Malnutrition enteropathy in Zambian and Zimbabwean children with severe acute malnutrition: A multi-arm randomized phase II trial.

Malnutrition underlies almost half of all child deaths globally. Severe Acute Malnutrition (SAM) carries unacceptable mortality, particularly if accompanied by infection or medical complications, including enteropathy. We evaluated four interventions for malnutrition enteropathy in a multi-centre phase II multi-arm trial in Zambia and Zimbabwe and completed in 2021. The purpose of this trial was to identify therapies which could be taken forward into phase III trials. Children of either sex were eligible for inclusion if aged 6-59 months and hospitalised with SAM (using WHO definitions: WLZ <-3, and/or MUAC <11.5 cm, and/or bilateral pedal oedema), with written, informed consent from the primary caregiver. We randomised 125 children hospitalised with complicated SAM to 14 days treatment with (i) bovine colostrum (n = 25), (ii) N-acetyl glucosamine (n = 24), (iii) subcutaneous teduglutide (n = 26), (iv) budesonide (n = 25) or (v) standard care only (n = 25). The primary endpoint was a composite of faecal biomarkers (myeloperoxidase, neopterin, α1-antitrypsin). Laboratory assessments, but not treatments, were blinded. Per-protocol analysis used ANCOVA, adjusted for baseline biomarker value, sex, oedema, HIV status, diarrhoea, weight-for-length Z-score, and study site, with pre-specified significance of P < 0.10. Of 143 children screened, 125 were randomised. Teduglutide reduced the primary endpoint of biomarkers of mucosal damage (effect size -0.89 (90% CI: -1.69,-0.10) P = 0.07), while colostrum (-0.58 (-1.4, 0.23) P = 0.24), N-acetyl glucosamine (-0.20 (-1.01, 0.60) P = 0.67), and budesonide (-0.50 (-1.33, 0.33) P = 0.32) had no significant effect. All interventions proved safe. This work suggests that treatment of enteropathy may be beneficial in children with complicated malnutrition. The trial was registered at ClinicalTrials.gov with the identifier NCT03716115

Toward a Unified Framework of Perceived Negative Leader Behaviors Insights from French and British Educational Sectors

In this paper, we challenge the commonly held assumption that actors in the education sector are largely ethical, and that there is therefore little need to scrutinize leader behaviors in this sector. We also overcome past scholars’ tendencies to either focus selectively on positive leader behaviors, or to stay content with categorizing leader behaviors into effective and ineffective (if at all they do focus on negative leader behaviors). Using data (Critical Incidents) from three case studies previously conducted in eight British and French academic establishments, we show that not only do negative leader behaviors abound in the education sector, but they can also be differentiated into three types: (1) behaviors emanating from leaders’ lack of functional skills i.e., ineffective behaviors, (2) behaviors emanating from leaders’ insouciance toward harming the organization and its members i.e., dysfunctional behaviors, and (3) behaviors emanating from leaders’ lack of honesty, integrity, ethicality, and transparency i.e., unauthentic behaviors. We enrich current understanding on ineffective, dysfunctional, and unauthentic leader behaviors, and offer a unified (yet differentiated) framework of negative leader behaviors in the academic sector. Since each type of negative behavior emanates from different motivational drivers, different measures are required to curb them. These are also discussed. A comparison of our findings with those from leadership studies in other sectors reveals that negative leader behaviors in the education sector are quite similar to those in other sectors

Integrated Crop-Livestock Systems in Newly Resettled Areas of Goromonzi District in Zimbabwe

Crop-livestock integration has been a foundation of agriculture for years. A survey was conducted to assess crop-livestock integration in resettled areas of ward 17, Goromonzi district in Zimbabwe. Five villages and 25 families per village were randomly selected in the ward. A semi- structured questionnaire was administered to collect information on household demography, level of education, farming history, livestock and crop management. Data were analyzed using the statistical package for the Social Sciences (SPSS) version 16. The youngest respondent was 27 while the oldest was over 77 years old. Ninety percent of the respondents produced maize. Cattle were the most common livestock species with an average herd size of 9.8 and providing draught power and manure. Maize stover was the crop residue widely used for feeding livestock. It was concluded that there was evidence of crop-livestock integration in Goromonzi and recommended that farmers improve the nutritive value of residues for feeding livestock.Keywords: Cattle, crops residues, draught power, livestock, maize, newly resettled farmer

Canine cutaneous neoplasms: prevalence and influence of age, sex and site on the presence and potential malignancy of cutaneous neoplasms in dogs from Zimbabwe

