GM Maize in KwaZulu Natal: labour displacement or efficient output expansion?

This study uses data for 2006/7, for the Hlabisa, Dumbe and Simdlangentsha districts in KwaZulu Natal, to investigate the relative efficiencies of conventional, insect resistant (Bt) and herbicide tolerant (RR) maize grown by small farmers. The paper fits a stochastic efficiency frontier using maximum likelihood methods. The results show that both GM technologies have very little impact on efficiency and that the tillage system is an important determinant of efficiency levels. This is despite the fact that farmers using herbicide tolerant seed have yields that were 85% higher. The cost of the seed cancels out this gain in the efficiency estimates and there is every reason to believe that these are the best farmers. The employment effects of the GM technologies are also investigated, as the RR technology is intended to be labour saving and used in conjunction with the minimum tillage method, locally known as planting without ploughing

Efficiency and employment effects of GM Maize producers in KwaZulu Natal

This study uses data for 2006/07, for the Hlabisa, Dumbe and Simdlangentsha districts in KwaZulu Natal, to investigate the relative efficiencies of conventional, insect resistant (Bt) and herbicide tolerant (RR) maize grown by small farmers. The paper fits a stochastic efficiency frontier using maximum likelihood methods. The results show that both GM technologies have very little impact on efficiency and that the tillage system is an important determinant of efficiency levels. This is despite the fact that farmers using herbicide tolerant seed have yields that were 85% higher. The cost of the seed cancels out this gain in the efficiency estimates and there is every reason to believe that these are the best farmers. The employment effects of the GM technologies are also investigated, as the RR technology is intended to be labour saving and used in conjunction with the minimum tillage method, locally known as planting without ploughing

Understanding the Operative Experience of the Practicing Pediatric Surgeon: Implications for Training and Maintaining Competency

Importance The number of practicing pediatric surgeons has increased rapidly in the past 4 decades, without a significant increase in the incidence of rare diseases specific to the field. Maintenance of competency in the index procedures for these rare diseases is essential to the future of the profession. Objective To describe the demographic characteristics and operative experiences of practicing pediatric surgeons using Pediatric Surgery Board recertification case log data. Design, Setting, and Participants We performed a retrospective review of 5 years of pediatric surgery certification renewal applications submitted to the Pediatric Surgery Board between 2009 and 2013. A surgeon’s location was defined by population as urban, large rural, small rural, or isolated. Case log data were examined to determine case volume by category and type of procedures. Surgeons were categorized according to recertification at 10, 20, or 30 years. Main Outcome and Measure Number of index cases during the preceding year. Results Of 308 recertifying pediatric surgeons, 249 (80.8%) were men, and 143 (46.4%) were 46 to 55 years of age. Most of the pediatric surgeons (304 of 308 [98.7%]) practiced in urban areas (ie, with a population >50 000 people). All recertifying applicants were clinically active. An appendectomy was the most commonly performed procedure (with a mean [SD] number of 49.3 [35.0] procedures per year), nonoperative trauma management came in second (with 20.0 [33.0] procedures per year), and inguinal hernia repair for children younger than 6 months of age came in third (with 14.7 [13.8] procedures per year). In 6 of 10 “rare” pediatric surgery cases, the mean number of procedures was less than 2. Of 308 surgeons, 193 (62.7%) had performed a neuroblastoma resection, 170 (55.2%) a kidney tumor resection, and 123 (39.9%) an operation to treat biliary atresia or choledochal cyst in the preceding year. Laparoscopy was more frequently performed in the 10-year recertification group for Nissen fundoplication, appendectomy, splenectomy, gastrostomy/jejunostomy, orchidopexy, and cholecystectomy (P < .05) but not lung resection (P = .70). It was more frequently used by surgeons recertifying in the 10-year group (used in 11 375 of 14 456 procedures [78.7%]) than by surgeons recertifying in the 20-year (used in 6214 of 8712 procedures [71.3%]) or 30-year group (used in 2022 of 3805 procedures [53.1%]). Conclusions and Relevance Practicing pediatric surgeons receive limited exposure to index cases after training. With regard to maintaining competency in an era in which health care outcomes have become increasingly important, these results are concerning

Management of Anorectal Malformations and Hirschsprung Disease.

Anorectal malformations (ARM) and Hirschsprung disease (HD) are managed with placement of normal intestine within the anal sphincter complex. Long-term complications specific to ARM include fistula remnants, recurrence, urinary reflux with associated chronic renal insufficiency, sexual dysfunction, and fertility difficulties. Complications specific to HD include enterocolitis, persistent or acquired aganglionosis, and internal sphincter achalasia. ARM and HD patients are both at risk of stricture, bowel dysfunction and incontinence, which can have a severe impact on quality of life. Bowel management strategies should be tailored to the patient\u27s specific category of bowel dysfunction

Temporary Retrograde Occlusion of High-Flow Tracheo-Esophageal Fistula

This report describes a temporary retrograde occlusion technique for control of a high-flow tracheo-esophageal fistula in a critically ill, premature infant born at 29 weeks’ gestational age, with a diagnosis of type C (Gross) esophageal atresia and tetralogy of Fallot (TOF). This procedure is a useful bridging maneuver before definitive surgical correction for extremely low birth weight, unstable neonates with tracheo-esophageal fistula who are suffering from associated malformations.</jats:p

Abdominal compartment syndrome associated with Norovirus infection

AbstractNorovirus infection is a leading cause of infectious gastroenteritis and is typically self-limited. Abdominal compartment syndrome is rare in the pediatric population. To date, there have been no reports of abdominal compartment syndrome secondary to Norovirus infection. This patient is a 7-year old female who presented with abdominal compartment syndrome and fulminant sepsis attributed to acute Norovirus infection. The patient was successfully treated with decompressive laparotomy, delayed abdominal closure, and supportive therapy. The patient's post-operative course was notable for acute hepatitis and pancreatitis, which resolved without further intervention. The patient was discharged home after a prolonged hospital stay in good condition