Methodology for environmental assessment of agri-environment schemes: the Agri Environmental Footprint Index

End of project reportAgri-environment schemes pay farmers for the provision of environmental services. Such schemes tend to have multiple measures that deliver multiple environmental objectives, and there is a lack of consistent methodology with which to measure the environmental benefits of such schemes. Funded by EU FP6, the Agri-Environment Footprint project (www.footprint.rdg.ac.uk) aimed to address this challenge, and this report provides results from selected components of the project.European Unio

Comparative durability of nevirapine versus efavirenz in first-line regimens during the first year of initiating antiretroviral therapy among Swaziland HIV-infected adults

Nevirapine (NVP) and Efavirenz (EFV) have generally comparable clinical and virologic efficacy. However, data comparing NVP durability to EFV are imprecise. We analyzed cohort data to compare durability of NVP to EFV among patients initiating ART in Mbabane, Swaziland. The primary outcome was poor regimen durability defined as any modification of NVP or EFV to the ART regimen. Multivariate Cox proportional hazards models were employed to estimate the risk of poor regimen durability (all-cause) for the two regimens and also separately to estimate risk of drug-related toxicity. We analyzed records for 769 patients initiating ART in Mbabane, Swaziland from March 2006 to December 2007. 30 patients (3.9%) changed their NVP or EFV-based regimen during follow up. Cumulative incidence for poor regimen durability was 5.3 % and 2.7 % for NVP and EFV, respectively. Cumulative incidence for drug-related toxicity was 1.9 % and 2.7 % for NVP and EFV, respectively. Burden of TB was high and 14 (46.7%) modifications were due to patients substituting NVP due to beginning TB treatment. Though the estimates were imprecise, use of NVP - based regimens seemed to be associated with higher risk of modifications compared to use of EFV - based regimens (HR 2.03 95%CI 0.58 - 7.05) and NVP - based regimens had a small advantage over EFV - based regimens with regard to toxicity - related modifications (HR 0.87 95%CI 0.26 - 2.90). Due to the high burden of TB and a significant proportion of patients changing their ART regimen after starting TB treatment, use of EFV as the preferred NNRTI over NVP in high TB endemic settings may result in improved first-line regimen tolerance. Further studies comparing the cost-effectiveness of delivering these two NNRTIs in light of their different limitations are required.Key words: Tolerability, Toxicity, Efavirenz, Nevirapine, Antiretroviral therapy, Resource limited setting, Swazilan

Land in balance: the scientific conceptual framework for land degradation neutrality

The health and productivity of global land resources are declining, while demand for those resources is increasing. The aim of land degradation neutrality (LDN) is to maintain or enhance land-based natural capital and its associated ecosystem services. The Scientific Conceptual Framework for Land Degradation Neutrality has been developed to provide a scientific approach to planning, implementing and monitoring LDN. The Science-Policy Interface of the United Nations Convention to Combat Desertification (UNCCD) led the development of the conceptual framework, drawing in expertise from a diverse range of disciplines. The LDN conceptual framework focuses on the supporting processes required to deliver LDN, including biophysical and socio-economic aspects, and their interactions. Neutrality implies no net loss of the land-based natural capital relative to a reference state, or baseline. Planning for neutrality involves projecting the likely cumulative impacts of land use and land management decisions, then counterbalancing anticipated losses with measures to achieve equivalent gains. Counterbalancing should occur only within individual land types, distinguished by land potential, to ensure “like for like” exchanges. Actions to achieve LDN include sustainable land management (SLM) practices that avoid or reduce degradation, coupled with efforts to reverse degradation through restoration or rehabilitation of degraded land. The response hierarchy of Avoid > Reduce > Reverse land degradation articulates the priorities in planning LDN interventions. The implementation of LDN is managed at the landscape level through integrated land use planning, while achievement is assessed at national level. Monitoring LDN status involves quantifying the balance between the area of gains (significant positive changes in LDN indicators) and area of losses (significant negative changes in LDN indicators), within each land type across the landscape. The LDN indicators (and associated metrics) are land cover (physical land cover class), land productivity (net primary productivity, NPP) and carbon stocks (soil organic carbon (SOC) stocks). The LDN conceptual framework comprises five modules: A: Vision of LDN describes the intended outcome of LDN; B: Frame of Reference clarifies the LDN baseline; C: Mechanism for Neutrality explains the counterbalancing mechanism; D: Achieving Neutrality presents the theory of change (logic model) articulating the impact pathway; and E: Monitoring Neutrality presents the LDN indicators. Principles that govern application of the framework provide flexibility while reducing risk of unintended outcomes.Annette L. Cowie, Barron J. Orr, Victor M. Castillo Sanchez, Pamela Chasek, Neville D. Crossman, Alexander Erlewein, Geertrui Louwagie, Martine Maron, Graciela I. Metternicht, Sara Minelli, Anna E. Tengberg, Sven Walter, Shelley Welto

