STRATEGIES TO INCREASE AGRICULTURAL PRODUCTIVITY AND REDUCE LAND DEGRADATION: EVIDENCE FROM UGANDA

This paper estimates a structural econometric model of household decisions regarding income strategies, participation in programs and organizations, crop choices, land management, and labor use, and their implications for agricultural production and land degradation; based upon a survey of over 450 households and their farm plots in Uganda. The results generally support the Boserupian model of population-induced agricultural intensification, but do not support the "more people-less erosion" hypothesis, with population pressure found to contribute to erosion in the densely populated highlands. Agricultural technical assistance programs have location-specific impacts on agricultural production and land degradation, contributing to higher value of crop production in the lowlands, but to soil erosion in the highlands. By contrast, NGO programs focusing on agriculture and environment are helping to reduce erosion, but have mixed impacts on production. We find little evidence of impact of access to markets, roads and credit, land tenure or title on agricultural intensification and crop production, though road access appears to contribute to land degradation in the highlands. Education increases household incomes, but also reduces crop production in the lowlands. We do not find evidence of a poverty-land degradation trap, while poverty has mixed impacts on agricultural production: smaller farms obtain higher crop production per hectare, while households with fewer livestock have crop production. These findings suggest that development of factor markets can improve agricultural efficiency. Several other factors that contribute to increased value of crop production, without significant impacts on land degradation, include specialized crop production, livestock and nonfarm income strategies, and irrigation. In general, the results imply that the strategies to increase agricultural production and reduce land degradation must be location-specific, and that there are few "win-win" opportunities to simultaneously increase production and reduce land degradation.Agricultural productivity, land degradation, agricultural development strategies, Uganda, farm size-productivity, Land Economics/Use, Productivity Analysis,

Strategies for sustainable land management and poverty reduction in Uganda:

"The government of Uganda, with help from its development partners, is designing and implementing policies and strategies to address poverty, land degradation, and declining agricultural productivity. Land degradation, especially soil erosion and depletion of soil nutrients, is widespread in Uganda and contributes to declining productivity, which in turn increases poverty. The report has four major objectives: (1) to examine the causes of land degradation in Uganda; (2) to identify the determinants of income strategies and land management decisions and their impacts on agricultural productivity, soil erosion, and household income; (3) to assess the trade-offs and complementarities among these different objectives; and (4) to analyze the soil nutrient depletion in eastern Uganda to determine the factors that influence it." from Text

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Annual cycles are the most common reproductive strategy in African tropical tree communities

We present the first cross continental comparison of the flowering and fruiting phenology of tropical forests across Africa. Flowering events of 5,446 trees from 196 species across 12 sites, and fruiting events of 4,595 trees from 191 species, across 11 sites were monitored over periods of 6 to 29 years, and analysed to describe phenology at the continental level. To study phenology we used Fourier analysis to identify the dominant cycles of flowering and fruiting for each individual tree and we identified the time of year African trees bloom and bear fruit and their relationship to local seasonality. Reproductive strategies were diverse and no single regular cycle was found in >50% of individuals across all 12 sites. Additionally, we found annual flowering and fruiting cycles to be the most common. Sub-annual cycles were the next most common for flowering whereas supra-annual patterns were the next most common for fruiting. We also identify variation in different subsets of species, with species exhibiting mainly annual cycles most common in West and West-Central African tropical forests, while more species at sites in East-Central and Eastern African forests showed cycles ranging from sub-annual to supra-annual. Despite many trees showing strong seasonality, at most sites some flowering and fruiting occurred all year round. Environmental factors with annual cycles are likely to be important drivers of seasonal periodicity in trees across Africa, but proximate triggers are unlikely to be constant across the continen

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral

The global retinoblastoma outcome study : a prospective, cluster-based analysis of 4064 patients from 149 countries

DATA SHARING : The study data will become available online once all analyses are complete.BACKGROUND : Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. METHODS : We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. FINDINGS : The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). INTERPRETATION : This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes.The Queen Elizabeth Diamond Jubilee Trust and the Wellcome Trust.https://www.thelancet.com/journals/langlo/homeam2023Paediatrics and Child Healt

A century of soils research and development in Uganda

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Nutrition and Academic Achievement: How Nutrition Protocols Affect International Students’ Food-choices and Academic Achievement in Higher Education. A Case Study for African International Students at the University of Toronto, St. George Campus (UTSG)

The University of Toronto (U of T) is referred to as a “city within a city”. This maxim is meant to imply that the University of Toronto epitomises all the characteristics of the City of Toronto which is commonly portrayed as ‘the most diverse urban centres of the world’. But how diverse is the University of Toronto and how effective are the university’s diversity and inclusion policies? This thesis draws from a Culturally Sensitive Nutritional Framework (CSNF) to examine the extent to which African international students are excluded from the food-choices offered by the University of Toronto food-service providers and how such unintended actions affect those students’ academic success and overall life experience at the university. Using oral-interviews, in-depth review of the literature, secondary sources, websites, as well as reviewing U of T’s nutrition protocols and the university’s Equity, Diversity and Inclusion (EDI) policies, I examined three related questions. (1) What are the current U of T EDI policies and nutrition practices, operating systems, rules and regulations? (2) How sensitive are these strategies, schemes and codes to the nutritional needs of African international students? (3) What are the programming shortcomings in these policies, operating principles, practices, rules and regulations and how can they be addressed? More specifically, the aim of this research was twofold. First, to evaluate the extent to which these protocols enhance the academic performance of African international students at the St. George Campus; and second, to provide suggestions on how these protocols could be further enriched to better serve the interests of African international students. The goal was to analyze effects of these protocols at the University of Toronto St. George campus and evaluate their potential relevance to the well-being of African international students. I argued that high-academic achievement is possible if the University of Toronto provides culturally sensitive nutritional choices to all international students and specifically African international students. The findings indicated diverse perceptions of nutritional needs and consequences for African international students. There were also evidence of implicit gaps among existing nutrition protocols and inclusion policies. Four recommendations are suggested to bridge existing gaps to ensure all international students are offered justifiable opportunities to enjoy thriving lives during their academic careers at the University of Toronto.M.A