Context and consequences of liquor sachets use among young people in Malawi

This article presents a relatively new phenomenon regarding alcohol related problems in Malawi; the context and consequences of the consumption of liquor sachets among young people. The results presented are part of a larger study looking at the prevalence and social norms related to alcohol use, as well as people’s opinions on policies and interventions related to alcohol in Malawi. The results presented here are from a qualitative component in three Malawian communities. The results imply that the introduction of sachets has contributed to an increase in alcohol consumption among young people. Major issues of concern are issues of age limits, packaging and alcohol content, as well as lack of empirical evidence on which to base policies and interventions. Finally, there is a need to mobilize positive adult role models for young people with regards to alcohol.Key words: Liquor sachets, Malawi, youth, alcohol consequences, qualitative stud

Empirical study of correlated survival times for recurrent events with proportional hazards margins and the effect of correlation and censoring.

Background: In longitudinal studies where subjects experience recurrent incidents over a period of time, such as respiratory infections, fever or diarrhea, statistical methods are required to take into account the within-subject correlation. Methods: For repeated events data with censored failure, the independent increment (AG), marginal (WLW) and conditional (PWP) models are three multiple failure models that generalize Cox"s proportional hazard model. In this paper, we revise the efficiency, accuracy and robustness of all three models under simulated scenarios with varying degrees of within-subject correlation, censoring levels, maximum number of possible recurrences and sample size. We also study the methods performance on a real dataset from a cohort study with bronchial obstruction. Results: We find substantial differences between methods and there is not an optimal method. AG and PWP seem to be preferable to WLW for low correlation levels but the situation reverts for high correlations. Conclusions: All methods are stable in front of censoring, worsen with increasing recurrence levels and share a bias problem which, among other consequences, makes asymptotic normal confidence intervals not fully reliable, although they are well developed theoretically

Efficacy of topical cobalt chelate CTC-96 against adenovirus in a cell culture model and against adenovirus keratoconjunctivitis in a rabbit model

BACKGROUND: Adenovirus (Ad), associated with significant morbidity, has no topical treatment. A leading CTC compound (CTC-96), a Co(III )chelate, was found to have potent in vitro and in vivo antiviral efficacy against herpes viruses. In this study CTC-96 is being tested for possible anti-Adenovirus activity. METHODS: The biological anti-adenovirus activity of CTC-96 in concentrations from 5 to 250 ug/ml, was evaluated initially by viral inactivation (viral exposure to CTC-96 followed by dilution and inoculation of cells), virucidal (viral exposure to CTC-96 and inoculation of cells without dilution) and antiviral (effect of CTC-96 on previously adsorbed virus) plaque assays on HeLa (human cervical carcinoma), A549 (human lung carcinoma) and SIRC (rabbit corneal) cells. After verifying the antiviral activity, New Zealand White rabbits were infected with Ad-5 into: 1) the anterior cul-de-sac scarifying the conjunctiva (Group "C+"); 2) the anterior cul-de-sac scarifying the conjunctiva and cornea (Group "CC+"); 3) the stroma (Group "CI+"). Controls were sham-infected ("C-", "CC-", "CI-"). Other rabbits, after "CC", were treated for 21 days with: 1) placebo, 9x/day ("-"); 2) CTC-96, 50 ug/ml, 9x/day ("50/9"); CTC-96, 50 ug/ml, 6x/day ("50/6"); CTC-96, 25 ug/ml, 6x/day ("25/6"). All animals were monitored via examination and plaque assays. RESULTS: In vitro viral inactivation, virucidal and antiviral assays all demonstrated CTC-96 to be effective against Adenvirus type 5 (ad-5). The in vivo model of Ad keratoconjunctivitis most similar to human disease and producing highest viral yield was "CC". All eyes (6/6) developed acute conjunctivitis. "CI" yielded more stromal involvement (1/6) and iritis (5/6), but lower clinical scores (area × severity). Infection via "C" was inconsistent (4/6). Fifty (50) ug/ml was effective against Ad-5 at 6x, 9x dosings while 25 ug/ml (6x) was only marginally effective. CONCLUSION: CTC-96 demonstrated virucidal activity against Ad5 in tissue culture with HeLa, A549 and SIRC cell lines. Animal Model Development: 1) "CC" produced conjunctival infection with occasional keratitis similar to human disease; "CI" yielded primarily stromal involvement; 2) "C" consistently produced neither conjunctivitis nor keratitis. CTC Testing: 1) Conjunctivitis in all eyes; 2) Resolution fastest in "50/9" ("50/9". "50/6" > "25/6" > "-"); 3) Efficacy in "50/6" was not statistically different than "50/9"; 4) Conjunctival severity was lower in treatment groups then controls; 5) Little corneal or intra-ocular changes were noted

