The proton pump inhibitors (PPIs) as a class are remarkably safe and effective for persons with peptic ulcer disorders. Serious adverse events are extremely rare for PPIs, with case reports of interstitial nephritis w...The proton pump inhibitors (PPIs) as a class are remarkably safe and effective for persons with peptic ulcer disorders. Serious adverse events are extremely rare for PPIs, with case reports of interstitial nephritis with omeprazole, hepatitis with omeprazole and lansoprazole, and disputed visual disturbances with pantoprazole and omeprazole. PPI use is associated with the development of fundic gland polyps (FGP); stopping PPIs is associated with regression of FGP. In the absence of Helicobacter pylori infection, the long-term use of PPIs has not been convincingly proven to cause or be associated with the progression of pre-existing chronic gastritis or gastric atrophy or intestinal metaplasia. Mild/modest hypergastrinemia is a physiological response to the reduction in gastric acid secretion due to any cause. The long-term use of PPIs has not been convincingly proven to cause enterochromaff in-like cell hyperplasia or carcinoid tumors. PPIs increase the risk of community acquired pneumonia, but not of hospital acquired (nosocomial) pneumonia. There is no data to support particular care in prescribing PPI therapy due to concerns about risk of hip fracture with the long-termuse of PPIs. Long-term use of PPIs does not lead to vitamin B12 def iciencies, except possibly in the elderly, or in persons with Zollinger-Ellison Syndrome who are on high doses of PPI for prolonged periods of time. There is no convincingly proven data that PPIs increase the risk of Clostridium difficile-associated diarrhea in persons in the community. The discontinuation of PPIs may result in rebound symptoms requiring further and even continuous PPI use for suppression of symptoms. As with all medications, the key is to use PPIs only when clearly indicated, and to reassess continued use so that long-term therapy is used judiciously. Thus, in summary, the PPIs are a safe class of medications to use longterm in persons in whom there is a clear need for the maintenance of extensive acid inhibition.展开更多
In 1999 no-tillage farming,synonymous of zero tillage farming or conservation agriculture,was adopted on about 45 million ha world wide,growing to 72 million ha in 2003 and to 111 million ha in 2009,corresponding to a...In 1999 no-tillage farming,synonymous of zero tillage farming or conservation agriculture,was adopted on about 45 million ha world wide,growing to 72 million ha in 2003 and to 111 million ha in 2009,corresponding to an growth rate of 6 million ha per annum.Fastest adoption rates have been experienced in South America where some countries are using no-tillage farming on about 70%of the total cultivated area.Opposite to countries like the USA where often fields under no-tillage farming are tilled every now and then,more than two thirds of the area under no-tillage systems in South America is permanently not tilled;in other words once adopted,the soil is never tilled again.The spread of no-tillage systems on more than 110 million ha world-wide shows the great adaptability of the systems to all kinds of climates,soils and cropping conditions.No-tillage is now being practiced from the artic circle over the tropics to about 50ºlatitude south,from sea level to 3,000 m altitude,from extremely rainy areas with 2,500 mm a year to extremely dry conditions with 250 mm a year.No-till farming offers a way of optimizing productivity and ecosystem services,offering a wide range of economic,environmental and social benefits to the producer and to the society.At the same time,no-till farming is enabling agriculture to respond to some of the global challenges associated with climate change,land and environmental degradation,and increasing cost of food,energy and production inputs.The wide recognition of no-till farming as a truly sustainable system should ensure the spread of the no-till technology and the associated practices of organic soil cover and crop rotation,as soon as the barriers to its adoption have been overcome,to areas where adoption is currently still low.The widespread adoption globally also shows that no-tillage farming cannot any more be considered a temporary fashion or a craze;instead largely through farmers’own effort,the system has established itself as a farming practice and a different way of thinking abo展开更多
Thrombotic thrombocytopenic purpura (TTP) is a rare but acute, life-threatening condition which may be precipitated by pregnancy. This disorder that presents with thrombocytopenia, haemolytic anemia, and clinical cons...Thrombotic thrombocytopenic purpura (TTP) is a rare but acute, life-threatening condition which may be precipitated by pregnancy. This disorder that presents with thrombocytopenia, haemolytic anemia, and clinical consequences of microvascular thrombosis such as stroke. The exact cause is not known but it is associated with a deficiency of ADAMTS13 enzymes. Immune mediated TTP is more common and can present in pregnancy. The aim of this case is to bring awareness as many clinicians are unaware of this condition in pregnancy, its diagnosis may be missed or delayed, leading to fetal loss or serious maternal implications. In this case the patient presented at 29 weeks with stroke in Emergency department, referred to delivery suit for Obstetric review, with suspicion of Pre-eclampsia/HELLP. The diagnosis of TTP was achieved by a multidisciplinary team who worked tirelessly together. The patient was transferred to a Specialist Tertiary Care Centre for further management. The pregnancy continued until 33 weeks and 5 days. She underwent an emergency caesarean section for fetal distress. Steroids and Rituximab were continued postnatally. The outcome was favourable due to fast and efficient multidisciplinary care. Awareness of this rare but important condition can lead to recognition of clinical presentation, prompt diagnosis and appropriate management.展开更多
