Status of Animal Feed Resources in Rwanda

Animal feed resources remain a major constraint for livestock development in tropical Africa. In Rwanda, grazing lands are shrinking sharply because crop cultivation is progressively encroaching on grazing areas with increasing human pressure (Mutimura and Everson 2011). Therefore, over 60% of households cultivating less than 0.7 ha, and owning livestock, practise zero-grazing, where farmers cut-and-carry forage and crop residues to feed animals that are kept exclusively under sheds (MINAGRI 2009). In general, the main feed for dairy cattle under a zero-grazing system is Napier grass (Pennisetum purpureum). For more than a decade, efforts to improve the feed resource base and feeding management have been based on the introduction, characterisation and evaluation of exotic forage species, including grasses and legumes. The main aim of this study was to identify and document the status of improved forages as animal feed resources and for use in environmental protection in Rwanda

Non-surgical Adult Male Circumcision Using the PrePex Device: Task-Shifting from Physicians to Nurses

The Republic of Rwanda is implementing a program of voluntary male circumcision (MC) to reduce HIV transmission but lacks the infrastructure for conventional surgical MC on a nationwide scale. Nonsurgical MC using the PrePex device was first assessed in 5 subjects on an inpatient basis. Subsequent procedures were on an outpatient basis. Physicians performed 100 outpatient procedures (Phase 1 of this study) and trained nurses in the technique; the nurses then independently performed 47 procedures (Phase 2). All subjects achieved complete circumcision and healing within 6 weeks. There were no cases of infection or bleeding. In Phase 1, one case of transient moderate diffuse edema occurred. In Phase 2, no adverse events were reported. Thus, outcomes of MC performed by nurses using the PrePex device were not inferior to outcomes achieved by physicians, suggesting that task-shifting MC by this method from physicians to nurses is feasible in Rwanda. (Afr J Reprod Health 2014; 18[1]: 61-70).Keywords: Circumcision, device, nurses, Rwanda, safety, task-shiftin

Ring-Pattern Dynamics in Smectic-C* and Smectic-C_A* Freely Suspended Liquid Crystal Films

Ring patterns of concentric 2pi-solitons in molecular orientation, form in freely suspended chiral smectic-C films in response to an in-plane rotating electric field. We present measurements of the zero-field relaxation of ring patterns and of the driven dynamics of ring formation under conditions of synchronous winding, and a simple model which enables their quantitative description in low polarization DOBAMBC. In smectic C_A* TFMHPOBC we observe an odd-even layer number effect, with odd number layer films exhibiting order of magnitude slower relaxation rates than even layer films. We show that this rate difference is due to much larger spontaneous polarization in odd number layer films.Comment: 4 RevTeX pgs, 4 eps figures, submitted to Phys. Rev. Let

Musculoskeletal Injuries and Outcomes Pre- and Post- Emergency Medicine Training Program

Introduction: Musculoskeletal injuries (MSI) comprise a large portion of the trauma burden in low- and middle-income countries (LMIC). Rwanda recently launched its first emergency medicine training program (EMTP) at the University Teaching Hospital-Kigali (UTH-K), which may help to treat such injuries; yet no current epidemiological data is available on MSI in Rwanda.Methods: We conducted this pre-post study during two data collection periods at the UTH-K from November 2012 to July 2016. Data collection for MSI is limited and thus is specific to fractures. We included all patients with open, closed, or mixed fractures, hereafter referred to as MSI. Gathered information included demographics and outcomes including death, traumatic complications, and length of hospital stay, before and after the implementation of the EMTP.Results: We collected data from 3609 patients. Of those records, 691 patients were treated for fractures, and 674 of them had sufficient EMTP data measured for inclusion in the analysis of results (279 from pre-EMTP and 375 from post-EMTP). Patient demographics demonstrate that a majority of MSI cases are male (71.6% male vs 28.4% female) and young (64.3% below 35 years of age). Among mechanisms of injury, major causes included road traffic accidents (48.1%), falls (34.2%), and assault (6.0%). There was also an observed association between EMTP and trends of the three primary outcomes: a reduction of death in the emergency department (ED) from those with MSI by 89.9%, from 2.51% to 0.25% (p = 0.0077); a reduction in traumatic complications for MSI patients by 71.7%, from 3.58% to 1.01% (p = 0.0211); and a reduction in duration of stay in the ED among those with MSI by 52.7% or 2.81 days on average, from 5.33 to 2.52 days (p = 0.0437).Conclusion: This study reveals the current epidemiology of MSI morbidity and mortality for a major Rwandan teaching hospital and the potential impacts of EM training implementation among those with MSI. Residency training programs such as EMTP appear capable of reducing mortality, complications, and ED length of stay among those with MSI caused by fractures. Such findings underscore the efficacy and importance of investments in educating the next generation of health professionals to combat prevalent MSI within their communities

Factors that affect quality of life among people living with HIV attending an urban clinic in Uganda: A cohort study