Histopathological examination was performed on cutaneous biopsies from 900 dogs with skin lesions from Zimbabwe, collected from 1996 to 2000. Clinical data were collected from medical records. Sixty per cent (540/900) of the cases were tumours and 40% (360/900) were non-neoplastic inflammatory or degenerative diseases. Thirty different histological types of tumour were diagnosed. The prevalence of epithelial, mesenchymal, lymphohistiocytic and melanocytic tumours was 39.4 %, 44.4 %, 7.4 % and 8.7 %, respectively. The 10 most common tumours, comprising 73.7% of all cutaneous neoplasms, were mast cell tumours, squamous cell carcinomas, perianal gland adenomas, lymphomas, benign melanomas, haemangiosarcomas, sebaceous gland adenomas, fibrosarcomas, lipomas and malignant melanomas. The prevalence of various neoplasms, age of affected dogs and sites of occurrence were similar to surveys in other countries, except that in Zimbabwe there was a greater prevalence of lymphomas and of tumours associated with increased exposure to ultraviolet light (squamous cell carcinomas, haemangiosarcomas and melanomas). For all classes of tumours the sex of the dog did not have any significant influence on the likelihood of developing a tumour. For a dog diagnosed with a tumour located on the trunk, the tumour was significantly more likely to be an epithelial tumour than a non-epithelial tumour. The occurrence of melanocytic tumours on the trunk was significantly lower than at other sites. Lymphohistiocytic tumours were 10 times more likely to occur at multiple locations as opposed to single locations

TAME trial: a multi-arm phase II randomised trial of four novel interventions for malnutrition enteropathy in Zambia and Zimbabwe - a study protocol.

INTRODUCTION: Severe acute malnutrition (SAM) in children in many countries still carries unacceptably high mortality, especially when complicated by secondary infection or metabolic derangements. New therapies are urgently needed and we have identified mucosal healing in the intestine as a potential target for novel treatment approaches. METHODS AND ANALYSIS: The TAME trial (Therapeutic Approaches for Malnutrition Enteropathy) will evaluate four novel treatments in an efficient multi-arm single-blind phase II design. In three hospitals in Zambia and Zimbabwe, 225 children with SAM will be randomised to one of these treatments or to standard care, once their inpatient treatment has reached the point of transition from stabilisation to increased nutritional intake. The four interventions are budesonide, bovine colostrum or N-acetyl glucosamine given orally or via nasogastric tube, or teduglutide given by subcutaneous injection. The primary endpoint will be a composite score of faecal inflammatory markers, and a range of secondary endpoints include clinical and laboratory endpoints. Treatments will be given daily for 14 days, and evaluation of the major endpoints will be at 14 to 18 days, with a final clinical evaluation at 28 days. In a subset of children in Zambia, endoscopic biopsies will be used to evaluate the effect of interventions in detail. ETHICS AND DISSEMINATION: The study has been approved by the University of Zambia Biomedical Research Ethics Committee (006-09-17, dated 9th July, 2018), and the Joint Research Ethics Committee of the University of Zimbabwe (24th July, 2019). Caregivers will provide written informed consent for each participant. Findings will be disseminated through peer-reviewed journals, conference presentations and to caregivers at face-to-face meetings. TRIAL REGISTRATION NUMBER: NCT03716115; Pre-results

Adaptation of the small intestine to microbial enteropathogens in Zambian children with stunting (vol 6, pg 445, 2021)

Correction to: Nature Microbiology https://doi.org/10.1038/s41564-020-00849-w, published online 15 February 2021

Debating Great Zimbabwe

We are humbled by Huffman’s acknowledgement of our contribution to the archaeology of Great Zimbabwe (Chirikure and Pikirayi 2008) and his spirit of constructive debate (Huffman 2010). Any reasonable scholar cannot deny the positive influence that his research has had on the archaeology of Great Zimbabwe. However, research is not just about reaffirming what has been done; it is more about reinterrogating the data even if it means swinging the pendulum of knowledge violently to push back the frontiers of knowledge. Often, some scholars seem reluctant to accept new thinking that contradicts what they believed earlier. As Martin Hall (1996, 6) once remarked, ‘facts like kings are no longer absolute, they cannot sustain themselves forever’. Hall was implying that without a detailed interrogation of both old and new data, there is really no point in doing research. With Great Zimbabwe the extremes would be that cognitive structuralism has explained everything so we do not need to study the site at all or that we should close our minds to new insights that put strong dents in the dominant interpretative reconstructions.http://www.tandf.co.uk/journals/raz

Multilevel perspectives on leadership in the African context

Despite the depth of research on leaders and leadership in the Western and Asian contexts, the study of leadership in the African context remains at a nascent stage. In this special issue, we take a multilevel perspective to review and synthesize current research on leadership in Africa in three distinct scholarly domains (Organizational Behavior & Human Resources (OB/HR), Strategy and Entrepreneurship). Based on this review, we offer specific recommendations to advance leadership research and improve the scope and rigor of theoretical and methodological approaches. Finally, we present three scholarly works that highlight the distinctive nature of leadership in Africa, including the perspectives of followership, emergence of entrepreneurial leadership in the informal sector, and a leadership style based on an African principle