13 research outputs found

    Epidemiology, risk factors and molecular analysis of carbapenem-resistant Enterobacteriaceae (CRE) in Mthatha, Eastern Cape, South Africa:

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    Abstract text. Background: The emergence of carbapenem resistance in Enterobacteriaceae is an important threat to global health. Reported outcomes of infections with carbapenem-resistant Enterobacteriaceae (CRE) are poor. Commonly used antibiotics are generally inactive against CRE. Therefore, timely detection of CRE is of paramount importance. This study aimed to investigate the resistance genes responsible for CRE in Mthatha and to identify risk factors. Methods and materials: Study design – Prospective cohort study. Study period – 23 April to 27 September 2019. Setting – Eastern Cape province, SA. Study population – All adult and paediatric CRE patients. CRE case definition according to CDC 2018. ID and AST-bioMérieux Vitek 2 system. Detection of the blaOXA-48, blaKPC, blaNDM, and blaVIM by the RESIST-4 OKNV assay (Coris). Patients were interviewed to determine risk factors associated with CRE. Results: Forty-four non-duplicate CRE patients were identified during the study period from microbiology lab at NMAH. Enterobacteriaceae species: K. pneumoniae 22 (61.4%), E. cloacae 10 (22.7%), E. coli 2 (4.5%) and K. oxytoca, P. rettgeri and M. morganii 1 each (4.3%). Adult patient 29 (65.9%0 and paediatric 15 (34.1%). Race: all black patients except one white. CRE genes-blaOXA-48 22 (50%), blaNDM 8 (18.2%), two isolates (4.5%) with both blaOXA and blaNDM. We did not find any blaKPC and blaVIM in our setting and 12 (27.2%) isolates were negative for all OKNV. Outcomes: Demised 18 (40.9%), still admitted in the ward 1 (2.3%), discharged home on basis of clinical grounds 22 (50%) and 3 (6.8%) were transferred back to the district hospitals. HAI in 27 (61.4%) with VAP 8, HABSI 8, CAUTI 5, SSI 3 and CLABSI in 3. Risk factors for CRE acquisition were antibiotic exposure 25 (58.7%), ICU stay 7 (15.9%), received medical care in last 6 months 35 (79.6%) and none travelled outside RSA. HIV positive – 19 (43.2%). Conclusion: In out setting our CRE mortality rate is 40.9%, common CRE genotypes are blaOXA-48 and blaNDM. K. pneumoniae is the most common CRE-producing Enterobacteriaceae and antibiotic exposure is an important risk factor in Mthatha and surrounding areas

    Legal frameworks for forest management in Asia : case studies of community/state relations

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    For more about the East-West Center, see http://www.eastwestcenter.org/Papers in this volume were prepared for a workshop sponsored by the EAst-West Center Program on Environment and the Ford Foundation from November 4-6, 1991, in Bali, Indonesia. Contents: The legal framework for joint management of forest lands in India / Mark Poffenberger, Chhatrapati Singh -- 2. Forest protection committees in West Bengal, India / S.B. Roy -- 3. Contractual agreements in the Java social forestry program / Frances J. Seymour, Danilyn Rutherford -- 4. A strategy for saving the Madhupur Sal Forest in Bangladesh -- 5. Development assistance and property rights in the Philippine Uplands / Donna Z. Gasgonia -- 6. Strengthening community stewardship agreements in the Philippines / Jefferson R. Plantilla -- 7. Legal issues in forest land management in Northeast Thailand / Viyouth Chamruspanth -- 8. Drafting a new community forest act in Thailand / Weera Attanatho -- 9. Community forestry legislation in Thailand: an NGO perspective / Yos Santasombat -- 10. The legal case for social forestry in the production forests of Indonesia / Sopari Wangsadidjaja, Agus Djoko Ismanto -- 11. Toward community-based forestry and recognition of Adat property rights in the outer islands of Indonesia / Sandra Moniaga -- 12. Differential access to resources and conflict resolution in a forest concession in Irian Jaya / Iwan Tjitradjaja -- The Parieri land dispute: a case study from Biak / Augustinus Rumansara, Decky Rumwaropen -- 14. Contractual agreements for community-based social forestry programs in Asia / Frances J. Seymour, Danilyn Rutherford