Sustainability, certification, and regulation of biochar

Biochar has a relatively long half-life in soil and can fundamentally alter soil properties, processes, and ecosystem services. The prospect of global-scale biochar application to soils highlights the importance of a sophisticated and rigorous certification procedure. The objective of this work was to discuss the concept of integrating biochar properties with environmental and socioeconomic factors, in a sustainable biochar certification procedure that optimizes complementarity and compatibility between these factors over relevant time periods. Biochar effects and behavior should also be modelled at temporal scales similar to its expected functional lifetime in soils. Finally, when existing soil data are insufficient, soil sampling and analysis procedures need to be described as part of a biochar certification procedure.O “biochar” tem um tempo de meia-vida no solo relativamente longo e pode alterar substancialmente as propriedades, processos e funções do solo. A perspectiva da aplicação de “biochar” aos solos, em escala global, evidencia a importância de se lhe atribuir um processo de certificação sofisticado e rigoroso. O objetivo deste trabalho foi discutir o conceito da integração das propriedades do “biochar” com os fatores ambientais e socioeconômicos relevantes do local de aplicação selecionado, como parte de um procedimento de certificação sustentável que otimize a complementaridade e a compatibilidade entre esses fatores, em períodos de tempo relevantes. Os efeitos e o comportamento do “biochar” devem, também, ser modelados em escalas temporais similares às de seu tempo de vida funcional nos solos do local selecionado. Finalmente, onde os dados existentes sobre as características do solo forem insuficientes, procedimentos de amostragem e análise do solo devem ser descritos como parte do procedimento de certificação do “biochar”.publishe

An investigation of factors associated with the health and well-being of HIV-infected or HIV-affected older people in rural South Africa

BackgroundDespite the severe impact of HIV in sub-Saharan Africa, the health of older people aged 50+ is often overlooked owing to the dearth of data on the direct and indirect effects of HIV on older people's health status and well-being. The aim of this study was to examine correlates of health and well-being of HIV-infected older people relative to HIV-affected people in rural South Africa, defined as participants with an HIV-infected or death of an adult child due to HIV-related cause. MethodsData were collected within the Africa Centre surveillance area using instruments adapted from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE). A stratified random sample of 422 people aged 50+ participated. We compared the health correlates of HIV-infected to HIV-affected participants using ordered logistic regressions. Health status was measured using three instruments: disability index, quality of life and composite health score. ResultsMedian age of the sample was 60 years (range 50-94). Women HIV-infected (aOR 0.15, 95% confidence interval (CI) 0.08-0.29) and HIV-affected (aOR 0.20, 95% CI 0.08-0.50), were significantly less likely than men to be in good functional ability. Women's adjusted odds of being in good overall health state were similarly lower than men's; while income and household wealth status were stronger correlates of quality of life. HIV-infected participants reported better functional ability, quality of life and overall health state than HIV-affected participants. Discussion and Conclusions The enhanced healthcare received as part of anti-retroviral treatment as well as the considerable resources devoted to HIV care appear to benefit the overall well-being of HIV-infected older people; whereas similar resources have not been devoted to the general health needs of HIV uninfected older people. Given increasing numbers of older people, policy and programme interventions are urgently needed to holistically meet the health and well-being needs of older people beyond the HIV-related care system. <br/

The impact of an employee wellness programme in clothing/textile manufacturing companies: a randomised controlled trial

