59 research outputs found
The impact of succession planning on the sustainability of cane production by small-scale cane growers in the north coast of Kwazulu-Natal, South Africa
This paper forms part of a research study for a PhD, which has been conducted in the North Coast of KwaZulu-Natal and focuses on the sustainability of emerging cane growers. The research problem of the study was that cane growers cannot be sustained beyond the current generation of existing farmers because young people are not interested. Agriculture takes place in rural areas which are characterised by high levels of poverty. Cane farming, like other agricultural production activities, is the major economic driver in these areas. However, the current cane growers are ageing and the economy will be negatively impacted unless the youth succeed their parents as farmers. Sustainability of cane production depends on the preparedness of the offspring of the cane growers to succeed them as farmers.The results of the study revealed two responses. The first response suggested that young people whose parents are cane growers are willing to succeed their parents and become cane growers. The second response suggested that where discussions on succession planning have taken place there was an increase in the number of young people indicating an interest in succeeding their parents. The paper concludes with a recommendation that there is a need for developing succession planning in the North Coast farming area.KEY WORDS: Cane grower, cane farmer, sustainability, succession planning, youth, extension implications
Epilepsy in rural South African children prevalence, associated disability and management
Objective. To determine the prevalence of epilepsy and its associated disabilities in rural South African children aged 2 - 9 years.Setting. Eight villages in the district of Bushbuckridge, Northern Province, South Africa_Design. A two-phase design was used_ The first phase involved screening children on a house-to-house baSis by interviewing mothers or caregivers using an internationally validated questionnaire for detecting childhood disability in developing countries. The second phase consisted of a paediatric/ neurodevelopmental assessment of the children who screened positive.Results. A total of 6692 children were screened; 722 (10.8%) had a paediatric evaluation and 49 (0.73%) had epilepsy. The· lifetime and active prevalences of epilepsy in these children were 7.3/1 000 and 6.7/1 000 respectively. Associated developmental disability was recorded in 35 affected children (71.4%), including 8 (16.3%) in whom this was moderate to severe. More than a half of the children with epilepsy (57.1%) did not receive anticonvulsant medication.Conclusion. The prevalence of epilepsy in the rural childhood population investigated is higher than that recorded in most similar studies from sub-Saharan Africa, and the poor utilisation of 'appropriate anticonvulsant treatment is cause for concern. This study highlights the paucity of relevant information on the epidemiology of epilepsy in South Africa and that the system available for its management, especially in rural areas, appears to have functional deficiencies. Appropriate research is needed to identify the problems in service delivery and to enable the planning and implementation of an appropriate primary health care-based system for the diagnosis and management of epilepsy in children
Mortality under early access to antiretroviral therapy vs Eswatiniâs national standard of care : the MaxART clustered randomized steppedâwedge trial
Objectives Current WHO guidelines recommend the treatment of all HIV-infected individuals with antiretroviral therapy (ART) to improve survival and quality of life, and decrease infection of others. MaxART is the first implementation trial of this strategy embedded within a government-managed health system, and assesses mortality as a secondary outcome. Because primary findings strongly supported scale-up of the 'treat all' strategy (hereafter Treat All), this analysis examines mortality as an additional indicator of its impact.
Methods MaxART was conducted in 14 Eswatinian health clinics through a clinic-based stepped-wedge design, by transitioning clinics from then-national standard of care (SoC) to the Treat All intervention. All-cause, disease-related, and HIV-related mortality were analysed using the Cox proportional hazards model, censoring SoC participants at clinic transition. Median follow-up time among study participants was 292 days. There were 36/2034 deaths in SoC (1.77%) and 49/1371 deaths in Treat All (3.57%).
Results Between September 2014 and August 2017, 3405 participants were enrolled. In SoC and Treat All interventions, respectively, the multivariable-adjusted 12-month all-cause mortality rates were 1.42% [95% confidence interval (CI): 0.66-2.17] and 1.60% (95% CI: 0.78-2.40), disease-related mortality rates were 1.02% (95% CI: 0.40-1.64) and 1.10% (95% CI: 0.46-1.73), and HIV-related mortality rates were 1.03% (95% CI: 0.40-1.65) and 0.99% (95% CI: 0.40-1.58). Treat All had no impact on all-cause [hazard ratio (HR) = 1.12, 95% CI: 0.58-2.18, P = 0.73], disease-related (HR = 1.04, 95% CI: 0.52-2.11, P = 0.90), or HIV-related mortality (HR = 0.93, 95% CI: 0.46-1.87, P = 0.83).