Intensification in rice crop production is generally understood as requiring increased use of material inputs: water, inorganic fertilizers, and agrochemicals. However, this is not the only kind of intensification ava...Intensification in rice crop production is generally understood as requiring increased use of material inputs: water, inorganic fertilizers, and agrochemicals. However, this is not the only kind of intensification available. More productive crop phenotypes, with traits such as more resistance to biotic and abiotic stresses and shorter crop cycles, are possible through modifications in the management of rice plants, soil, water, and nutrients, reducing rather than increasing material inputs. Greater factor productivity can be achieved through the application of new knowledge and more skill, and(initially) more labor, as seen from the System of Rice Intensification(SRI), whose practices are used in various combinations by as many as 10 million farmers on about 4 million hectares in over 50 countries. The highest yields achieved with these management methods have come from hybrids and improved rice varieties, confirming the importance of making genetic improvements. However,unimproved varieties are also responsive to these changes, which induce better growth and functioning of rice root systems and more abundance, diversity, and activity of beneficial soil organisms. Some of these organisms as symbiotic endophytes can affect and enhance the expression of rice plants' genetic potential as well as their phenotypic resilience to multiple stresses, including those of climate change. SRI experience and data suggest that decades of plant breeding have been selecting for the best crop genetic endowments under suboptimal growing conditions, with crowding of plants that impedes their photosynthesis and growth, flooding of rice paddies that causes roots to degenerate and forgoes benefits derived from aerobic soil organisms, and overuse of agrochemicals that adversely affect these organisms as well as soil and human health. This review paper reports evidence from research in India and Indonesia that changes in crop and water management can improve the expression of rice plants' genetic potential, thereby creating more producti展开更多
In response to the dust bowls of the mid-thirties in the USA,soil and water conservation programmes involving reduced tillage were promoted to control land degradation,particularly soil erosion.The farming and land ma...In response to the dust bowls of the mid-thirties in the USA,soil and water conservation programmes involving reduced tillage were promoted to control land degradation,particularly soil erosion.The farming and land management practices that were considered to adequately address soil and water conservation objectives were based on no-till seeding and maintenance of soil mulch cover.This collection of practices led to what became known as conservation tillage,although no-till systems by definition avoid soil disturbance by no-till direct seeding,and maintain an organic mulch cover on the soil surface.This article is an overview of achievements in soil and water conservation on agricultural lands through the experience derived from the adoption and spread of Conservation Agriculture(CA)world-wide.CA is an agro-ecological approach to sustainable production intensification.It involves the application of three inter-linked principles that underpin agricultural production systems based on locally formulated practices:(i)permanent no or minimum mechanical soil disturbance,which in practice entails direct seeding through mulch into no-till soils;(ii)maintenance of soil cover with crop residues and green manure crops,particularly legumes;and(iii)diversified cropping system involving annuals and perennial in rotations,sequences and associations.In 2011,CA had spread over 125 million hectares(9%of the global cropped land)across all continents and most agro-ecologies,including small and large farms.In addition,there is a significant area of CA orchards in the Mediterranean countries.CA is now considered to be a practical agro-ecological approach to achieving sustainable agriculture intensification.It offers environmental,economic and social advantages that are not fully possible with tillage-based production systems,as well as improved productivity and resilience,and improved ecosystem services while minimizing the excessive use of agrochemicals,energy and heavy machinery.While there are challenges to the adoption of CA,there展开更多
