Differential returns from globalization to women smallholder coffee and food producers in rural Uganda

Background: Globalization-related measures to liberalize trade and stimulate export production were applied in Uganda in the late 1980s, including in the coffee production sector, to revitalize agricultural production, increase incomes to farmers and improve rural food security.Objective: To explore the different effects of such measures on the health and dietary outcomes of female coffee and food small holder farmers in Uganda.Methods: We gathered evidence through a cross-sectional comparative interview survey of 190 female coffee producers and 191 female food producers in Ntungamo district. The study mostly employed quantitative methods of data collection, targeting the sampled households. We also utilized qualitative data; collected three months after the household survey data had been collected and their analysis had been accomplished. Using qualitative interviews based on an unstructured interview guide, extra qualitative information was collected from key informants at national, district and community levels. This was among other underlying principles to avoid relying on snapshot information earlier collected at household level in order to draw valid and compelling conclusions from the study. We used indicators of production, income, access to food and dietary patterns, women’s health and health care. Of the two groups selected from the same area, female coffee producers represented a higher level of integration into liberalised export markets.Results: Document review suggests that, although Uganda’s economy grew in the period, the household economic and social gains after the liberalization measures may have been less than expected. In the survey carried out, both food and coffee producers were similarly poor, involved in small-scale production, and of a similar age and education level. Coffeeproducers had greater land and livestock ownership, greater access to  inputs and higher levels of income and used a wider variety of markets than food producers, but they had to work longer hours to obtain these economic returns, and spent more cash on health care and food from commercial sources. Their health outcomes were similar to those of the food producers, but with poorer dietary outcomes and greater food stress.Conclusions: The small-scale women farmers who are producing food cannot rely on the economic infrastructure to give them support for meaningful levels of production. However, despite having higher incomes than their food producing counterparts, the evidence showed that women who are producing coffee in Uganda as an export commodity cannot rely on the income from their crops to guarantee their health and nutritional wellbeing, and that the income advantage gained in coffee-producing households has not translated into consistently better health or food security outcomes. Both groups have limited levels of autonomy and control to address these problems.Key words: Globalization, women’s health, gender, smallholder farmers, Uganda, nutrition, food security, coffee producers, food producer

Development of white common beans for the processing industry in East Africa: Adaptability, resistance to selected diseases, cooking time and canning quality

