26 research outputs found
Quality and value chain analyses of Ethiopian coffee
The objective of this paper is to analyze the quality and value chain of Ethiopian coffee in a way to identify opportunities that maximize the benefits from the sector. First the Ethiopian coffee sector is overviewed and then analyzed qualitatively and quantitatively starting from the crop up to the cup based on data collected from secondary sources. As a result, in spite of the comparative advantage in flavor, the Ethiopian green coffee price in the international market is lower than other countries’ price. In addition, actors are not fairly priced because of quality and value addition. The causes for poor quality are mainly associated with harvesting and post-harvesting practice including collection, dry and wet processing, storage and transportation. The value chain actors will play a critical role to increases the profit plow back in the Ethiopian coffee sector and then will significantly improve living standards of the poor who are at the source of the chain.Key words – Coffee, Quality, Value additio
New pneumococcal conjugate vaccine introductions in four sub-Saharan African countries: a cross-country analysis of health systems\u2019 impacts
Background: Pneumonia is a main cause of under-five mortality in
low-income settings. The pneumococcal conjugate vaccine (PCV) has been
introduced in many countries as a tool in the disease\u2019s
prevention. Although PCV\u2019s effectiveness has been established,
less is known about the effects of introducing additional injectable
vaccines into routine immunisation programmes, particularly in the
context of resource-constrained settings. Objectives: To explore the
effects of PCV introduction on the immunisation programmes and health
systems in four low-income countries. Methods: This study was carried
out in Cameroon, Ethiopia, Kenya and Mali. Three to four regions and
nine to 10 districts were selected within each country. Semi-structured
interviews were carried out at national, regional and district levels
(n=173). Researcher-administered questionnaires were completed with
facility staff (n=124). Routine data on monthly vaccination activities
were collected at district and facility levels. Results: PCV was
generally well integrated into existing routine immunisation. Little or
no impact was found in most areas of the health systems. Some minor
effects were found on immunisation programmes, particularly in areas
with either planning activities or investments e.g. staff skills were
strengthened and there were limited improvements in surveillance.
Although health sector workers perceived increases in the coverage of
other vaccines following the introduction of PCV, routine service data
did not confirm this claim. No substantial impacts were seen in health
system management, service delivery or performance. Conclusions: The
introduction of PCV had marginal impacts on the Expanded Programme for
Immunisation and little to none on broader health systems
Individual and joint effects of metformin and statins on mortality among patients with high-risk prostate cancer.
BACKGROUND: Pre-clinical studies suggest that metformin and statins may delay prostate cancer (PCa) metastases; however, data in humans are limited. To the best of our knowledge, this is the first human study aimed to quantify the individual and joint effects of statin and metformin use among patients with high-risk PCa.
METHODS: This population-based retrospective cohort study identified patients from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Exposure to metformin and statins was ascertained from Medicare Prescription Drug Event files. The association with all-cause and PCa mortality were evaluated using Cox proportional hazard model with competing causes of death, where propensity scores were used to adjusted imbalances in covariates across groups.
RESULTS: Based on 12 700 patients with high-risk PCa, statin alone or in combination with metformin was significantly associated with reduced all-cause mortality (Hazard Ratio [HR]: 0.89; 95% Confidence Interval [CI]: 0.83, 0.96; and HR: 0.75; 95% CI, 0.67-0.83, respectively) and PCa mortality (HR, 0.80; 95% CI: 0.69, 0.92) and 0.64; 95% CI, d 0.51-0.81, respectively. The effects were more pronounced in post-diagnostic users: combination use of metformin/statins was associated with a 32% reduction in all-cause mortality (95% CI, 0.57-0.80), and 54% reduction in PCa mortality (95% CI, 0.30-0.69). No significant association of metformin alone was observed with either all-cause mortality or PCa mortality.
CONCLUSIONS: Statin use alone or in combination with metformin was associated with lower all-cause and PCa mortality among high-risk patients, particularly in post-diagnostic settings; further studies are warranted
Application of Linear Programming Model for Industrial Supply Chain Network Design: A Case Study
No Abstract