Do national resources have to be centrally managed? Vested interests and institutional reform in Norwegian fisheries governance

Corporatism -with its privileged access, restricted participation and centralized structures - has a long history in Norwegian fisheries governance. Co-management – understood as a decentralized, bottom-up and more inclusive form of fisheries governance - has not been considered a relevant alternative.. Why does corporatism still prevail in a context where stakeholder status in fisheries governance globally – both in principle and practice - has been awarded environmental organizations, municipal authorities and even consumer advocacy groups? Why then have alternatives to the corporatist system of centralized consultation and state governance never been seriously considered in Norway, in spite of the growing emphasis on fish as a public resource and fisheries management as human intervention in geographically confined and complex ecosystems? We suggest that thismay have to do with the fundamental assumptions behind Norwegian fisheries governance that since fish is a national resource, it must be centrally managed. We argue that this is an assumption that may be contested

Accuracy of cause of death data routinely recorded in a population-based cancer registry: impact on cause-specific survival and validation using the Geneva Cancer Registry.

BACKGROUND: Information on the underlying cause of death of cancer patients is of interest because it can be used to estimate net survival. The population-based Geneva Cancer Registry is unique because registrars are able to review the official cause of death. This study aims to describe the difference between the official and revised cause-of-death variables and the impact on cancer survival estimates. METHODS: The recording process for each cause of death variable is summarised. We describe the differences between the two cause-of-death variables for the 5,065 deceased patients out of the 10,534 women diagnosed with breast cancer between 1970 and 2009. The Kappa statistic and logistic regression are applied to evaluate the degree of concordance. The impact of discordance on cause-specific survival is examined using the Kaplan Meier method. RESULTS: The overall agreement between the two variables was high. However, several subgroups presented a lower concordance, suggesting differences in calendar time and less attention given to older patients and more advanced diseases. Similarly, the impact of discordance on cause-specific survival was small on overall survival but larger for several subgroups. CONCLUSION: Estimation of cancer-specific survival could therefore be prone to bias when using the official cause of death. Breast cancer is not the more lethal cancer and our results can certainly not be generalised to more lethal tumours

Green alliances and the role of taxation

We examine two alternative strategies that an environmental group can embark when interacting with a firm. The first one which is already discussed in the literature is when the group campaigns against the firm. The second one which has not been modelled in the literature is when the group collaborates with the firm (green alliance) to reduce the cost of the cleaner technology. We look at the case of both options being available for the group in a setting with an environmental tax. One of the main results of the paper argues that for higher taxation the conflict scenario is more likely to happen, implying that collaboration and a more stringent environmental policy are substitutes. This identifies a previously unexamined and possibly adverse effect of public policy on environmental quality because it weakens the impact of the pollution tax on emission intensity. We also characterise the optimal tax that maximises social welfare and find that under pure conflict –when conflict is the only option for the environmentalists– optimal tax is higher than when the group can choose to act against or join forces with the firm, indicating that a less stringent environmental policy is needed in the latter scenario