Common bean ( Phaseolus vulgaris L.) provides dietary protein, energy, fiber, and micronutrients, especially iron and zinc to over 800 million people in Africa and Latin America. The crop has various seed types. White beans are very popular for the processing industry. This study aimed to investigate the agronomic performance, canning quality, cooking time (COOKT) and response to root rots ( Fusarium cuneirostrum and Pythium ultimum ) and angular leaf spot (ALS; Pseudocercospora griseola ) diseases among 151 drought tolerant small and large seeded white bean genotypes from trials conducted between 2013 to 2018 in East Africa. Significant (P<0.001) differences existed among the genotypes for response to the three pathogens, COOKT and canning quality traits. Resistance to each of the pathogens was expressed in 24-75% of the genotypes, while dual resistance to any two pairs of the pathogens occurred in 10-44% of the genotypes. Four genotypes; ICNBunsixSxB405/4C-1C-1C-88, RAZ-11, ETSNAP18 and ETSNAP3 expressed resistance to the three pathogens but had COOKT of 46-56 minutes (based on a Matson cooker), and below average canning quality. They are recommended as sources of diseases resistance but could be further improved for COOKT and canning quality. Sixty-eight genotypes had COOKT <50 minutes while 24 expressed good to excellent visual canning quality. Some phenotypes: RAZ-120, RAZ36-Caballero, NavyLine-60, NavyLine-25, ZABR16573-25F22, ZABR16575-60F22, ETSNAP33, Bifortsmallseeded-15 and ZABR16574-37F22, that were cooked in <45 minutes, exhibited good to excellent canning quality and expressed resistant to intermediate diseases resistance responses. These may be used as parental lines and/or fast tracked for variety release through regional trials.Le haricot commun ( Phaseolus vulgaris L.) fournit des prot\ue9ines alimentaires, de l\u2019\ue9nergie, des fibres et des micronutriments, en particulier du fer et du zinc \ue0 plus de 800 millions de personnes en Afrique et en Am\ue9rique latine. La culture a divers types des graines, mais les haricots blancs sont tr\ue8s populaires dans l\u2019industrie de la transformation. Cette \ue9tude visait \ue0 \ue9tudier la qualit\ue9 agronomique et de mise en conserve, le temps de cuisson et la r\ue9ponse des haricots blancs aux pourritures des racines et \ue0 la tache angulaire (ALS, angular leaf spot) qui provoquent des pertes de rendement importantes dans la production des haricots en Afrique de l\u2019Est. Les haricots \ue0 petites et grandes graines am\ue9lior\ue9s pour la tol\ue9rance \ue0 la s\ue9cheresse ont \ue9t\ue9 \ue9valu\ue9s de 2013 \ue0 2018. Des diff\ue9rences significatives (P<0,001) existaient entre les 151 g\ue9notypes pour la r\ue9ponse \ue0 trois agents pathog\ue8nes ( Fusarium cuneirostrum , Pythium ultimum and Pseudocercospora griseola ), le temps de cuisson et les caract\ue9ristiques de qualit\ue9 de mise en conserve. Il \ue9tait possible de s\ue9lectionner une r\ue9sistance \ue0 la maladie simple, double et triple. La r\ue9sistance \ue0 chacun des agents pathog\ue8nes a \ue9t\ue9 exprim\ue9e dans 24 \ue0 75 % des g\ue9notypes ; tandis qu\u2019une double r\ue9sistance \ue0 deux paires des agents pathog\ue8nes s\u2019est produite dans 10 \ue0 44 % des g\ue9notypes. Les quatre g\ue9notypes ; ICNBunsixSxB405/4C-1C-1C-88, RAZ-11, ETSNAP18 et ETSNAP3 qui ont exprim\ue9 une r\ue9sistance \ue0 trois agents pathog\ue8nes ont \ue9t\ue9 cuits en 46-56 minutes et sont recommand\ue9s comme sources de r\ue9sistance pour la reproduction, mais pourraient \ueatre encore am\ue9lior\ue9s pour une cuisson rapide et la qualit\ue9 de la mise en conserve \ue9tant donn\ue9 qu\u2019une qualit\ue9 g\ue9n\ue9rale de mise en conserve inf\ue9rieure \ue0 la moyenne a \ue9t\ue9 observ\ue9e. Les soixante-huit g\ue9notypes ont \ue9t\ue9 cuits en moins de 50 minutes tandis que 24 exprimaient une qualit\ue9 visuelle de mise en conserve bonne \ue0 excellente. Les g\ue9notypes comme RAZ-120, RAZ36-Caballero, NavyLine-60, NavyLine-25, ZABR16573-25F22, ZABR16575-60F22, ETSNAP33, Bifortsmallseed-15 et ZABR16574-37F22, cuits en moins de 45 minutes, pr\ue9sentaient une bonne \ue0 excellente mise en conserve la qualit\ue9 et la r\ue9sistance \ue0 une r\ue9ponse interm\ue9diaire aux maladies \ue9valu\ue9es ont \ue9t\ue9 recommand\ue9es \ue0 des fins de s\ue9lection et pour une \ue9valuation plus approfondie en vue d\u2019une promotion \ue9ventuelle

Cardiovascular risk factor mapping and distribution among adults in Mukono and Buikwe districts in Uganda: small area analysis

Background Sub-Saharan Africa (SSA) is experiencing an increasing burden of Cardiovascular Diseases (CVDs). Modifiable risk factors including hypertension, diabetes, obesity, central obesity, sedentary behaviours, smoking, poor diet (characterised by inadequate vegetable and fruit consumption), and psychosocial stress are attributable to the growing burden of CVDs. Small geographical area mapping and analysis of these risk factors for CVD is lacking in most of sub-Saharan Africa and yet such data has the potential to inform monitoring and exploration of patterns of morbidity, health-care use, and mortality, as well as the epidemiology of risk factors. In the current study, we map and describe the distribution of the CVD risk factors in 20 parishes in two neighbouring districts in Uganda. Methods A baseline survey benchmarking a type-2 hybrid stepped wedge cluster randomised trial design was conducted in December 2018 and January 2019. A sample of 4372 adults aged 25–70 years was drawn from 3689 randomly selected households across 80 villages in 20 parishes in Mukono and Buikwe districts in Uganda. Descriptive statistics and generalized linear modelling controlled for clustering were conducted for this analysis in Stata 13.0, and a visual map showing risk factor distribution developed in QGIS. Results Mapping the prevalence of selected CVD risk factors indicated substantial gender and small area geographic heterogeneity which was masked on aggregate analysis. Patterns and clustering were observed for hypertension, physical inactivity, smoking, alcohol consumption and risk factor combination. Prevalence of unhealthy diet was very high across all parishes with no significant observable differences across areas. Conclusion Modifiable cardiovascular risk factors are common in this low-income context. Moreover, across small area geographic setting, it appears significant differences in distribution of risk factors exist. These differences suggest that underlying drivers such as sociocultural, environmental and economic determinants may be promoting or inhibiting the observed risk factor prevalences which should be further explored. In addition, the differences emphasize the value of small geographical area mapping and analysis to inform more targeted risk reduction interventions

