Global Status of DDT and Its Alternatives for Use in Vector Control to Prevent Disease

Objective - I review the status of dichlorodiphenyltrichloroethane (DDT), used for disease vector control, along with current evidence on its benefits and risks in relation to the available alternatives. Data sources and extraction - Contemporary data on DDT use were largely obtained from questionnaires and reports. I also conducted a Scopus search to retrieve published articles. Data synthesis - DDT has been recommended as part of the arsenal of insecticides available for indoor residual spraying until suitable alternatives are available. Approximately 14 countries use DDT for disease control, and several countries are preparing to reintroduce DDT. The effectiveness of DDT depends on local settings and merits close consideration in relation to the alternatives. Concerns about the continued use of DDT are fueled by recent reports of high levels of human exposure associated with indoor spraying amid accumulating evidence on chronic health effects. There are signs that more malaria vectors are becoming resistant to the toxic action of DDT, and that resistance is spreading to new countries. A comprehensive cost assessment of DDT versus its alternatives that takes side effects into account is missing. Effective chemical methods are available as immediate alternatives to DDT, but the choice of insecticide class is limited, and in certain areas the development of resistance is undermining the efficacy of insecticidal tools. New insecticides are not expected in the short term. Nonchemical methods are potentially important, but their effectiveness at program level needs urgent study. Conclusions - To reduce reliance on DDT, support is needed for integrated and multipartner strategies of vector control and for the continued development of new technologies. Integrated vector management provides a framework for developing and implementing effective technologies and strategies as sustainable alternatives to reliance on DD

INTERNATIONAL RISK ASSESSMENT AND DECISION MAKING IN DUTCH SMALL AND MEDIUM SIZED ENTERPRISES

In this article we will discuss the process of judgment and decision-making (JDM) the management of a company goes through when they are confronted with the opportunity to operate internationally. In particular we will focus on the way country risks are incorporated in the assessment that companies make concerning the feasibility of these international opportunities. Although the literature appears to offer a systematic approach based on research, the actual JDM follows a different route, one of intuition. This will be demonstrated by research in five sectors in the Netherlands. The gap between theory and its application offers a model for an improved way of doing things by clarifying why business is only partially using the outcome of research

SCENARIO ANALYSIS AS A TOOL FOR COUNTRY RISK ASSESSMENT: A THEORETICAL EXPLORATION

Purpose: This article is an exploration of the applicability of scenario analysis in country risk assessment executed by decision makers in small and medium sized enterprises when they engage in international business. Approach: The exploration is realized through two assessment. In the fi rst assessment it is presented whether country risks can be classifi ed as highly complex and highly uncertain according to the forecasting methods classifi ed by Schoemaker (2009) and the argumentation whether country risks need to be classifi ed as risk or uncertainty. For the second assessment it is presented whether the assessment of country risks according to the method of scenario analysis assumes the use of judgmental heuristics and the occurrence of bias in accordance with the heuristics and biases approach described by Kahneman and Tversky and identifi ed in country risk assessment by Van den Berg (2013).Findings: The fi rst conclusion of this exploration is that approaching country risk assessment with the support of scenario analysis supports decision makers in a fundamental manner and hence, contributes to the well-functioning of the company. The second conclusion is that, although the heuristics and biases that occur due to judgment and decision making under uncertainty are not supposed to occur anymore, a diff erent set of biases is to be expected.Implications: Although scenario analysis seems to be a valid technique to be used in country risk assessment, further research is required to determine how it should be operationalized for small and medium sized enterprises

A simple visual model to compare existing nutrient profiling schemes

Nutrient profiling is a highly pressing issue. However, as there are currently various nutrient profiling schemes it may be difficult to maintain an overview. We therefore developed a simple visual model where the various choices that can be made are indicated. This allows for easy comparison of existing schemes. The model is available in PowerPoint format and attached as a separate file to this paper (see Supplementary files under Reading Tools online)

The Farmer Field School: a method for enhancing the role of rural communities in malaria control ?