The current growing demand for Conservation Agriculture(CA)at the national level in the countries of the Asia-Pacific region presents an opportunity to promote its widespread adoption and up-scaling through national p...The current growing demand for Conservation Agriculture(CA)at the national level in the countries of the Asia-Pacific region presents an opportunity to promote its widespread adoption and up-scaling through national policy and institutional support that appears necessary.Despite the obvious benefits of CA,it does not spread automatically unless the constraints that hinder adoption are understood and addressed in specific situations.These can include a combination of intellectual,social,financial,biophysical,technical,infrastructure constraints,or policy related support.Knowing what the bottlenecks are is important in developing strategies to overcome them.This paper presents:(a)some of the generic policy opportunities that exist for the adoption and uptake of CA;(b)a summary proceedings and outcome of the Regional Expert Consultation Workshop held in Beijing and sponsored by FAO Regional Office for Asia-Pacific which describes the status of CA in the Asia-Pacific region;(c)the challenges to CA adoption and uptake in the Asia-Pacific region;and(d)the conditions that need to be taken into account in designing and promoting policy and institutional support strategies for up-scaling CA.展开更多
Objective:To assess delivery outcomes in women with placental malaria who presented at public hospitals in Kisumu,a holoendemic region in western Kenya. Methods:A crosssectional study using both histology andmolecular...Objective:To assess delivery outcomes in women with placental malaria who presented at public hospitals in Kisumu,a holoendemic region in western Kenya. Methods:A crosssectional study using both histology andmolecular biologywas conducted with 90 consecutive pregnant women who presented at 3 hospitals during a 2-week period. Data collectors completed standardized questionnaires using each patient’s hospital record and physical examination results,and registered birth indices such as weight,head circumference,and weight-head ratio. Malaria infection of the placenta was assessed using a molecular biology approach (for genomic differences among parasite species) as well as histology techniques. Of the 5 histologic classes of placental infection,class 1 corresponds to active infection and class 4 to past infection; class 2 and 3 to active chronic infection; and class 5 to uninfected individuals. Plasmodium species typing was determined by polymerase chain reaction amplification of the parasite’s genome. Results:In newborns at term,low birth weight was directly associated with classes 2 and 4 of placental infection (P = 0.053 and P = 0.003,respectively),and differences in birth weight remained significant between the 5 classes (P < 0.001) even after adjusting for parity and mother’s age. Plasmodium falciparum was the only detected parasite. Conclusions:In Kisumu,infection with P. falciparum is an important cause of low birth weight and morbidity when it is associated with histologic classes 2 and 4 of placental infection. Moreover,polymerase chain reaction assays should be supported by ministries of health as an ancillary method of collecting data for malaria control during pregnancy and providing a baseline for future interventions.展开更多
Incidence of caesarean section for breech presentation has increased markedly. External cephalic version (ECV) is effective in reducing non cephalic presentation at births and caesarean section (CS) for breech present...Incidence of caesarean section for breech presentation has increased markedly. External cephalic version (ECV) is effective in reducing non cephalic presentation at births and caesarean section (CS) for breech presentation. Success rates are good but there is increasing need for induction of labour (IOL) as well as for intrapartum CS for reasons that are not clear. The aim of this study was to report the experience with ECV at a single centre where ECVs were performed by or under the guidance of one senior clinician. This was a 7-year retrospective audit of 147 ECVs at a single centre in Queensland. ECV was successful in 53.7%, 34% in nulliparous and 69% in multiparous women. Of the few variables explored, nulliparity was the only variable that was associated with poor success. Among those with successful ECV, 32 (40.5%) had IOL. Intrapartum CS rate in women who had had a successful ECV was 16.5% compared to 11% for the hospital. There was no difference in early neonatal outcome between the groups. We have confirmed a success rate that is comparable with many other studies. Mothers with successful ECV do have a higher IOL and a higher CS rate especially in women whose labour is induced. We suggest a need to look at some novel methods to increase uptake further and to improve success rates in nulliparous women.展开更多
