusters, the theoretical outlook on the role played by mimetic interactions in co-location processes are certainly one of the most promising. Mimetic behaviors of location (in economics and sociology) are introduced in order to demonstrate that co-location processes can be the result of sequentiality, uncertainty, legitimacy and non market interactions, rather than full rational and isolated decisions and pure strategic market interactions. According to the type of mimetic behavior at work in the clustering process, the nature of socio-economic proximity can differ and have a strong influence of the “evolutionary stability” of clusters. All these theoretical considerations are illustrated through the emblematic French case of “Silicon Sentier”, cluster which has gathered together three hundred firms of the French net-economy (the famous “dotcom”) during the Internet bubble swelling.cluster, mimetic interactions, proximity, stability, Silicon Sentier

The impacts of telecommuting in Dublin

Telecommuting has been perceived as an effective means of reducing commuter related trips, travel time and emissions. Previously, the lack of access to broadband Internet connection and teleconferencing software from home has acted as a barrier to telecommuting regularly or at all. However, with advances in information and communication technology in recent years telecommuting is becoming a viable option for employers and employees to undertake. This paper examines the current trends of full day and part day telecommuting in the Greater Dublin Area (GDA), and attempts to ascertain the most influential drivers and constraints related to telecommuting. The research presented estimates of the environmental benefits from individuals that telecommute. Finally, this paper seeks to determine the magnitude of carbon emissions savings from individuals adopting telecommuting and provides a social cost of carbon saving value. The survey results presented suggest that approximately 44% of the population of the GDA telecommute at least once a month. The findings also indicate that needing contact with colleagues is the most influential constraint to telecommuting, while greater flexibility and avoiding travelling in peak periods are the most important drivers in the propensity to telecommute. Finally, this study shows that there are substantial carbon reductions and social cost of carbon savings. Thus illustrating how telecommuting can be a viable and sustainable policy in the GDA or in other similar sized regions

Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis

Background: The combination of cyclophosphamide and prednisolone is effective for the treatment of severe lupus nephritis but has serious adverse effects. Whether mycophenolate mofetil can be substituted for cyclophosphamide is not known. Methods: In 42 patients with diffuse proliferative lupus nephritis we compared the efficacy and side effects of a regimen of prednisolone and mycophenolate mofetil given for 12 months with those of a regimen of prednisolone and cyclophosphamide given for 6 months, followed by prednisolone and azathioprine for 6 months. Complete remission was defined as a value for urinary protein excretion that was less than 0.3 g per 24 hours, with normal urinary sediment, a normal serum albumin concentration, and values for serum creatinine and creatinine clearance that were no more than 15 percent above the base-line values. Partial remission was defined as a value for urinary protein excretion that was between 0.3 and 2.9 g per 24 hours, with a serum albumin concentration of at least 3.0 g per deciliter. Results: Eighty-one percent of the 21 patients treated with mycophenolate mofetil and prednisolone (group 1) had a complete remission, and 14 percent had a partial remission, as compared with 76 percent and 14 percent, respectively, of the 21 patients treated with cyclophosphamide and prednisolone followed by azathioprine and prednisolone (group 2). The improvements in the degree of protelnuria and the serum albumin and creatinine concentrations were similar in the two groups. One patient in each group discontinued treatment because of side effects. Infections were noted in 19 percent of the patients in group 1 and in 33 percent of those in group 2 (P=0.29). Other adverse effects occurred only in group 2; they included amenorrhea (in 23 percent of the patients), hair loss (19 percent), leukopenia (10 percent), and death (10 percent). The rates of relapse were 15 percent and 11 percent, respectively. Conclusions: For the treatment of diffuse proliferative lupus nephritis, the combination of mycophenolate mofetil and prednisolone is as effective as a regimen of cyclophosphamide and prednisolone followed by azathioprine and prednisolone. (C) 2000, Massachusetts Medical Society.published_or_final_versio

From Paris 2005 to Accra 2008: Will Aid Become More Accountable and Effective?

This draft position paper has been prepared by the International CSO1 Steering Group (ISG) coordinating the “CSO Parallel Process to the Ghana High Level Forum Network”. The ISG coordinating CSO Parallel Process to the Ghana High Level Forum network brings together various local, national, regional and international NGOs who are engaged in development issues, particularly the aid architecture and the aid effectiveness agenda. This network is involved in a multi-stakeholder process of engagement leading towards the High Level Forum on Aid Effectiveness, to be held in Accra, Ghana, in September 2008

Genetic response of growing cockerels to sorghum offal substitute for sorghum meal in a research environment

One hundred and fifty (150) Day old Anak cockerel chicks were used in this study, to evaluate the effect of feeding Sorghum Offal (SO) in the bird's performance, nutrient utilization and carcass characteristics. They were distributed into five dietary treatments, with varied levels of weight for weight replacement (2, 3, 4, and 5 contained 15, 35, 55 and 75 % sorghum offal in place of sorghum meal) respectively. While treatment 1 with zero replacement serving as control. The response of the birds, in terms of feed intake weight gained, feed conversion efficiency, and  apparent nutrient digestibility and retention were determined. The organ weights and weight of cut parts were also recorded. The result showed that weight of organs such as spleen, heart, liver, kidney and proventriculus increased significantly across the row. The study indicated that the substitution of sorghum offal for sorghum meal at levels up to 35 % can be tolerated by cockerel chicks.KEYWORDS: Nutrient utilization, digestibility, Sorghum offal, carcass characteristics, performance, response