Malaria has strong linkages with agriculture, and farmers in malarious regions have a central position in creating or controlling the conditions that favour disease transmission. An interdisciplinary and integrated approach is needed to involve farmers and more than one sector in control efforts. It is suggested that malaria control can benefit from a complementary intervention in rural development, the Farmer Field School (FFS) on Integrated Pest Management (IPM). This is a form of education that uses experiential learning methods to build farmers' expertise, and has proven farm-level and empowerment effects. The benefits of incorporating malaria control into the IPM curriculum are discussed. An example of a combined health-agriculture curriculum, labeled Integrated Pest and Vector Management (IPVM), developed in Sri Lanka is presented. Institutional ownership and support for IPVM could potentially be spread over several public sectors requiring a process for institutional learning and reform

E1A expression dysregulates IL-8 production and suppresses IL-6 production by lung epithelial cells

BACKGROUND: The adenoviral protein E1A has been proposed to play a role in the pathophysiology of COPD, in particular by increasing IL-8 gene transcription of lung epithelial cells in response to cigarette smoke-constituents such as LPS. As IL-8 production is also under tight post-transcriptional control, we planned to study whether E1A affected IL-8 production post-transcriptionally. The production of IL-6 by E1A-positive cells had not been addressed and was studied in parallel. Based on our previous work into the regulation of IL-8 and IL-6 production in airway epithelial cells, we used the lung epithelial-like cell line NCI-H292 to generate stable transfectants expressing either E1A and/or E1B, which is known to frequently co-integrate with E1A. We analyzed IL-8 and IL-6 production and the underlying regulatory processes in response to LPS and TNF-α. METHODS: Stable transfectants were generated and characterized with immunohistochemistry, western blot and flow cytometry. IL-8 and IL-6 protein production was measured by ELISA. Levels of IL-8 and IL-6 mRNA were measured using specific radiolabeled probes. EMSA was used to assess transcriptional activation of relevant transcription factors. Post-transcriptional regulation of mRNA half-life was measured by Actinomycin D chase experiments. RESULTS: Most of the sixteen E1A-expressing transfectants showed suppression of IL-6 production, indicative of biologically active E1A. Significant but no uniform effects on IL-8 production, nor on transcriptional and post-transcriptional regulation of IL-8 production, were observed in the panel of E1A-expressing transfectants. E1B expression exerted similar effects as E1A on IL-8 production. CONCLUSION: Our results indicate that integration of adenoviral DNA and expression of E1A and E1B can either increase or decrease IL-8 production. Furthermore, we conclude that expression of E1A suppresses IL-6 production. These findings question the unique role of E1A protein in the pathophysiology of COPD, but do not exclude a role for adenoviral E1A/E1B DNA in modulating inflammatory responses nor in the pathogenesis of COPD

Impacts of farmer field schools in the human, social, natural and financial domain : a qualitative review

The Farmer Field School (FFS) is a widely used method seeking to educate farmers to adapt agricultural decisions to diverse and variable field conditions. Out of 218 screened studies, 65 were selected to review the impact of the FFS. An analytical framework was developed with effects (outputs, outcomes and impacts) arranged according to the human, social, natural and financial domains. Impacts on non-participants of the FFS were addressed as peripheral effects. The FFS demonstrated its potential to enhance human, social, natural and financial capital of rural communities. Human capital was built in the form of critical thinking, innovation, confidence, and quality of life. Effects on social capital included mutual trust, bonding, collective action, networking, and emancipation. Natural capital was enhanced through improvements in field practices, food production, agricultural diversification, and food security. Financial capital was enhanced through increased income and profits, savings and loans schemes, with a potential to reduce poverty. The available body of evidence was unbalanced across the capital domains, providing high coverage of the natural domain but low coverage of the human, social and financial domains. In-depth case studies are needed to elucidate the interactions between livelihood assets, and the influences of the policy, institutional and external environment, in order to adjust FFS interventions aiming to optimize their impacts. Considering the positive effects the FFS can have on rural livelihoods, the FFS has potential to contribute to achieving the Sustainable Development Goals. However, quality assurance of the FFS and a balanced evaluation across the capital domains require attention.</p