Background: Currently pregnant women with abnormal glucose screening test (GCT), performed at 26?-?28 weeks gestation with a subsequent normal glucose tolerance test (GTT) receive routine care. Could these women be at...Background: Currently pregnant women with abnormal glucose screening test (GCT), performed at 26?-?28 weeks gestation with a subsequent normal glucose tolerance test (GTT) receive routine care. Could these women be at risk of adverse pregnancy? Objective: Compare rate of caesarean section (CS), induction of labour (IOL), macrosomia, admission to special care nursery and neonatal hypoglycaemia. Designs: Retrospective cohort study. Setting: Ipswich Hospital, Ipswich, Queensland. Participants: Pregnant women having had the test at the hospital laboratory. Methods: Charts review of outcome measures including induction of labour, caesarean section, macrosomia, RDS and short-term neonatal morbidity. Results: We reviewed 882 charts (441 cases and 441 controls). There was a higher IOL rate among cases 21.1% versus 16.6% (OR and 95% CI 1.45;1.03?-?2.06) and a higher CS rate, 30.4 versus 23.6 (OR and 95% CI 1.41;1.05?-?1.91). Compared to women with BMI 18.5 - 24.9, women with BMI of 30 and above had a significantly higher IOL rate (47.1% versus 22.6%), higher CS rate (47.2% versus 25.7%) and higher rate of macrosomic baby (79.2% versus 4.2%). There were more women amongst the cases who were older, smoked, had a BMI 30 and above and had previous history of GDM. After adjusting for maternal age, BMI and smoking status, there was still an increased odds of CS, IOL and macrosomia, but this did not reach statistical significance. Conclusion: Abnormal glucose screening test in the absence of gestational diabetes is associated with adverse pregnancy outcome. This is largely contributed by maternal obesity.展开更多
This manuscript is mainly to investigate gender discrimination in building construction industry in Nigeria. The manuscript aimed at establishing the level of women participation in building construction industry in d...This manuscript is mainly to investigate gender discrimination in building construction industry in Nigeria. The manuscript aimed at establishing the level of women participation in building construction industry in developed nations and developing nations in order to proffer solutions for its improvement in Nigeria. It was found that the percentage of women participation in building construction work is higher among developed countries than in developing countries. In developing countries Nigeria inclusive, higher percentages of women were found to be engaged as helpers or labourers and in other unskilled jobs. It was also revealed that some of the factors affecting women participation in building construction work in Nigerian include: lack of self-confidence to compete with their male counterparts, effect of stereotyping of the profession as masculine jobs, religious believes, norms, and customs and so on.展开更多
Background: Approximately 1 in 4 children hospitalized with injuries from traffic crashes and their parents experience symptoms of acute stress disorder (ASD). These families represent a minority of those exposed to t...Background: Approximately 1 in 4 children hospitalized with injuries from traffic crashes and their parents experience symptoms of acute stress disorder (ASD). These families represent a minority of those exposed to the trauma of a crash. To date, no studies have explored the prevalence of ASD symptoms in the broader population of children and parents exposed to crashes. Objective: To describe the prevalence of and risk factors for ASD symptoms in children and their driver parents after vehicle crashes. Design, Setting, and Participants: Cross-sectional study via telephone survey of parent drivers and children (aged 5- 15 years), using an exposure-based crash surveillance system. A probability sample of 1091 crashes involving 1483 children weighted to represent 24 376 children in 18 422 crashes was collected. Main Outcome Measure(s)- : Parent-reported ASD symptoms and impairment. Results: Significant ASD symptoms occurred in 1.6% (95% confidence interval, 0.9% - 2.3% ) of children in crashes and 4.7% (95% confidence interval, 4.0% - 5.5% ) of parents. In children, ASD symptoms were independently associated with sustaining an injury and with receiving medical care; in parents, symptoms were independently associated with child injury, child receiving medical care, Hispanic ethnicity, lower income (<＄ 40 000), and higher crash severity. Conclusions: Sustaining injuries and receiving medical treatment were strong predictors for developing ASD symptoms after crashes but ASD symptoms often occurred in the absence of these risk factors. Health care professionals should consider screening for traumatic stress symptoms in children and their parents when children are involved in traffic crashes, particularly if they sustain injuries.展开更多
