Results from the Survey of Antibiotic Resistance (SOAR) 2011-14 in the Democratic Republic of Congo, Ivory Coast, Republic of Senegal and Kenya

Objectives: To assess antibiotic susceptibility of community-acquired respiratory tract isolates from Ivory Coast, Kenya, Democratic Republic of Congo (DRC) and Senegal in 2011–14. Methods: Bacterial isolates were collected and MICs determined using Etest® for all antibiotics except erythromycin, for which testing was by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide interpretation, CLSI breakpoints were adjusted for incubation in CO2. Results: Susceptibility to penicillin (using CLSI oral or EUCAST breakpoints) was low among isolates of Streptococcus pneumoniae from the DRC and Kenya (17.4% and 19%, respectively) but higher among isolates from the Ivory Coast (70%) and Senegal (85.7%). Penicillin susceptibility using CLSI iv breakpoints was higher in all countries, but still only 69.6% in the DRC. Macrolide susceptibility (based on CLSI erythromycin disc diffusion breakpoints) was also low in Kenya (∼65%) but 87%–100% elsewhere.Haemophilus influenzae were only collected in the DRC and Senegal, with β-lactamase prevalence of 39% and 4%, respectively. Furthermore, β-lactamase-negative ampicillin-resistant (BLNAR) isolates were found in DRC (four isolates, 17%), but only two isolates were found in Senegal (by EUCAST definition). Amoxicillin/clavulanic acid in vitro susceptibility was 73.9% in the DRC and 100% in Senegal based on CLSI breakpoints, but this reduced to 65.2% in the DRC when BLNAR rates were considered. Clarithromycin susceptibility was \u3e95% in both countries. Conclusions: There was considerable variability in antibiotic susceptibility among the African countries participating in the surveillance programme. Thus, continued surveillance is necessary to track future changes in antibiotic resistance. Use of EUCAST versus CLSI breakpoints showed profound differences for cefaclor and ofloxacin against S. pneumoniae, with EUCAST showing lower susceptibility

AN INVESTIGATION INTO THE APPLICABILITY OF GREEN IT CONCEPTS INTO GREEN IS

In the last five years, research on the role of IT in managing the environment has been accelerated by Information Technology (IT) practitioners such as Google, IBM and Microsoft as well as by the academic community. Research in this field seems to have been narrowed down in two areas; Green Information Technology (Green IT) and Green Information Systems (Green IS). Confusion reigns on whether green IT and green IS are the same thing or two different concepts. Within the academic community, a review of literature shows that there exists a difference based on the definition and scope of each of these concepts whereas practitioner research seems to be more focused on the former (green IT) where direct benefits can be easily accrued by individuals and customers and left out the part on Green IS. Most IS academic researchers have encouraged that more research needs to be directed to Green IS which has the potential to bring in more benefits in terms of organizations drive to reduce their environmental footprint. Green IT aims to reduce the IT induced global green house Gas emissions while Green IS tries to look at the innovative ways in which computing can be used as the solution to environmental pollution. The aim of this paper therefore was to investigate the applicability of Green IT concepts in Green IS. This was done by carrying out a tentative review of Green IT and Green IS research and then carrying out the comparisons between the two concepts to identify any gaps and overlaps. Later on, the researcher proposes future research areas based on the results

Five recommendations to accelerate sustainable solutions in cement and concrete through partnership

Though the technical knowledge to make cement and concrete more sustainable already exists, implementation of solutions lags behind the rate needed to mitigate climate change and meet the targets set by the Sustainable Development Goals. Whilst most of the focus around the built environment is on embodied carbon, we stress an important but neglected dimension: partnership (SDG17). Effective partnerships can be powerful enablers to accelerate sustainable solutions in cement and concrete, and let such solutions transfer from academia to the market. This can be achieved through knowledge generation, solution implementation, and policy development, among other routes. In this article, we share five recommendations for how partnerships can address neglected research questions and practical needs: 1) reform Science, Technology, Engineering and Mathematics (STEM) education to train “circular citizens”; 2) map out routes by which cementitious materials can contribute to a “localization” agenda; 3) generate open-access maps for the geographical distribution of primary and secondary raw materials; 4) predict the long-term environmental performance of different solutions for low-CO2 cements in different geographical areas; 5) overhaul standards to be technically and regionally fit for purpose. These approaches have the potential to make a unique and substantial contribution towards achieving collective sustainability goals