In-Vivo Hyperspectral Human Brain Image Database for Brain Cancer Detection

The use of hyperspectral imaging for medical applications is becoming more common in recent years. One of the main obstacles that researchers find when developing hyperspectral algorithms for medical applications is the lack of specific, publicly available, and hyperspectral medical data. The work described in this paper was developed within the framework of the European project HELICoiD (HypErspectraL Imaging Cancer Detection), which had as a main goal the application of hyperspectral imaging to the delineation of brain tumors in real-time during neurosurgical operations. In this paper, the methodology followed to generate the first hyperspectral database of in-vivo human brain tissues is presented. Data was acquired employing a customized hyperspectral acquisition system capable of capturing information in the Visual and Near InfraRed (VNIR) range from 400 to 1000 nm. Repeatability was assessed for the cases where two images of the same scene were captured consecutively. The analysis reveals that the system works more efficiently in the spectral range between 450 and 900 nm. A total of 36 hyperspectral images from 22 different patients were obtained. From these data, more than 300 000 spectral signatures were labeled employing a semi-automatic methodology based on the spectral angle mapper algorithm. Four different classes were defined: normal tissue, tumor tissue, blood vessel, and background elements. All the hyperspectral data has been made available in a public repository

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Development of white common beans for the processing industry in East Africa: Adaptability, resistance to selected diseases, cooking time and canning quality

Common bean (Phaseolus vulgaris L.) provides dietary protein, energy, fiber, and micronutrients, especially iron and zinc to over 800 million people in Africa and Latin America. The crop has various seed types. White beans are very popular for the processing industry. This study aimed to investigate the agronomic performance, canning quality, cooking time (COOKT) and response to root rots (Fusarium cuneirostrum and Pythium ultimum) and angular leaf spot (ALS; Pseudocercospora griseola) diseases among 151 drought tolerant small and large seeded white bean genotypes from trials conducted between 2013 to 2018 in East Africa. Significant (P&lt;0.001) differences existed among the genotypes for response to the three pathogens, COOKT and canning quality traits. Resistance to each of the pathogens was expressed in 24-75% of the genotypes, while dual resistance to any two pairs of the pathogens occurred in 10-44% of the genotypes. Four genotypes; ICNBunsixSxB405/4C-1C-1C-88, RAZ-11, ETSNAP18 and ETSNAP3 expressed resistance to the three pathogens but had COOKT of 46-56 minutes (based on a Matson cooker), and below average canning quality. They are recommended as sources of diseases resistance but could be further improved for COOKT and canning quality. Sixty-eight genotypes had COOKT &lt;50 minutes while 24 expressed good to excellent visual canning quality. Some phenotypes: RAZ-120, RAZ36-Caballero, NavyLine-60, NavyLine-25, ZABR16573-25F22, ZABR16575-60F22, ETSNAP33, Bifort small seeded-15 and ZABR16574-37F22, that were cooked in &lt;45 minutes, exhibited good to excellent canning quality and expressed resistant to intermediate diseases resistance responses. These may be used as parental lines and/or fast tracked for variety release through regional trials.&nbsp

Clinical presentation of 6q24 transient neonatal diabetes mellitus (6q24 TNDM) and genotype-phenotype correlation in an international cohort of patients

AIMS/HYPOTHESIS: 6q24 transient neonatal diabetes mellitus (TNDM) is a rare form of diabetes presenting in the neonatal period that remits during infancy but, in a proportion of cases, recurs in later life. We aim to describe the clinical presentation of 6q24 TNDM in the largest worldwide cohort of patients with defined molecular aetiology, in particular seeking differences in presentation or clinical history between aetiological groups. METHODS: One-hundred and sixty-three patients with positively diagnosed 6q24 TNDM were ascertained from Europe, the Americas, Asia and Australia. Clinical data from referrals were recorded and stratified by the molecular aetiology of patients. RESULTS: 6q24 TNDM patients presented at a modal age of one day, with growth retardation and hyperglycaemia, irrespective of molecular aetiology. There was a positive correlation between age of presentation and gestational age, and a negative correlation between adjusted birthweight SD and age of remission. Congenital anomalies were significantly more frequent in patients with paternal uniparental disomy of chromosome 6 or hypomethylation of multiple imprinted loci defects than in those with 6q24 duplication or isolated hypomethylation defects. Patients with hypomethylation had an excess representation of assisted conception at 15%. CONCLUSIONS/INTERPRETATION: This, the largest case series of 6q24 TNDM published, refines and extends the clinical phenotype of the disorder and confirms its clinical divergence from other monogenic TNDM in addition to identifying previously unreported clinical differences between 6q24 subgroups