This paper,complementing the first part(Shaxson et al.,2014),sketches the outlines of an ecologically-based approach to better care of soils,within the overarching context of‘land husbandry’,contributing to more-eff...This paper,complementing the first part(Shaxson et al.,2014),sketches the outlines of an ecologically-based approach to better care of soils,within the overarching context of‘land husbandry’,contributing to more-effective conservation of soil and water.It suggests an up-dated paradigm which concentrates more on renewing and conserving the biologically-moderated spaces in the soil in the root-zone rather than on the solid soil-particles themselves.When read in sequence,the two papers offer contributions to better understanding of both the problems and the possibilities for solving the ongoing uncertainties of how best to repair damaged lands,to maintain and improve those areas already in use,and to safeguard the potentials of those as-yet-unopened areas which surely will be brought into production in the future,by the planning and executing of optimum strategies for assuring sustainability of their uses into the future.These two papers do not set out to challenge existing knowledge,but rather to suggest additions to,and alternative interpretations of,what may already be known.The conclusions suggest some important amplifications to any curriculum for the training and/or up-dating of people involved in those subject-areas which contribute to better land husbandry and more-effective conservation of soil and water,as well as to the buffering of soils’productive capacities against the possible adverse effects of climate change.展开更多
文摘The proton pump inhibitors (PPIs) as a class are remarkably safe and effective for persons with peptic ulcer disorders. Serious adverse events are extremely rare for PPIs, with case reports of interstitial nephritis with omeprazole, hepatitis with omeprazole and lansoprazole, and disputed visual disturbances with pantoprazole and omeprazole. PPI use is associated with the development of fundic gland polyps (FGP); stopping PPIs is associated with regression of FGP. In the absence of Helicobacter pylori infection, the long-term use of PPIs has not been convincingly proven to cause or be associated with the progression of pre-existing chronic gastritis or gastric atrophy or intestinal metaplasia. Mild/modest hypergastrinemia is a physiological response to the reduction in gastric acid secretion due to any cause. The long-term use of PPIs has not been convincingly proven to cause enterochromaff in-like cell hyperplasia or carcinoid tumors. PPIs increase the risk of community acquired pneumonia, but not of hospital acquired (nosocomial) pneumonia. There is no data to support particular care in prescribing PPI therapy due to concerns about risk of hip fracture with the long-termuse of PPIs. Long-term use of PPIs does not lead to vitamin B12 def iciencies, except possibly in the elderly, or in persons with Zollinger-Ellison Syndrome who are on high doses of PPI for prolonged periods of time. There is no convincingly proven data that PPIs increase the risk of Clostridium difficile-associated diarrhea in persons in the community. The discontinuation of PPIs may result in rebound symptoms requiring further and even continuous PPI use for suppression of symptoms. As with all medications, the key is to use PPIs only when clearly indicated, and to reassess continued use so that long-term therapy is used judiciously. Thus, in summary, the PPIs are a safe class of medications to use longterm in persons in whom there is a clear need for the maintenance of extensive acid inhibition.
文摘In 1999 no-tillage farming,synonymous of zero tillage farming or conservation agriculture,was adopted on about 45 million ha world wide,growing to 72 million ha in 2003 and to 111 million ha in 2009,corresponding to an growth rate of 6 million ha per annum.Fastest adoption rates have been experienced in South America where some countries are using no-tillage farming on about 70%of the total cultivated area.Opposite to countries like the USA where often fields under no-tillage farming are tilled every now and then,more than two thirds of the area under no-tillage systems in South America is permanently not tilled;in other words once adopted,the soil is never tilled again.The spread of no-tillage systems on more than 110 million ha world-wide shows the great adaptability of the systems to all kinds of climates,soils and cropping conditions.No-tillage is now being practiced from the artic circle over the tropics to about 50ºlatitude south,from sea level to 3,000 m altitude,from extremely rainy areas with 2,500 mm a year to extremely dry conditions with 250 mm a year.No-till farming offers a way of optimizing productivity and ecosystem services,offering a wide range of economic,environmental and social benefits to the producer and to the society.At the same time,no-till farming is enabling agriculture to respond to some of the global challenges associated with climate change,land and environmental degradation,and increasing cost of food,energy and production inputs.The wide recognition of no-till farming as a truly sustainable system should ensure the spread of the no-till technology and the associated practices of organic soil cover and crop rotation,as soon as the barriers to its adoption have been overcome,to areas where adoption is currently still low.The widespread adoption globally also shows that no-tillage farming cannot any more be considered a temporary fashion or a craze;instead largely through farmers’own effort,the system has established itself as a farming practice and a different way of thinking abo
