The legal and political imperatives for proposed amendments of the South African Patents Act to implement TRIPS flexibilities and enhance the framework for access to medicines

Includes bibliographical references.A multitude of factors affect the ability of South Africans to access the essential medicines, intellectual property (IP) is one of them. This dissertation considers some of opportunities open to South Africa through international IP flexibilities, which are aimed at safeguarding public health rights against the sometimes access-restricting effects of patent right monopolies. Potential pitfalls are also highlighted, noting strategies for South Africa to avoid the worst of them. The paper begins by giving an overview of the way in which patents affect access to medicines, and contending that the time for making the proposed amendments is now

Increasing Effectiveness in Global NGO Networks

A tsunami hits a densely populated coast. Aid organizations mobilize, and the world watches as several national members of the same global network respond independently in an uncoordinated way. A new treaty is being developed that would allow countries to claim carbon offsets through forest conservation. But national leaders in the same global nonprofit network disagree about its value. A large organization solicits funds from a major U.S. foundation. At the same time, its sister nonprofit, with the same brand name, approaches the foundation. The funder's leaders are confused, and wonder about the seeming conflict. The question of how much to centralize -- or decentralize -- decision-making and operations has dogged global organizations for centuries. Studies of for-profits show that the best answer can be different at different points in an organization's growth. But few such studies exist for nongovernmental organizations (NGOs), and for too many of these nonprofits, the scenarios described above will sound all too familiar because they reflect flashpoints that occur when an operational structure is no longer optimal. What's needed is a way for an NGO's leaders to get out ahead of these flashpoints when possible, by learning to determine in advance when their organization's approach to operations and decision-making need to be revised, and along what lines. In an effort to help with this important task, we synthesized what we've learned through case work with a diverse group of global nonprofits; we also conducted interviews with the leaders and staff at more than 30 global NGOs. Our findings illuminate an emerging approach that blends the best of efficiencies at an organization's center and local innovation in the field

Reported waterborne outbreaks of gastrointestinal disease in Australia are predominantly associated with recreational exposure

Objective: To examine the frequency and circumstances of reported waterborne outbreaks of gastroenteritis in Australia. Method: Examination of data reported to OzFoodNet between 2001 and 2007. Results: During these seven years, 6,515 gastroenteritis outbreaks were reported to OzFoodNet, most of which were classifed as being transmitted person-to-person or from an unknown source. Fifty-four (0.83%) outbreaks were classifed as either 'waterborne' or 'suspected waterborne', of which 78% (42/54) were attributed to recreational water and 19% (10/54) to drinking water. Of the drinking water outbreaks, implicated pathogens were found on all but one occasion and included Salmonella sp. (fve outbreaks), Campylobacter jejuni (three outbreaks) and Giardia (one outbreak). Conclusions: There have been few waterborne outbreaks detected in Australia, and most of those reported have been associated with recreational exposure. However, there are difficulties in identifying and categorising gastroenteritis outbreaks, as well as in obtaining microbiological and epidemiological evidence, which can result in misclassifcation or underestimation of water-associated events. Implications: Gastroenteritis surveillance data show that, among reported waterassociated gastroenteritis outbreaks in Australia, recreational exposure is currently more common than a drinking water source. However, ongoing surveillance for waterborne outbreaks is important, especially as drought conditions may necessitate replacement of conventional drinking water supplies with alternative water sources, which could incur potential for new health risks

Patterns of Sedentary Behaviour in Female Office Workers

Background: Prolonged sedentary behaviour is associated with poor health outcomes. Office workers often engage in excessive sedentary behaviour, however limited research reports on how this sedentary behaviour is accumulated. This study examines objectively measured patterns of prolonged sedentary behaviour in female office workers during weekdays and weekend days and across time of day. Methods: Full time female office workers from a Scottish University participated (N = 27 mean age 43.0 ± 11.5 yrs; BMI 25.8 ± 4.1 kg/m2). Participants wore an activPAL™ for 7 days and completed a diary of waking and working hours. Average week and weekend time sitting, standing and stepping was calculated and also expressed as a proportion of waking day. Average week and weekend daily step count and sit to stand transitions were calculated. Continuous bouts of sedentary behaviour were categorised as: 20–40, 40–60 and > 60 minutes and compared between week and weekend days and across time of day. Results: Average weekday sitting time and proportion was higher (P 0.05) on weekdays vs weekend days. The pattern of sedentary behaviour bouts was different between week and weekend days. Week days were dominated by a consistent pattern of shorter (20–40 mins) sedentary behaviour bouts. The longest continuous sedentary behaviour bouts occurred in the evening, particularly at weekends. Conclusions: In office workers the most prolonged sedentary behaviour occurred in the evening, particularly at weekends. Interventions need to target these highly saturated periods of sedentary behaviour

Intelligent Systems for Geosciences: An Essential Research Agenda

A research agenda for intelligent systems that will result in fundamental new capabilities for understanding the Earth system. Many aspects of geosciences pose novel problems for intelligent systems research. Geoscience data is challenging because it tends to be uncertain, intermittent, sparse, multiresolution, and multiscale. Geosciences processes and objects often have amorphous spatiotemporal boundaries. The lack of ground truth makes model evaluation, testing, and comparison difficult. Overcoming these challenges requires breakthroughs that would significantly transform intelligent systems, while greatly benefitting the geosciences in turn

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