263 research outputs found

    Social networks and farming resilience

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    Deposition efficiency in the preparation of ozone-producing nickel and antimony doped tin oxide anodes

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    The influence of precursor salts in the synthesis of nickel and antimony doped tin oxide (NATO) electrodes using thermal decomposition from dissolved chloride salts was investigated. The salts investigated were SnCl45H2O, SnCl22H2O, SbCl3 and NiCl26H2O. It was shown that the use of SnCl45H20 in the preparation process leads to a tin loss of more than 85 %. The loss of Sb can be as high as 90 % while no indications of Ni loss was observed. As a consequence, the concentration of Ni in the NATO coating will be much higher than in the precursor solution. This high and uncontrolled loss of precursors during the preparation process will lead to an unpredictable composition in the NATO coating and will have negative economic and environmental effects. It was found that using SnCl22H20 instead of SnCl45H2O can reduce the tin loss to less than 50 %. This tin loss occurs at higher temperatures than when using SnCl45H2O where the tin loss occurs from 56 – 147 °C causing the composition to change both during the drying (80 – 110 °C) and calcination (460 -550 °C) steps of the preparation process. Electrodes coated with NATO based on the two different tin salts were investigated for morphology, composition, structure, and ozone electrocatalytic properties

    Monitoring the South African National Antiretroviral Treatment Programme, 2003-2007: the IeDEA Southern Africa collaboration.

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    OBJECTIVES: To introduce the combined South African cohorts of the International epidemiologic Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration as reflecting the South African national antiretroviral treatment (ART) programme; to characterise patients accessing these services; and to describe changes in services and patients from 2003 to 2007. DESIGN AND SETTING: Multi-cohort study of 11 ART programmes in Gauteng, Western Cape, Free State and KwaZulu-Natal. SUBJECTS: Adults and children (<16 years old) who initiated ART with > or =3 antiretroviral drugs before 2008. RESULTS: Most sites were offering free treatment to adults and children in the public sector, ranging from 264 to 17,835 patients per site. Among 45,383 adults and 6,198 children combined, median age (interquartile range) was 35.0 years (29.8-41.4) and 42.5 months (14.7-82.5), respectively. Of adults, 68% were female. The median CD4 cell count was 102 cells/microl (44-164) and was lower among males than females (86, 34-150 v. 110, 50-169, p<0.001). Median CD4% among children was 12% (7-17.7). Between 2003 and 2007, enrolment increased 11-fold in adults and 3-fold in children. Median CD4 count at enrolment increased for all adults (67-111 cells/microl, p<0.001) and for those in stage IV (39-89 cells/microl, p<0.001). Among children <5 years, baseline CD4% increased over time (11.5-16.0%, p<0.001). CONCLUSIONS: IeDEA-SA provides a unique opportunity to report on the national ART programme. The study describes dramatically increased enrolment over time. Late diagnosis and ART initiation, especially of men and children, need attention. Investment in sentinel sites will ensure good individual-level data while freeing most sites to continue with simplified reporting

    Estimating the impact of antiretroviral treatment on adult mortality trends in South Africa: A mathematical modelling study

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    Substantial reductions in adult mortality have been observed in South Africa since the mid-2000s, but there has been no formal evaluation of how much of this decline is attributable to the scale-up of antiretroviral treatment (ART), as previous models have not been calibrated to vital registration data. We developed a deterministic mathematical model to simulate the mortality trends that would have been expected in the absence of ART, and with earlier introduction of ART

    Program Leadership from a Nordic Perspective - Managing Education Development

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    Nordic Five Tech (N5T) is a strategic alliance between five technical universities in Denmark, Finland, Norway and Sweden. The overall aim is to “utilize shared and complementary strengths and create synergy within education, research and innovation”. In this paper we focus on university educational development issues by investigating the program leadership at five Nordic technical universities. Specifically, the paper compares definitions, views and experiences of education leadership in the Nordic Five Tech (N5T) universities. The paper does this by, first, reviewing the definitions of roles and responsibilities for program directors at each university, and second, by presenting results from a survey carried out in March 2012 among program directors at the N5T universities. Based on this data, we analyze how program directors experience their role, their possibilities to lead, and their opportunities of learning to lead. How is time for reflection and development as leaders handled at the different universities? The paper goes on to consider what impact the mandate of the leadership role has on the possibilities for developing educational programs. For instance, how can program directors ensure that learning objectives concerning generic skills and abilities are reached? How can program directors drive implementation of integrative and value-oriented topics such as sustainable development, innovation and entrepreneurship

    Early mortality and loss to follow-up in HIV-infected children starting antiretroviral therapy in Southern Africa.