文摘Thrombotic thrombocytopenic purpura (TTP) is a rare but acute, life-threatening condition which may be precipitated by pregnancy. This disorder that presents with thrombocytopenia, haemolytic anemia, and clinical consequences of microvascular thrombosis such as stroke. The exact cause is not known but it is associated with a deficiency of ADAMTS13 enzymes. Immune mediated TTP is more common and can present in pregnancy. The aim of this case is to bring awareness as many clinicians are unaware of this condition in pregnancy, its diagnosis may be missed or delayed, leading to fetal loss or serious maternal implications. In this case the patient presented at 29 weeks with stroke in Emergency department, referred to delivery suit for Obstetric review, with suspicion of Pre-eclampsia/HELLP. The diagnosis of TTP was achieved by a multidisciplinary team who worked tirelessly together. The patient was transferred to a Specialist Tertiary Care Centre for further management. The pregnancy continued until 33 weeks and 5 days. She underwent an emergency caesarean section for fetal distress. Steroids and Rituximab were continued postnatally. The outcome was favourable due to fast and efficient multidisciplinary care. Awareness of this rare but important condition can lead to recognition of clinical presentation, prompt diagnosis and appropriate management.
文摘Intensification in rice crop production is generally understood as requiring increased use of material inputs: water, inorganic fertilizers, and agrochemicals. However, this is not the only kind of intensification available. More productive crop phenotypes, with traits such as more resistance to biotic and abiotic stresses and shorter crop cycles, are possible through modifications in the management of rice plants, soil, water, and nutrients, reducing rather than increasing material inputs. Greater factor productivity can be achieved through the application of new knowledge and more skill, and(initially) more labor, as seen from the System of Rice Intensification(SRI), whose practices are used in various combinations by as many as 10 million farmers on about 4 million hectares in over 50 countries. The highest yields achieved with these management methods have come from hybrids and improved rice varieties, confirming the importance of making genetic improvements. However,unimproved varieties are also responsive to these changes, which induce better growth and functioning of rice root systems and more abundance, diversity, and activity of beneficial soil organisms. Some of these organisms as symbiotic endophytes can affect and enhance the expression of rice plants' genetic potential as well as their phenotypic resilience to multiple stresses, including those of climate change. SRI experience and data suggest that decades of plant breeding have been selecting for the best crop genetic endowments under suboptimal growing conditions, with crowding of plants that impedes their photosynthesis and growth, flooding of rice paddies that causes roots to degenerate and forgoes benefits derived from aerobic soil organisms, and overuse of agrochemicals that adversely affect these organisms as well as soil and human health. This review paper reports evidence from research in India and Indonesia that changes in crop and water management can improve the expression of rice plants' genetic potential, thereby creating more producti
文摘In response to the dust bowls of the mid-thirties in the USA,soil and water conservation programmes involving reduced tillage were promoted to control land degradation,particularly soil erosion.The farming and land management practices that were considered to adequately address soil and water conservation objectives were based on no-till seeding and maintenance of soil mulch cover.This collection of practices led to what became known as conservation tillage,although no-till systems by definition avoid soil disturbance by no-till direct seeding,and maintain an organic mulch cover on the soil surface.This article is an overview of achievements in soil and water conservation on agricultural lands through the experience derived from the adoption and spread of Conservation Agriculture(CA)world-wide.CA is an agro-ecological approach to sustainable production intensification.It involves the application of three inter-linked principles that underpin agricultural production systems based on locally formulated practices:(i)permanent no or minimum mechanical soil disturbance,which in practice entails direct seeding through mulch into no-till soils;(ii)maintenance of soil cover with crop residues and green manure crops,particularly legumes;and(iii)diversified cropping system involving annuals and perennial in rotations,sequences and associations.In 2011,CA had spread over 125 million hectares(9%of the global cropped land)across all continents and most agro-ecologies,including small and large farms.In addition,there is a significant area of CA orchards in the Mediterranean countries.CA is now considered to be a practical agro-ecological approach to achieving sustainable agriculture intensification.It offers environmental,economic and social advantages that are not fully possible with tillage-based production systems,as well as improved productivity and resilience,and improved ecosystem services while minimizing the excessive use of agrochemicals,energy and heavy machinery.While there are challenges to the adoption of CA,there
基金the Program for Changjiang Scholars and Innovative Research Team in University of China(Grant No.IRT13039).