    LONG-TERM SEQUELAE OF <i>HEMOPHILUS INFLUENZAE</i> MENINGITIS

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    The long-term effects of H. influenzae meningitis were studied in 86 patients who were treated with acceptable antibiotic therapy during acute episode in 1950 to 1964 in Nashville, Tennessee. Follow-up revealed that 11 were dead (eight died within first 24 hours of hospitalization). Fifty-six of them returned to Vanderbilt Medical Center for the following appraisals: history, general physical and neurological examinations; pure tone audiometry evaluation; and psychological testing by Wechsler Intelligence Scale for Children. Nineteen others sent information by questionnaire. Results indicated that 26 (29%) survivors had severe or significant handicaps; 12 (14%) had possible residuals; and 37 (43%) were free of detectable deficits. It was concluded that prevention of this disease should now be a prime goal.</jats:p

    Mainstreaming biodiversity : conservation for the twenty-first century

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    CITATION: Redford, K. H. et al. 2015. Mainstreaming biodiversity : conservation for the twenty-first century. Frontiers in Ecology and Evolution, 3:137, doi:10.3389/fevo.2015.00137.The original publication is available at http://journal.frontiersin.org/journal/ecology-and-evolutionInsufficient focused attention has been paid by the conservation community to conservation of biodiversity outside of protected areas. Biodiversity mainstreaming addresses this gap in global conservation practice by “embedding biodiversity considerations into policies, strategies and practices of key public and private actors that impact or rely on biodiversity, so that it is conserved, and sustainably used, both locally and globally” (Huntley and Redford, 2014). Biodiversity mainstreaming is designed to change those policies and practices that influence land uses outside of protected areas as well as to change economic and development decision-making by demonstrating the importance of conserving biodiversity for achieving development outcomes. The practice of mainstreaming is tied to implementation of the Convention on Biological Diversity and is practiced with billions of dollars of investment by development agencies, national government agencies, and the Global Environment Facility (GEF) and its implementing organizations as well as other donors. It is essential for the long-term survival of biodiversity inside and outside protected areas. However, it is virtually unheard of in the main conservation science field. This must change so as to bring careful documentation, analysis, monitoring, publishing, and improvement of practices—all things that conservation science should provide as partners to practitioners of biodiversity mainstreaming. The situation is ripe for informed coordination and consolidation and creation of a science-driven field of biodiversity mainstreaming.http://journal.frontiersin.org/article/10.3389/fevo.2015.00137/fullPublisher's versio

    Progress towards the CBD protected area management effectiveness targets

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    The management effectiveness of protected areas is a critically important consideration for their conservation success. Over 40 different protected area management effectiveness (PAME) data collection tools have been developed to systematically assess protected area management effectiveness. Many of these assessments have recently been collated into the Global IUCN Protected Area Management Effectiveness (PAME) database. We use the PAME database together with and the World Database on Protected Areas (WDPA) to assess current progress towards the Convention on Biological Diversity’s (CBD) 2010 and 2015 targets for PAME, which call for at least 30 per cent and 60 per cent of the total area of protected areas to have been assessed in terms of management effectiveness, respectively. We show that globally 29 per cent of the area protected has been assessed and 23 per cent of countries have reached the 60 per cent target. In addition 46 per cent of countries have reached the 30 per cent target. However, analytical results show that there are biases in the type of protected area assessed; protected areas with larger areas, and protected areas designated as National Parks (IUCN category II) are much more likely to have conducted a PAME assessment. In addition there is a paucity of PAME assessments from Europe and North America, where assessments of protected area management may already be integrated into protected area planning and monitoring systems, creating a challenge for reporting to the CBD. We further discuss the potential and limitations of PAME assessments as tools for tracking and evaluating protected area management, and the need for further assessment tools to address the ‘equity’ elements of Target 11 of the CBD
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