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    BACKGROUND: Many HIV-infected children in Southern Africa have been started on antiretroviral therapy (ART), but loss to follow up (LTFU) can be substantial. We analyzed mortality in children retained in care and in all children starting ART, taking LTFU into account. PATIENTS AND METHODS: Children who started ART before the age of 16 years in 10 ART programs in South Africa, Malawi, Mozambique, and Zimbabwe were included. Risk factors for death in the first year of ART were identified in Weibull models. A meta-analytic approach was used to estimate cumulative mortality at 1 year. RESULTS: Eight thousand two hundred twenty-five children (median age 49 months, median CD4 cell percent 11.6%) were included; 391 (4.8%) died and 523 (7.0%) were LTFU in the first year. Mortality at 1 year was 4.5% [95% confidence interval (CI): 2.8% to 7.4%] in children remaining in care, but 8.7% (5.4% to 12.1%) at the program level, after taking mortality in children and LTFU into account. Factors associated with mortality in children remaining in care included age [adjusted hazard ratio (HR) 0.37; 95% CI: 0.25 to 0.54 comparing > or =120 months with <18 months], CD4 cell percent (HR: 0.56; 95% CI: 0.39 to 0.78 comparing > or =20% with <10%), and clinical stage (HR: 0.12; 95% CI: 0.03 to 0.45 comparing World Health Organization stage I with III/IV). CONCLUSIONS: In children starting ART and remaining in care in Southern Africa mortality at 1 year is <5% but almost twice as high at the program level, when taking LTFU into account. Age, CD4 percentage, and clinical stage are important predictors of mortality at the individual level

    The effect of the COVID-19 lockdown on mental health care use in South Africa: an interrupted time-series analysis.

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    AIMS The coronavirus disease 2019 (COVID-19) pandemic and ensuing restrictions have negatively affected the mental health and well-being of the general population, and there is increasing evidence suggesting that lockdowns have led to a disruption of health services. In March 2020, South Africa introduced a lockdown in response to the COVID-19 pandemic, entailing the suspension of all non-essential activities and a complete ban of tobacco and alcohol sales. We studied the effect of the lockdown on mental health care utilisation rates in private-sector care in South Africa. METHODS We conducted an interrupted time-series analysis using insurance claims from 1 January 2017 to 1 June 2020 of beneficiaries 18 years or older from a large private sector medical insurance scheme. We calculated weekly outpatient consultation and hospital admission rates for organic mental disorders, substance use disorders, serious mental disorders, depression, anxiety, other mental disorders, any mental disorder and alcohol withdrawal syndrome. We calculated adjusted odds ratios (OR) for the effect of the lockdown on weekly outpatient consultation and hospital admission rates and the weekly change in rates during the lockdown until 1 June 2020. RESULTS 710 367 persons were followed up for a median of 153 weeks. Hospital admission rates (OR 0.38; 95% confidence interval (CI) 0.33-0.44) and outpatient consultation rates (OR 0.74; 95% CI 0.63-0.87) for any mental disorder decreased substantially after the introduction of the lockdown and did not recover to pre-lockdown levels by 1 June 2020. Health care utilisation rates for alcohol withdrawal syndrome doubled after the introduction of the lockdown, but the statistical uncertainty around the estimates was large (OR 2.24; 95% CI 0.69-7.24). CONCLUSIONS Mental health care utilisation rates for inpatient and outpatient services decreased substantially after the introduction of the lockdown. Hospital admissions and outpatient consultations for alcohol withdrawal syndrome increased after the introduction of the lockdown, but statistical uncertainty precludes strong conclusions about a potential unintended effect of the alcohol sales ban. Governments should integrate strategies for ensuring access and continuity of essential mental health services during lockdowns in pandemic preparedness planning
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