文摘The current growing demand for Conservation Agriculture(CA)at the national level in the countries of the Asia-Pacific region presents an opportunity to promote its widespread adoption and up-scaling through national policy and institutional support that appears necessary.Despite the obvious benefits of CA,it does not spread automatically unless the constraints that hinder adoption are understood and addressed in specific situations.These can include a combination of intellectual,social,financial,biophysical,technical,infrastructure constraints,or policy related support.Knowing what the bottlenecks are is important in developing strategies to overcome them.This paper presents:(a)some of the generic policy opportunities that exist for the adoption and uptake of CA;(b)a summary proceedings and outcome of the Regional Expert Consultation Workshop held in Beijing and sponsored by FAO Regional Office for Asia-Pacific which describes the status of CA in the Asia-Pacific region;(c)the challenges to CA adoption and uptake in the Asia-Pacific region;and(d)the conditions that need to be taken into account in designing and promoting policy and institutional support strategies for up-scaling CA.
文摘Objective:To assess delivery outcomes in women with placental malaria who presented at public hospitals in Kisumu,a holoendemic region in western Kenya. Methods:A crosssectional study using both histology andmolecular biologywas conducted with 90 consecutive pregnant women who presented at 3 hospitals during a 2-week period. Data collectors completed standardized questionnaires using each patient’s hospital record and physical examination results,and registered birth indices such as weight,head circumference,and weight-head ratio. Malaria infection of the placenta was assessed using a molecular biology approach (for genomic differences among parasite species) as well as histology techniques. Of the 5 histologic classes of placental infection,class 1 corresponds to active infection and class 4 to past infection; class 2 and 3 to active chronic infection; and class 5 to uninfected individuals. Plasmodium species typing was determined by polymerase chain reaction amplification of the parasite’s genome. Results:In newborns at term,low birth weight was directly associated with classes 2 and 4 of placental infection (P = 0.053 and P = 0.003,respectively),and differences in birth weight remained significant between the 5 classes (P < 0.001) even after adjusting for parity and mother’s age. Plasmodium falciparum was the only detected parasite. Conclusions:In Kisumu,infection with P. falciparum is an important cause of low birth weight and morbidity when it is associated with histologic classes 2 and 4 of placental infection. Moreover,polymerase chain reaction assays should be supported by ministries of health as an ancillary method of collecting data for malaria control during pregnancy and providing a baseline for future interventions.
文摘Incidence of caesarean section for breech presentation has increased markedly. External cephalic version (ECV) is effective in reducing non cephalic presentation at births and caesarean section (CS) for breech presentation. Success rates are good but there is increasing need for induction of labour (IOL) as well as for intrapartum CS for reasons that are not clear. The aim of this study was to report the experience with ECV at a single centre where ECVs were performed by or under the guidance of one senior clinician. This was a 7-year retrospective audit of 147 ECVs at a single centre in Queensland. ECV was successful in 53.7%, 34% in nulliparous and 69% in multiparous women. Of the few variables explored, nulliparity was the only variable that was associated with poor success. Among those with successful ECV, 32 (40.5%) had IOL. Intrapartum CS rate in women who had had a successful ECV was 16.5% compared to 11% for the hospital. There was no difference in early neonatal outcome between the groups. We have confirmed a success rate that is comparable with many other studies. Mothers with successful ECV do have a higher IOL and a higher CS rate especially in women whose labour is induced. We suggest a need to look at some novel methods to increase uptake further and to improve success rates in nulliparous women.
