Building sustainable smallholder cooperatives in emerging market economies: findings from a five-year project in Kenya

A comparative study of two smallholder dairy cooperatives in Kenya examines the question: what factors are conducive to producing sustainable smallholder cooperatives that can gain entry into the vertical value chain in liberalized post-colonial economies? The relative weight of income advantage; selective individual incentives and, social capital on maintaining member patronage are assessed within variable environmental constraints and opportunities facing different cooperatives. The methodology includes case study observation of the cooperatives during a five-year period, as well as sample surveys of members and non-members that include indicators of dairy income; reasons why farmers elect to join or not join the cooperative; and assessments of the importance of different services provided by the cooperative. The findings show how the relative weight of specific incentives for cooperative membership can vary from one environment to another within the same nation. The most important finding is that maintaining sustainable smallholder cooperatives within an increasingly competitive environment depends on the ability of managers to create business strategies that are compatible with the cooperative’s environmental constraints but, at the same time, incentivize members’ patronage

Short-Lived Trace Gases in the Surface Ocean and the Atmosphere

The two-way exchange of trace gases between the ocean and the atmosphere is important for both the chemistry and physics of the atmosphere and the biogeochemistry of the oceans, including the global cycling of elements. Here we review these exchanges and their importance for a range of gases whose lifetimes are generally short compared to the main greenhouse gases and which are, in most cases, more reactive than them. Gases considered include sulphur and related compounds, organohalogens, non-methane hydrocarbons, ozone, ammonia and related compounds, hydrogen and carbon monoxide. Finally, we stress the interactivity of the system, the importance of process understanding for modeling, the need for more extensive field measurements and their better seasonal coverage, the importance of inter-calibration exercises and finally the need to show the importance of air-sea exchanges for global cycling and how the field fits into the broader context of Earth System Science

How to integrate individual patient values and preferences in clinical practice guidelines? A research protocol.

Contains fulltext : 88291.pdf (publisher's version ) (Open Access)BACKGROUND: Clinical practice guidelines are largely conceived as tools that will inform health professionals' decisions rather than foster patient involvement in decision making. The time now seems right to adapt clinical practice guidelines in such a way that both the professional's perspective as care provider and the patients' preferences and characteristics are being weighed equally in the decision-making process. We hypothesise that clinical practice guidelines can be adapted to facilitate the integration of individual patients' preferences in clinical decision making. This research protocol asks two questions: How should clinical practice guidelines be adapted to elicit patient preferences and to support shared decision making? What type of clinical decisions are perceived as most requiring consideration of individual patients' preferences rather than promoting a single best choice? METHODS: Stakeholders' opinions and ideas will be explored through an 18-month qualitative study. Data will be collected from in-depth individual interviews. A purposive sample of 20 to 25 key-informants will be selected among three groups of stakeholders: health professionals using guidelines (e.g., physicians, nurses); experts at the macro- and meso-level, including guideline and decision aids developers, policy makers, and researchers; and patient representatives. Ideas and recommendations expressed by stakeholders will be prioritized by nominal group technique in expert meetings. DISCUSSION: One-for-all guidelines do not account for differences in patients' characteristics and for their preferences for medical interventions and health outcomes, suggesting a need for flexible guidelines that facilitate patient involvement in clinical decision making. The question is how this can be achieved. This study is not about patient participation in guideline development, a closely related and important issue that does not however substitute for, or guarantee individual patient involvement in clinical decisions. The study results will provide the needed background for recommendations about potential effective and feasible strategies to ensure greater responsiveness of clinical practice guidelines to individual patient's preferences in clinical decision-making