Prevalence and risk factors of hepatitis B and C viruses among haemodialysis patients in Gaza strip, Palestine

<p>Abstract</p> <p>Background</p> <p>The prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and its associated risk factors among haemodialysis (HD) patients in Gaza strip was investigated using serological and molecular techniques.</p> <p>Results</p> <p>The overall prevalence of HBV among the four HD centers was 8.1%. The main risk factors were HD center (p = 0.05), history of blood transfusion (p < 0.01), and treatment abroad (p = 0.01). The overall prevalence of HCV among the four HD centers was 22%. The main risk factors were HD center (p < 0.01), time duration on HD (p < 0.01), history of blood transfusion (p < 0.01), treatment abroad (p < 0.01), and history of blood transfusion abroad (p < 0.01). Serum aminotransferases levels decreased in HD patients compared with normal population but still there was a direct association between the activity of liver enzymes and both HBV (p < 0.01) and HCV (p < 0.01) infection.</p> <p>Conclusion</p> <p>The much higher prevalence of Hepatitis viruses among HD patients compared to the normal population of Gaza strip indicates a causative relation between HD and hepatitis viruses transmission. Therefore extremely careful observation of preventive infection control measures is essential to limit Hepatitis viruses' transmission in HD centers.</p

Virological efficacy and emergence of drug resistance in adults on antiretroviral treatment in rural Tanzania

Background Virological response to antiretroviral treatment (ART) in rural Africa is poorly described. We examined virological efficacy and emergence of drug resistance in adults receiving first-line ART for up to 4 years in rural Tanzania. Methods Haydom Lutheran Hospital has provided ART to HIV-infected patients since October 2003. A combination of stavudine or zidovudine with lamivudine and either nevirapine or efavirenz is the standard first-line regimen. Nested in a longitudinal cohort study of patients consecutively starting ART, we carried out a cross-sectional virological efficacy survey between November 2007 and June 2008. HIV viral load was measured in all adults who had completed at least 6 months first-line ART, and genotypic resistance was determined in patients with viral load >1000 copies/mL. Results Virological response was measured in 212 patients, of whom 158 (74.5%) were women, and median age was 35 years (interquartile range [IQR] 29–43). Median follow-up time was 22.3 months (IQR 14.0–29.9). Virological suppression, defined as <400 copies/mL, was observed in 187 patients (88.2%). Overall, prevalence of ≥1 clinically significant resistance mutation was 3.9, 8.4, 16.7 and 12.5% in patients receiving ART for 1, 2, 3 and 4 years, respectively. Among those successfully genotyped, the most frequent mutations were M184I/V (64%), conferring resistance to lamivudine, and K103N (27%), Y181C (27%) and G190A (27%), conferring resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs), whereas 23% had thymidine analogue mutations (TAMs), associated with cross-resistance to all nucleoside reverse transcriptase inhibitors (NRTIs). Dual-class resistance, i.e. resistance to both NRTIs and NNRTIs, was found in 64%. Conclusion Virological suppression rates were good up to 4 years after initiating ART in a rural Tanzanian hospital. However, drug resistance increased with time, and dual-class resistance was common, raising concerns about exhaustion of future antiretroviral drug options. This study might provide a useful forecast of drug resistance and demand for second-line antiretroviral drugs in rural Africa in the coming years

International entrepreneurship in SMEs: a study of influencing factors in the textile industry

The final publication is available at Springer via http://dx.doi.org/10.1007/s11365-012-0242-3International entrepreneurship is an incipient research area with a rapidly increasing body of knowledge and contributions. An important part of this literature has focused on the analysis of the contributing factors to IE development. From these studies, this work attempts to analyse and validate through an integrative model the effect on this construct in SME of some of the main factors proposed by the literature such as Skills and Competences, Attitude and Proactiveness, Creativity and Innovation, Networking, Employees and Activity. To proceed with this aim, we conducted an empirical research focused on 174 textile SME in Spain. The results obtained confirm a positive relationship between the studied factors and the IE development. 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The export orientation and export performance of high-technology SMEs in emerging markets: the effects of knowledge transfer by returnee entrepreneurs

Combining international business research with the knowledge-based view, this paper examines factors affecting the export orientation and export performance of high-technology Small and medium enterprises (SMEs) in an emerging economy. Using a unique, hand-collected dataset of 711 SMEs from Zhongguancun Science Park in China, it argues that export orientation and performance depend not only on the development of capabilities through R&amp;D and technology transfer, but also on entrepreneurial characteristics, such as the founder’s international background and global networks. It is also shown that both export orientation and performance are positively associated with the presence of a ‘‘returnee’’ entrepreneur

Organizational change within charities: improved performance via introduction of market orientation and other strategic orientations

Market orientation is recognised as the key strategic orientation enabling for-profit organizations to gain improved performance. Adopting such an orientation can also aid nonprofit charities facing pressure to become more businesslike due to increasing competition in the current global environment. Knowledge regarding exactly how charities can change is however highly under-researched. Based upon examination of multiple case studies of charities that underwent organisational change to improve performance, the change management process is analysed using a discourse transformation framework to identify how charity managers successfully introduced new strategic orientations dominated by a market orientation. A checklist is developed that offers nonprofit charity managers valuable insights to assist performance improvement. Few previous papers have studied the process by which management of charities can successfully implement change towards market orientation and aspects of other strategic orientations. The paper also expands the use a discourse transformation in examining the change management process within charities