Does contract farming improve Cassava production, price determination and farmer’s income in Ruhango district in Rwanda?

This study analyses the impact of contract farming on cassava production, price determination and farmer’s income in Ruhango district in Rwanda. It uses a participatory assessment method using an interactive tool commonly named “it takes two to tango”. Data were collected from cassava farmers and a Cassava Processing Plant employees. The findings show that the contract farming did not contribute to cassava production improvement. The contract farming did not help in the availability and accessibility of agricultural inputs such as planting material and fertilizer used in cassava farming. Findings of the study also show that the contract farming did not lead to mutual cassava price determination. Regarding the income, farmers indicated that the contract farming did not lead to the increase in income. The Cassava Processing Plant should support the farmers in improving cassava production through the training on land preparation, management of the planting material, fertilizing, cropping, weeding and harvesting. The price of fresh cassava should be fully determined together by the farmers and the Cassava Processing Plant. Improvement in cassava production and mutual price determination should help the farmers to have consistent income. Keywords: Contract farming, Cassava production, Cassava Processing Plant, Rwand

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Catalytic Dimerization of Alkynes via C–H Bond Cleavage by a Platinum–Silylene Complex

International audienceThe cyclodimerization of diphenylacetylene derivatives catalyzed by a platinum-silylene complex is reported. The reaction proceeds via the cleavage of a carbon-hydrogen bond at the ortho-position of an alkynyl group and no additives are needed. Platinum complexes bearing other common ligands, such as phosphines and NHCs, failed to promote this reaction, highlighting the utility of the silylene ligand in this reaction

Mentorship of the next generation of One Health workers through experiential learning: A case of students of Makerere University

Abstract Multiple zoonotic disease outbreaks occurred in Uganda over the past two decades and have needed operationalization of the One Health (OH) Approach to respond effectively. Between 2016 and 2018, the African One Health University Network (AFROHUN) supported 61 students (25 females, 36 males) to join multisectoral and multidisciplinary government national and district task force disease response teams. The goal of joining these teams was to build and strengthen the students’ disease investigation and response skills in real time using a One Health approach. Qualitative methods were used to collect student and partner responses on their field experiences. The AFROHUN project identified the experiential knowledge and skills that the students gained. Student project reports were reviewed by the joint technical teams from the university and the national/district task forces. These included training materials and disease outbreak investigation and response reports. Partnerships and collaboration between the university One Health networks and the government enabled 35 graduate and 26 undergraduate students to receive joint mentorship from the national or district task force outbreak response teams. Most participants were from degree programs in Public Health, Epidemiology, Environmental Health, Veterinary, Wildlife Sciences, and Infectious Disease Management, while few students were from social sciences. Students were mentored in seven competency-based areas of disease management: (1) biorisk management, (2) community engagement and coordination, (3) epidemiology, (4) leadership, (5) outbreak investigation and response, (6) risk communication, and (7) surveillance. In conclusion, zoonotic outbreaks provided real-life learning opportunities for students in disease outbreak investigation and response using a multidisciplinary and multisectoral approach. The identified skills can be incorporated into educational materials such as curricula and present an ideal opportunity to build partnerships for workforce development. One Health impact statement The next generation of One Health workers, those capable of working across sectors and disciplines to improve the health of animals, humans, plants, and the environment, need soft and technical skills to guarantee optimal preparedness, prevention, and response to disease outbreaks and understand the animal to human transmission dynamics of disease. In countries where emerging, re-emerging, and endemic zoonoses and hemorrhagic fevers are prevalent, it is crucial to provide these real-life or experiential training opportunities for university students, working closely in multidisciplinary teams. The “real-time” joint mentorship by the government’s multidisciplinary and multisectoral outbreak response teams, during disease outbreaks, provides an opportunity to build and strengthen student skills in biorisk management, community engagement and coordination, epidemiology, leadership, outbreak investigation and response, risk communication, and surveillance