BACKGROUND: The prevalence of health risk behaviours is growing amongst South African employees. Health risk behaviours have been identified as a major contributor to reduced health related quality of life (HRQoL) and the increased prevalence of non-communicable diseases. Worksite wellness programmes promise to promote behaviour changes amongst employees and to improve their HRQoL. The aim of this study was to evaluate the short-term effects of an employee wellness programme on HRQoL, health behaviour change, body mass index (BMI) and absenteeism amongst clothing and textile manufacturing employees. METHODS: The study used a randomised control trial design. The sample consisted of 80 subjects from three clothing manufacturing companies in Cape Town, South Africa. The experimental group was subjected to a wellness programme based on the principles of cognitive behaviour therapy (CBT) as well as weekly supervised exercise classes over six weeks. The control group received a once-off health promotion talk and various educational pamphlets, with no further intervention. Measurements were recorded at baseline and at six weeks post-intervention. Outcome measures included the EQ-5D, Stanford Exercise Behaviours Scale, body mass index and absenteeism.Data was analysed with the Statistica-8 software program. Non-parametric tests were used to evaluate the differences in the medians between the two groups and to determine the level of significance. The Sign test was used to determine the within group changes. The Mann-Whitney U test was used to determine the difference between the two groups. RESULTS: At six weeks post intervention the experimental group (39 subjects) demonstrated improvement in almost every parameter. In contrast, apart from an overall decrease in time off work and a reduction in BMI for all study participants, there was no significant change noted in the behaviour of the control group (41 subjects). Seventy percent of the experimental group had improved HRQoL EQ-5D VAS scores post intervention, indicating improved perceived HRQoL. In comparison, only 58% of the control group had improved HRQoL EQ-5D VAS scores post intervention. There was no significant difference between the two groups at baseline or at six weeks post intervention. CONCLUSION: An employee wellness programme based on the principles of CBT combined with weekly aerobic exercise class was beneficial in improving the perceived HRQoL and changing health-related behaviours of clothing manufacturing employees. However, it cannot be concluded that the EWP was more effective than the once off health promotion talk as no significant changes were noted between the two groups at 6-weeks post intervention.This trial has been registered with ClinicalTrials.gov (trial registration number NCT01625039)

Diversity of HIV-1 Subtype B: Implications to the Origin of BF Recombinants

BACKGROUND: The HIV-1 subtype B epidemic in Brazil is peculiar because of the high frequency of isolates having the GWGR tetramer at V3 loop region. It has been suggested that GWGR is a distinct variant and less pathogenic than other subtype B isolates. METHODOLOGY/PRINCIPAL FINDINGS: Ninety-four percent of the HIV-1 subtype B worldwide sequences (7689/8131) obtained from the Los Alamos HIV database contain proline at the tetramer of the V3 loop of the env gene (GPGR) and only 0.74% (60/8131) have tryptophan (GWGR). By contrast, 48.4% (161/333) of subtype B isolates from Brazil have proline, 30.6% (102/333) contain tryptophan and 10.5% (35/333) have phenylalanine (F) at the second position of the V3 loop tip. The proportion of tryptophan and phenylalanine in Brazilian isolates is much higher than in worldwide subtype B sequences (chi-square test, p = 0.0001). The combined proportion of proline, tryptophan and phenylalanine (GPGR+GWGR+GFGR) of Brazilian isolates corresponds to 89% of all amino acids in the V3 loop. Phylogenetic analysis revealed that almost all subtype B isolates in Brazil have a common origin regardless of their motif (GWGR, GPGR, GGGR, etc.) at the V3 tetramer. This shared ancestral origin was also observed in CRF28_BF and CRF29_BF in a genome region (free of recombination) derived from parental subtype B. These results imply that tryptophan substitution (e.g., GWGR-to-GxGR), which was previously associated with the change in the coreceptor usage within the host, also occurs at the population level. CONCLUSIONS/SIGNIFICANCE: Based on the current findings and previous study showing that tryptophan and phenylalanine in the V3 loop are related with coreceptor usage, we propose that tryptophan and phenylalanine in subtype B isolates in Brazil are kept by selective mechanisms due to the distinct coreceptor preferences in target cells of GWGR, GFGR and GFGR viruses