Conclusion There was no immediate benefit of the Treat All strategy on mortality, nor evidence of harm. Longer follow-up of participants is needed to establish long-term consequences
Dissemination of Drinking Water Contamination Data to Consumers: A Systematic Review of Impact on Consumer Behaviors
Drinking water contaminated by chemicals or pathogens is a major public health threat in the developing world. Responses to this threat often require water consumers (households or communities) to improve their own management or treatment of water. One approach hypothesized to increase such positive behaviors is increasing knowledge of the risks of unsafe water through the dissemination of water contamination data. This paper reviews the evidence for this approach in changing behavior and subsequent health outcomes.A systematic review was conducted for studies where results of tests for contaminants in drinking water were disseminated to populations whose water supply posed a known health risk. Studies of any design were included where data were available from a contemporaneous comparison or control group. Using multiple sources >14,000 documents were located. Six studies met inclusion criteria (four of arsenic contamination and two of microbiological contamination). Meta-analysis was not possible in most cases due to heterogeneity of outcomes and study designs. Outcomes included water quality, change of water source, treatment of water, knowledge of contamination, and urinary arsenic. Source switching was most frequently reported: of 5 reporting studies 4 report significantly higher rates of switching (26â72%) among those who received a positive test result and a pooled risk difference was calculate for 2 studies (RDâ=â0.43 [CI0.4.0â0.46] 6â12 months post intervention) suggesting 43% more of those with unsafe wells switched source compared to those with safe wells. Strength of evidence is low since the comparison is between non-equivalent groups. Two studies concerning fecal contamination reported non-significant increases in point-of-use water treatment.Despite the publication of some large cohort studies and some encouraging results the evidence base to support dissemination of contamination data to improve water management is currently equivocal. Rigorous studies on this topic are needed, ideally using common outcome measures
Evolution and Impact of EU Aid for Food and Nutrition Security: A Review
In the aftermath of the world food price crisis, the issue of food and nutrition security has received a high level of political attention and the international donor community has repeatedly underlined its commitment to combat hunger in the world. In order to enhance the effectiveness of the international communityâs efforts in addressing the widespread problem of malnutrition, we need to improve our knowledge on what activities donors are currently engaging in and which interventions have been shown to be successful. This paper offers both an overview of the aid for food and nutrition security landscape and how it has changed and an extensive review of the available evidence on the impact of a wide array of interventions aimed at addressing all four dimensions of food and nutrition security; availability, access, utilization and stability. We find that despite the renewed interest and elevated levels of funding for food and nutrition security assistance in developing countries, the empirical evidence base for the effectiveness of these interventions in improving beneficiariesâ food and nutrition security â although in several cases promising â is weak. In particular, the question whether different interventions improve the quality of food consumption and consequently nutrient intake and status, remains largely unanswered. Moreover, few studies assess longer-term effects and there exists relatively little rigorous evidence that compares different interventions. It is therefore strongly recommended to undertake additional research to improve the evidence base as this would allow researchers and policy makers to establish the type of approaches that improve food and nutrition security in the most efficient and cost-effective manner. Finally, in order to facilitate this process, there is a need for a clear and uniform definition of food and nutrition security assistance on the one hand as well as agreed upon, comprehensive indicators on the other hand.status: publishe
Implementing the parametric bootstrap in capture-recapture models with continuous covariates
The parametric bootstrap is a method for variance estimation advocated by many researchers in multiple capture studies. Most applications thus far used the parametric bootstrap in log-linear modelling, that is, where there are possibly categorical covariates which relate to the probabilities of capture. In this article we present an algorithm for the parametric bootstrap that can be used when there are continuous covariates.Bootstrap Population-size estimation Capture-recapture Multinomial logit model Log-linear model
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