Socio-Cultural Factors Challenging Development Interventions in Cattle Production in the Remote Areas of Vietnam

The northwest highlands of Vietnam are characterized by high altitude, low infrastructure, and low population densities composed of a wide diversity of different ethnic groups. Their socio-cultural characteristics strongly influence their lifestyle and production systems, including agricultural activities. The majority of these people have suffered from slow economic development, with the highest poverty rate in the country. This is a real need for plausible interventions where behavioral changes of smallholders throughout local value chains would be a critical foundation. Our project implemented in this context of development in the Northwest highlands of Vietnam aims to understand the role of socio-cultural factors in cattle production systems in order to propose and examine feasible technical and marketing interventions to improve local grazing-based cattle production. Data on farmers and other actors (collectors, slaughterhouses, retailers and consumers) in local cattle value chains of two selected provinces (Son La and Dien Bien) were collected at the beginning of the project via a baseline survey. In addition, different group discussions with farmers were conducted until the end of the project to monitor the project’s progress and changes created through its interventions. We found that such behavioral changes cannot be motivated by development interventions per se without integrating an understanding of socio-cultural factors (i.e. ethnicity, geographical location and grazing-practices)

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Assessing the potential for expanding vegetable production in Central Province, Papua New Guinea

It has been commonly assumed that most of the vegetable supply in Port Moresby, the capital city of Papua New Guinea, comes from the PNG highlands and from overseas, because Port Moresby and most parts of Central Province are too dry and infertile for vegetable production. However, contrary to that assumption, a market survey conducted in 2008 found that in fact nearly 90% of vegetable supplies come from Central Province, and particularly from smallholders in peri urban areas around Port Moresby. Demand for fresh produce in Port Moresby has been growing due to population and economic growth and is expected to grow significantly in coming years and into the foreseeable future as a result of the PNG LNG project and other mining and agricultural development projects around the country. The objective of this paper was therefore to assess the potential for increasing vegetable production in Central Province, by carrying out a preliminary feasibility study based on informant interviews, field observations and a literature review

From Serendipity to Sustainable Competitive Advantage: Insights From Houston's Farm and Their Journey Of Co-Innovation

Purpose – The purpose of this article is to demonstrate the importance of a strategic approach to collaborative innovation and the use of a value chain research methodology for identifying opportunities for co-innovation. Design/methodology/approach – Value chain analysis is used to map three flows in the Houston Farms value chain; material flow, information flow and relationships. Having diagnosed the current level of co-innovation we then identify improvement projects and opportunities for co-innovation to reduce cost and add value, for the benefit of the value chain as a whole. Findings – The application of the value chain analysis methodology to the Houston Farms value chain revealed the importance of strategy and robust processes in key areas for co-innovation – R&D and new product development. It also revealed that small businesses can enjoy a degree of success as a result of comparative advantage in certain areas but that sustainable competitive advantage cannot occur by chance – identifying the potential for co-innovation is an important first step in the right direction. Research limitations/implications – The value chain innovation roadmap represents a useful framework for exploring the current state and future capability for co-innovation in a value chain. The value chain analysis methodology is an effective diagnostic tool as it focuses on what happens at the interface between stakeholders and how this relates to what final consumers regard as value adding, rather than traditional financial and functional KPIs which make it difficult to explore the competitiveness of the value chain as a whole. Originality/value – The explicit and objective measurement of what consumers value is an important addition to the value chain analysis methodology and the co-innovation roadmap is an original attempt to illustrate the core drivers and capabilities for achieving co-innovation in a value chain. The insights from the case demonstrate the value of this approach to companies who are open to innovation and recognise the need to focus the use of scarce value-adding resources on specific value chains and the needs and wants of final consumers therein

PERCEPTIONS OF ENTREPRENEURSHIP IN A UNIVERSITY AGRIBUSINESS PROGRAM: DEVELOPING A SCALE

This paper develops a scale to measure student perceptions of entrepreneurship in an agribusiness undergraduate program. The study builds on Morris, Webb, Fu and Singhal (2013) and Kriewall and Mekemson (2010) conceptualization of entrepreneurial competencies to develop a brief nine-item scale for agribusiness students. It contributes to the integration of entrepreneurship into the agribusiness curriculum by first explaining the challenges that may be best addressed through building competencies in innovation and entrepreneurship in undergraduate agribusiness education. In this scale development study, undergraduate agribusiness students from a U.S. Land Grant University considered oral communication, motivation and the ability to recognize opportunities to be the most significant capabilities for entrepreneurship

Leveraging innovation knowledge management to create positional advantage in agricultural value chains

This study employs resource advantage theory to identify how beef cattle value chain actors’ resources are translated into the positional advantage and how that then affects their financial performance in an emerging country context. The study tested was designed to understand if: (1) the resources of beef cattle value chain actors are positively related to positional advantage; and (2) positional advantage is positively related to the financial performance of the actors within the value chain. The unit of analysis in this study is a single beef cattle value chain. One hundred and ninety value chain actors were interviewed and the findings appear to indicate that chain actors’ resources are an antecedent to positional advantage in the marketplace and that this market advantage is an antecedent to the superior financial performance of beef cattle value chain. Resumen: Este estudio emplea la teoría de la ventaja de recursos para identificar cómo los recursos de los actores de la cadena de valor del ganado vacuno se traducen en la ventaja posicional y cómo afecta entonces su desempeño financiero en el contexto de un país emergente. El estudio probado fue diseñado para comprender si: (1) los recursos de los actores de la cadena de valor del ganado vacuno están positivamente relacionados con la ventaja posicional; Y (2) la ventaja posicional está positivamente relacionada con el desempeño financiero de los actores dentro de la cadena de valor. La unidad de análisis en este estudio es una sola cadena de valor de ganado vacuno. Se entrevistaron a ciento noventa actores de la cadena de valor y los hallazgos parecen indicar que los recursos de los actores de la cadena son antecedentes de la ventaja posicional en el mercado y que estas ventajas de mercado son antecedentes del desempeño financiero superior de la cadena de valor del ganado vacuno. JEL classification: M3, Q1, P3, Keywords: Differentiation, Market orientation, Innovation, Low-cost advantage, Positional advantage, Palabras clave: Diferenciación, Orientación al mercado, Innovación, Ventaja de bajo costo, Ventaja posiciona

Exploring market orientation, innovation, and financial performance in agricultural value chains in emerging economies

This study explored the usefulness of market orientation in an agricultural value chain in an emerging economy: Vietnam. Drawing on data from 190 actors in a beef cattle value chain in Vietnam's Central Highlands, the study examined the relationship between market orientation and innovation. The findings indicate that there is no significant relationship between market orientation and performance. However, customer orientation and inter-functional coordination are positively related to innovation, and there is a positive relationship between innovation and financial performance. The findings provide insight into the relationships among market orientation, innovation, and performance in agricultural value chains in emerging economies. (C) 2017 Journal of Innovation & Knowledge. Published by Elsevier Espana, S.L.U