文摘Background: Currently pregnant women with abnormal glucose screening test (GCT), performed at 26?-?28 weeks gestation with a subsequent normal glucose tolerance test (GTT) receive routine care. Could these women be at risk of adverse pregnancy? Objective: Compare rate of caesarean section (CS), induction of labour (IOL), macrosomia, admission to special care nursery and neonatal hypoglycaemia. Designs: Retrospective cohort study. Setting: Ipswich Hospital, Ipswich, Queensland. Participants: Pregnant women having had the test at the hospital laboratory. Methods: Charts review of outcome measures including induction of labour, caesarean section, macrosomia, RDS and short-term neonatal morbidity. Results: We reviewed 882 charts (441 cases and 441 controls). There was a higher IOL rate among cases 21.1% versus 16.6% (OR and 95% CI 1.45;1.03?-?2.06) and a higher CS rate, 30.4 versus 23.6 (OR and 95% CI 1.41;1.05?-?1.91). Compared to women with BMI 18.5 - 24.9, women with BMI of 30 and above had a significantly higher IOL rate (47.1% versus 22.6%), higher CS rate (47.2% versus 25.7%) and higher rate of macrosomic baby (79.2% versus 4.2%). There were more women amongst the cases who were older, smoked, had a BMI 30 and above and had previous history of GDM. After adjusting for maternal age, BMI and smoking status, there was still an increased odds of CS, IOL and macrosomia, but this did not reach statistical significance. Conclusion: Abnormal glucose screening test in the absence of gestational diabetes is associated with adverse pregnancy outcome. This is largely contributed by maternal obesity.
文摘This manuscript is mainly to investigate gender discrimination in building construction industry in Nigeria. The manuscript aimed at establishing the level of women participation in building construction industry in developed nations and developing nations in order to proffer solutions for its improvement in Nigeria. It was found that the percentage of women participation in building construction work is higher among developed countries than in developing countries. In developing countries Nigeria inclusive, higher percentages of women were found to be engaged as helpers or labourers and in other unskilled jobs. It was also revealed that some of the factors affecting women participation in building construction work in Nigerian include: lack of self-confidence to compete with their male counterparts, effect of stereotyping of the profession as masculine jobs, religious believes, norms, and customs and so on.
文摘Background: Approximately 1 in 4 children hospitalized with injuries from traffic crashes and their parents experience symptoms of acute stress disorder (ASD). These families represent a minority of those exposed to the trauma of a crash. To date, no studies have explored the prevalence of ASD symptoms in the broader population of children and parents exposed to crashes. Objective: To describe the prevalence of and risk factors for ASD symptoms in children and their driver parents after vehicle crashes. Design, Setting, and Participants: Cross-sectional study via telephone survey of parent drivers and children (aged 5- 15 years), using an exposure-based crash surveillance system. A probability sample of 1091 crashes involving 1483 children weighted to represent 24 376 children in 18 422 crashes was collected. Main Outcome Measure(s)- : Parent-reported ASD symptoms and impairment. Results: Significant ASD symptoms occurred in 1.6% (95% confidence interval, 0.9% - 2.3% ) of children in crashes and 4.7% (95% confidence interval, 4.0% - 5.5% ) of parents. In children, ASD symptoms were independently associated with sustaining an injury and with receiving medical care; in parents, symptoms were independently associated with child injury, child receiving medical care, Hispanic ethnicity, lower income (<＄ 40 000), and higher crash severity. Conclusions: Sustaining injuries and receiving medical treatment were strong predictors for developing ASD symptoms after crashes but ASD symptoms often occurred in the absence of these risk factors. Health care professionals should consider screening for traumatic stress symptoms in children and their parents when children are involved in traffic crashes, particularly if they sustain injuries.
文摘This paper,complementing the first part(Shaxson et al.,2014),sketches the outlines of an ecologically-based approach to better care of soils,within the overarching context of‘land husbandry’,contributing to more-effective conservation of soil and water.It suggests an up-dated paradigm which concentrates more on renewing and conserving the biologically-moderated spaces in the soil in the root-zone rather than on the solid soil-particles themselves.When read in sequence,the two papers offer contributions to better understanding of both the problems and the possibilities for solving the ongoing uncertainties of how best to repair damaged lands,to maintain and improve those areas already in use,and to safeguard the potentials of those as-yet-unopened areas which surely will be brought into production in the future,by the planning and executing of optimum strategies for assuring sustainability of their uses into the future.These two papers do not set out to challenge existing knowledge,but rather to suggest additions to,and alternative interpretations of,what may already be known.The conclusions suggest some important amplifications to any curriculum for the training and/or up-dating of people involved in those subject-areas which contribute to better land husbandry and more-effective conservation of soil and water,as well as to the buffering of soils’productive capacities against the possible adverse effects of climate change.