Culture-sensitive psychotraumatology

Background Although there is some evidence of the posttraumatic stress disorder (PTSD) construct’s cross cultural validity, trauma-related disorders may vary across cultures, and the same may be true for treatments that address such conditions. Experienced therapists tailor psychotherapy to each patient’s particular situation, to the nature of the patient’s psychopathology, to the stage of therapy, and so on. In addition, culture-sensitive psychotherapists try to understand how culture enhances the meaning of their patient’s life history, the cultural components of their illness and help-seeking behaviors, as well as their expectations with regard to treatment. We cannot take for granted that all treatment-seeking trauma survivors speak our language or share our cultural values. Therefore, we need to increase our cultural competencies. Methods The authors of this article are clinicians and/or researchers from across the globe, working with trauma survivors in various settings. Each author focused on one or more specific cultural aspects of working with trauma survivors and highlighted the following aspects. Results As a result of culture-specific individual and collective meanings linked to trauma and trauma-related disorders survivors may be exposed to (self-)stigma in the aftermath of trauma. Patients who are reluctant to talk about their traumatic experiences may instead be willing to write or use other ways of accessing the painful memories such as drawing. In other cultures, community and family cohesion are crucial elements of recovery. While awareness of culture-specific aspects is important, we also need to beware of premature cultural stereotyping.When disseminating empirically supported psychotherapies for PTSD across cultures, a number of additional challenges need to be taken into account: many low and middle income countries have very limited resources available and suffer from a poor health infrastructure. Conclusion In summary, culture-sensitive psychotraumatology means assuming an empathic and nonjudgmental attitude, trying to understand each individual’s cultural background.</p

Viral shedding in patients infected with pandemic influenza A (H1N1) virus in Kenya, 2009

Understanding shedding patterns of 2009 pandemic influenza A (H1N1) (pH1N1) can inform recommendations about infection control measures. We evaluated the duration of pH1N1 virus shedding in patients in Nairobi, Kenya. Nasopharyngeal (NP) and oropharyngeal (OP) specimens were collected from consenting laboratory-confirmed pH1N1 cases every 2 days during October 14-November 25, 2009, and tested at the Centers for Diseases Control and Prevention-Kenya by real time reverse transcriptase polymerase chain reaction (rRT-PCR). A subset of rRT-PCR-positive samples was cultured. Of 285 NP/OP specimens from patients with acute respiratory illness, 140 (49%) tested positive for pH1N1 by rRT-PCR; 106 (76%) patients consented and were enrolled. The median age was 6 years (Range: 4 months-41 years); only two patients, both asthmatic, received oseltamivir. The median duration of pH1N1 detection after illness onset was 8 days (95% CI: 7-10 days) for rRT-PCR and 3 days (Range: 0-13 days) for viral isolation. Viable pH1N1 virus was isolated from 132/162 (81%) of rRT-PCR-positive specimens, which included 118/125 (94%) rRT-PCR-positive specimens collected on day 0-7 after symptoms onset. Viral RNA was detectable in 18 (17%) and virus isolated in 7/18 (39%) of specimens collected from patients after all their symptoms had resolved. In this cohort, pH1N1 was detected by rRT-PCR for a median of 8 days. There was a strong correlation between rRT-PCR results and virus isolation in the first week of illness. In some patients, pH1N1 virus was detectable after all their symptoms had resolved

Kaplan Meier plot showing the probability of rRT-PCR-positive pH1N1 test result by day after symptom onset.

<p>Kaplan Meier plot showing the probability of rRT-PCR-positive pH1N1 test result by day after symptom onset.</p

Signs and Symptoms associated with pH1N1 rRT-PCR-positive test results.

<p>*This information was not obtained from patients <5 years old.</p

Demographic characteristics of 285 patients with acute respiratory illness who presented to Kibera Clinic, Nairobi, Kenya and had specimens collected, Oct–Nov 2009.

<p>*16 people were tested for HIV.</p