Achieving food security and climate change mitigation through entrepreneurship development in rural Nigeria: Gender perspective

Globally, problem of food security and climate change demands innovative strategies that seek to promote an integrated approach of supporting the full continuum of production, processing and marketing of food to be done. For this reason this paper contends that rural entrepreneurial development could serve as panacea to achieving food security and climate change mitigation. Gender perspective is viewed as significant to achieving this goal since there are more females engaged in rural entrepreneurial practices than male. In 2008, agriculture contributed about 42% to the GDP with a growth rate of 6.54%. Of the 66% of the populace engaged in agriculture, 92% is male and 8% is female. Further, data shows that there are over 75 million females, both adults and children, amongst the about 150 million Nigerians. The population of people living in rural Nigeria is estimated at about 48% as at 2007, meaning that over 72 million persons live there, made up of approximately 35 million females and 37 million males. Agricultural practices through food and livestock production contribute to climate change. As at 2002, arable land in the country was about 34% of the total land mass of about 910,768 km2. As 2003 livestock and poultry inventory was estimated at about 290 million. In addition, the competing uses of the various food and cash crops, as well as grain from Nigeria’s agricultural farmland have added pressure to the need for more land for food and cash crop as well as grain production. Desert encroachment and reduced rainfall have also affected livestock production. These factors have created food security challenges, with threats of hunger and poverty: 70% of the population lives on less than N100 (US $ 0.7) per day, about 60.8% of the population is malnourished; even though smallholder farmers constitute 80% of all farm holdings their production system is inefficient and it always results in regular shortfall in national domestic production; this makes food importation a common feature in the country. Secondary data were sourced to analyze the current situation and to proffer recommendations for achieving food security and climate change mitigation. Inventory of greenhouse gases emission from agricultural practices and livestock production in the country was assessed using Inter-governmental panel of climate change (IPCC) methodology. Cost-benefit analysis was then conducted for identified options that enabled informed suggested recommendations for entrepreneurship development in rural Nigeria viewed with gender perspective.Key words: Food security, climate change mitigation, rural entrepreneurship development, gender perspective

The state of pediatric asthma in Chicago's Humboldt Park: a community-based study in two local elementary schools

Abstract Background Pediatric asthma is a serious public health problem in Chicago and has been designated a high priority concern by residents of Chicago's Humboldt Park, a diverse community area with a large number of Puerto Rican, African American, and Mexican American families. Methods In May 2009, following the principles of community-based participatory research, a cross-sectional asthma screening survey was administered to adult caregivers of children attending two Humboldt Park elementary schools. Data were analyzed to determine the prevalence of diagnosed and probable asthma as well as the degree of asthma control among affected children; associations between asthma outcomes and mutable triggers were evaluated. Results Surveys from 494 children were evaluated. Physician-diagnosed asthma was reported for 24.9% of children and probable asthma identified in an additional 16.2% of children. Asthma was poorly or moderately controlled in 60.0% of diagnosed children. Smoking occurred inside 25.0% of households and 75.0% of caregivers reported idling of vehicles in their community. Report of general stress among caregivers, stress due to community crime, and/or an inability to cope with everyday life were significantly and positively associated with poor asthma morbidity and control among affected children. Conclusions Despite high prevalence rates and poor asthma morbidity and control in Humboldt Park, the association of these measures with mutable variables is promising. A community-based asthma intervention to address the issues identified in this study is needed to affect positive change.http://deepblue.lib.umich.edu/bitstream/2027.42/112574/1/12887_2010_Article_357.pd

Comparing traditional and participatory dissemination of a shared decision making intervention (ADAPT-NC): a cluster randomized trial

BACKGROUND: Asthma is a common disease that affects people of all ages and has significant morbidity and mortality. Poor outcomes and health disparities related to asthma result in part from the difficulty of disseminating new evidence and care delivery methods such as shared decision making (SDM) into clinical practice. This 3-year study explores the ideal framework for rapid dissemination of an evidence-based SDM toolkit for asthma management. The study leverages a partnership between the North Carolina (NC) statewide Medicaid network and the NC Network Consortium of practice-based research networks (PBRNs). METHODS/DESIGN: This non-blinded study will randomize 30 primary care clinics in NC stratified by four PBRNs. We will test dissemination across these practices using a facilitator-led participatory approach to dissemination (FLOW), a novel method of participatory dissemination involving key principles of community-based participatory research, and a more typical “lunch and learn” dissemination method. Specifically, we will use cluster randomization to assign each of the 30 practices to one of three arms: (1) control, no dissemination; (2) traditional dissemination, one didactic session a year and distribution of educational material; and (3) FLOW dissemination. We hypothesize that at the unit of randomization, the clinic, patients in the FLOW dissemination arm will be more likely to share in their treatment decisions compared to patients in the traditional dissemination or control arms. All outcomes will be measured at the level of the clinic. Adoption of the SDM approach will be evaluated by 1) asthma exacerbations, 2) level of patient involvement in the decision making process, and 3) qualitative assessments from patients and providers. The research question is: What dissemination strategy most effectively increases practice level adoption of a shared decision making approach to asthma management? This study will provide important data to support best practices in dissemination of an evidence-based toolkit and implementation of shared decision making into primary care practices. TRIAL REGISTRATION: The trial was registered on January 27, 2014 through the United States National Institutes of Health’s ClinicalTrials.gov NCT02047929 and funded by the Patient-Centered Outcomes Research Institute (PCORI)