Getting by in the dry season: Ololilis in Tanzania

Peer Revie

Reinforcing participation of women in dairy production and marketing in Tanzania

Irish Ai

The Women’s Empowerment in Livestock Index

The empowerment of women in the livestock sector is fundamental to achieve gender equality. It also is instrumental for increased household productivity and improved household health and nutrition. Diverse strategies exist to empower women, yet these strategies are difficult to prioritize without a reliable and adapted means to measure women’s empowerment. One quantitative measure is the Women’s Empowerment in Agriculture Index (WEAI). Despite its reliability in certain agricultural contexts, the WEAI requires adaptation in settings where livestock farming is the dominant form of livelihood. Using the WEAI as a starting point, a multidisciplinary team of researchers developed the Women’s Empowerment in Livestock Index (WELI), a new index to assess the empowerment of women in the livestock sector. This paper presents the WELI and the dimensions of empowerment it includes: (1) decisions about agricultural production; (2) decisions related to nutrition; (3) access to and control over resources; (4) control and use of income; (5) access to and control of opportunities; and (6) workload and control over own time. The paper illustrates the use of the WELI by introducing pilot findings from dairy smallholders in four districts of northern Tanzania. The paper addresses considerations for the appropriate use and adaptation of the WELI to balance the needs for context specificity and cross-cultural comparisons; it also discusses its limitations. The paper recommends participatory and qualitative methods that are complementary to the WELI to provide context-specific insights on the processes of women’s empowerment in the livestock sector

Integrating gender analysis in understanding dual-purpose cattle breeding practices in Nicaragua

Dual purpose cattle production in mixed farming systems of Nicaragua is predominantly based on permanent grazing of naturalized grasslands, introduced pastures and crop residues. Milk production and animal offtake rates are low. Information to guide gender responsive interventions to improve livestock production is being generated through a collaborative project by the International Livestock Research Institute (ILRI), the International Center for Tropical Agriculture (CIAT), the National Agrarian University of Nicaragua (UNA), and the University of Natural Resources and life Sciences in Austria (BOKU). Gender disaggregated data on milk production of 447 animals on 59 farms from Camoapa in central Nicaragua have been collected over 8 months. The data shows that more than 40% of the households keep Brown Swiss crosses, however, male headed households keep significantly more Brahman and Holstein crosses than female headed households. The average daily milk production per animal is also significantly lower in female headed households (3.54±1.55kg) than in male headed households (4.14 ±1.87kg). Farmers are conversant with Artificial Insemination (AI), however the technology is not widely adopted. Reasons mentioned for low adoption include: high costs of service, need for repeat services, and unavailability of semen from desired breed-types (e.g. Brahman × Brown Swiss). Gender analysis revealed that the need for repeated services, which increased the costs of AI, is caused by a time mismatch between the animals' heat and the AI provision. These delays are in turn determined by the gender division of labour in livestock management: women are in charge of identifying when animals come into heat but have to wait for the men to call the AI service providers. Women head of households have difficulty accessing AI services and information altogether as they are less involved in cooperative groups and training on technologies related to cattle production. This reduces the effectiveness of AI in both male and female headed households. Practical training programs are required on reproductive management and the use of AI designed with gender responsive approaches

Initial Use of Ambrisentan plus Tadalafil in Pulmonary Arterial Hypertension

BACKGROUND: Data on the effect of initial combination therapy with ambrisentan and tadalafil on long-term outcomes in patients with pulmonary arterial hypertension are scarce. METHODS: In this event-driven, double-blind study, we randomly assigned, in a 2:1:1 ratio, participants with World Health Organization functional class II or III symptoms of pulmonary arterial hypertension who had not previously received treatment to receive initial combination therapy with 10 mg of ambrisentan plus 40 mg of tadalafil (combination-therapy group), 10 mg of ambrisentan plus placebo (ambrisentan-monotherapy group), or 40 mg of tadalafil plus placebo (tadalafil-monotherapy group), all administered once daily. The primary end point in a time-to-event analysis was the first event of clinical failure, which was defined as the first occurrence of a composite of death, hospitalization for worsening pulmonary arterial hypertension, disease progression, or unsatisfactory long-term clinical response. RESULTS: The primary analysis included 500 participants; 253 were assigned to the combination-therapy group, 126 to the ambrisentan-monotherapy group, and 121 to the tadalafil-monotherapy group. A primary end-point event occurred in 18%, 34%, and 28% of the participants in these groups, respectively, and in 31% of the pooled-monotherapy group (the two monotherapy groups combined). The hazard ratio for the primary end point in the combination-therapy group versus the pooled-monotherapy group was 0.50 (95% confidence interval [CI], 0.35 to 0.72; P<0.001). At week 24, the combination-therapy group had greater reductions from baseline in N-terminal pro-brain natriuretic peptide levels than did the pooled-monotherapy group (mean change, -67.2% vs. -50.4%; P<0.001), as well as a higher percentage of patients with a satisfactory clinical response (39% vs. 29%; odds ratio, 1.56 [95% CI, 1.05 to 2.32]; P=0.03) and a greater improvement in the 6-minute walk distance (median change from baseline, 48.98 m vs. 23.80 m; P<0.001). The adverse events that occurred more frequently in the combination-therapy group than in either monotherapy group included peripheral edema, headache, nasal congestion, and anemia. CONCLUSIONS: Among participants with pulmonary arterial hypertension who had not received previous treatment, initial combination therapy with ambrisentan and tadalafil resulted in a significantly lower risk of clinical-failure events than the risk with ambrisentan or tadalafil monotherapy

Cardiopulmonary assessment of patients with systemic sclerosis for hematopoietic stem cell transplantation: recommendations from the European Society for Blood and Marrow Transplantation Autoimmune Diseases Working Party and collaborating partners.

Systemic sclerosis (SSc) is a rare disabling autoimmune disease with a similar mortality to many cancers. Two randomized controlled trials of autologous hematopoietic stem cell transplantation (AHSCT) for SSc have shown significant improvement in organ function, quality of life and long-term survival compared to standard therapy. However, transplant-related mortality (TRM) ranged from 3-10% in patients undergoing HSCT. In SSc, the main cause of non-transplant and TRM is cardiac related. We therefore updated the previously published guidelines for cardiac evaluation, which should be performed in dedicated centers with expertize in HSCT for SSc. The current recommendations are based on pre-transplant cardiopulmonary evaluations combining pulmonary function tests, echocardiography, cardiac magnetic resonance imaging and invasive hemodynamic testing, initiated at Northwestern University (Chicago) and subsequently discussed and endorsed within the EBMT ADWP in 2016

Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery : the Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA)

Non-cardiac surgery; Pre-operative cardiac risk assessment; Pre-operative cardiac testing; Pre-operative coronary artery revascularization; Perioperative cardiac management; Renal disease; Pulmonary disease; Neurological disease; Anaesthesiology; Post-operative cardiac surveillanc