Introduction With the availability of antiretroviral therapy (ART) and primary general care for people living with HIV (PLHIV) in resource limited settings, PLHIV are living longer, and HIV has been transformed into a chronic illness. People are diagnosed and started on treatment when they are relatively well. Although ART results in clinical improvement, the ultimate goal of treatment is full physical functioning and general well-being, with a focus on quality of life rather than clinical outcomes. However, there has been little research on the relationship of specific factors to quality of life in PLHIV. The objective of this study was to investigate factors associated with quality of life among PLHIV in Uganda receiving basic care and those on ART. Methods We enrolled 1274 patients attending an HIV outpatient clinic into a prospective cohort study. Of these, 640 received ART. All were followed up at 3 and 6 months. Health related quality of life was assessed with the MOS-HIV Health Survey and the Global Person Generated Index (GPGI). Multivariate linear regression and logistic regression with generalized estimating equations were used to examine the relationship of social behavioral and disease factors with Physical Health Summary (PHS) score, Mental Health Summary (MHS) score, and GPGI. Results Among PLHIV receiving basic care, PHS was associated with: sex (p=0.045) - females had lower PHS; age in years at enrollment (p=0.0001) - older patients had lower PHS; and depression (p<0.001) - depressed patients had lower PHS. MHS was only associated with opportunistic infection (p=0.01) - presence of an opportunistic infection was associated with lower MHS. For the GPG the associated variables were age (p=0.03) - older patients had lower GPGI; education (p=0.01) – higher education associated with higher GPGI; and depression - patients with depression had a lower GPGI (p<0.001). Among patients on ART, PHS was associated with: study visit (p=0.01), with increase in time there was better PHS, and this also improved with increase in education level (p=0.002). Patients with WHO disease stage 3&4 had a lower PHS compared to patients at stage 1&2 (p=0.006), and depressed patients had lower PHS (p<0.001). MHS improved from baseline to six month study visit (p<0.001), and females had lower MHS compared to males (p=0.01). GPGI was associated with higher income (p=0.04), alcohol use was associated with lower GPGI (p=0.004), and depressed patients had a lower GPGI (p<0.001). Conclusion Quality of life improved over time for PLHIV on ART. Regardless of treatment status, PLHIV with depression or low education level and female gender were at risk of having a poor quality of life. Clinicians and policy makers should be aware of these findings, and address them to improve quality of life for PLHIV

Agricultural innovation platform as a tool for development oriented research: Lessons and challenges in the formation and operationalization

The emergence of Integrated Agricultural Research for Development (IAR4D) presents an opportunity to address any development problem. It involves innovative principles and an integrated research agenda while recognizing the need for greater organizational capacities among stakeholders in agriculture. Operationalization of IAR4D revolves around successful establishment and operation of an Agricultural Innovation Platform (AIP). Agricultural Innovation Platforms are being implemented in Lake Kivu Pilot Learning Site (LKPLS) of the Sub-Saharan Africa Challenge Programme, covering three countries (Uganda, Rwanda and Democratic Republic of Congo) with widely differing social political environments to address agricultural development challenges. This paper presents the processes, general guidelines lessons and experiences pertaining to “good practices” for organising and forming AIPs in the LKPLS. The life of AIPs covers three phases, namely; pre-formation, formation and post formation. The lessons and experiences are shared across 6 stages of AIP formation, namely; Identification of a research and developmental challenge(s), Site selection, Consultative and scoping study, Visioning and Stakeholder analysis, Development of action plans and Implementation of the action plans. Emerging lessons highlight AIPs as grounds and pillars for multi-level, multi-stakeholder interactions to identify, understand and address a complex challenge, concomitant emerging issues and learning towards achieving the agreed vision. Agricultural Innovation Platform formation is a dynamic, highly context specific process that incorporates all essential ingredients for successful innovation at once and provides an opportunity for local innovations to bear while at the same time nourishing on introduced innovations. In AIP formation, the recognition and value of indigenous knowledge and capitalization on prevailing policy, institutional setting and involvement of local leadership is vital. The form, nature and time taken by AIP formation process depends on both the conceptual and local context, quality of facilitation, socio-economic, culture, biophysical, political environment in which a common challenge and/or opportunity is identified and on the capacity of stakeholders to comprehend the Innovation Systems Approach (ISA). The process of AIP formation was faster in creating win-wins when market led. Strong leadership, strategic partnership, information flow, interactions and dealing with recurrent challenges during the AIP formation process are critical in fostering innovations. The major challenges included capacitating the stakeholders in requisite skills and dealing with persistent “handout-syndrome”

Pattern of seat belt use by drivers in Trinidad and Tobago, West Indies

<p>Abstract</p> <p>Background</p> <p>In Trinidad and Tobago, the law on the mandatory use of seat belts was passed in 1995, but this law is hardly enforced. The objective of this study was to determine the frequency and predictors of seat belt use by motor vehicle drivers in the country.</p> <p>Findings</p> <p>A cross-sectional study of 959 motor vehicle drivers using a self-administered questionnaire. Data analysis included Pearson Chi square test and multinomial logistic regression analysis in order to determine the possible predictors of seat belt use by the drivers in Trinidad and Tobago. A majority of the drivers sometimes (51.8%) or always (31.6%) use a seat belt. About 16.7%, 29% and 54.2% of the drivers perceived that the other drivers use their seat belts more frequently, with the same frequency and less frequently respectively compared to themselves. The main reason for not using seat belt by the drivers was given as frequent stops (40.7%) and the main motivation to use seat belt by the drivers was given as stiffer penalties for non-compliance with the seat belt law (44.5%). The predictors of seat belt use were male driver, no formal or lower level of education, driving for less than 10 years, and the perception that the other drivers use seat belts with the same or higher frequency compared to the respondents.</p> <p>Conclusion</p> <p>Only a small proportion of the drivers in Trinidad and Tobago always use a seat belt when driving. There is the need to enforce the seat belt legislation in the country.</p