We evaluate the boundary of the Anthropocene geological time interval as an epoch, since it is useful to have a consistent temporal definition for this increasingly used unit, whether the presently informal term is eventually formalized or not. Of the three main levels suggested – an ‘early Anthropocene’ level some thousands of years ago; the beginning of the Industrial Revolution at ∼1800 CE (Common Era); and the ‘Great Acceleration’ of the mid-twentieth century – current evidence suggests that the last of these has the most pronounced and globally synchronous signal. A boundary at this time need not have a Global Boundary Stratotype Section and Point (GSSP or ‘golden spike’) but can be defined by a Global Standard Stratigraphic Age (GSSA), i.e. a point in time of the human calendar. We propose an appropriate boundary level here to be the time of the world's first nuclear bomb explosion, on July 16th 1945 at Alamogordo, New Mexico; additional bombs were detonated at the average rate of one every 9.6 days until 1988 with attendant worldwide fallout easily identifiable in the chemostratigraphic record. Hence, Anthropocene deposits would be those that may include the globally distributed primary artificial radionuclide signal, while also being recognized using a wide range of other stratigraphic criteria. This suggestion for the Holocene–Anthropocene boundary may ultimately be superseded, as the Anthropocene is only in its early phases, but it should remain practical and effective for use by at least the current generation of scientists.

Background: Di use In ltrative
Lymphocytosis Syndrome (DILS) is
characterised by a persistent CD8+
lymphocytosis and lymphocytic
in ltration of various organs. The exact
prevalence isn’t known but some studies
have reported between 0.85 – 3%, and
appears to be more common in African
population. Patients with DILS tend to have higher CD4 cell counts and survive
longer than those patients without DILS.
Most patients present with bilateral
parotid gland enlargement and features
of the Sicca syndrome. Common sites
of extra glandular involvement are the
lungs being the most common site,
followed by peripheral neuropathy and
liver. With the high incidence of HIV in
our population it is likely that DILS is
under diagnosed probably due to our
ignorance of this disease. Awareness of
its various presentations may bring to
light undiscovered patients with DILS.
Objective: To review pathogenesis,
diagnostic approach and current trends
in the management of di use interstitial
lymphocytic syndrome.
Data source:  Literature review of
relevant published literature from both
Africa and the rest of the world.
Data synthesis: Pathologically, under
light microscopy, DILS resembles the
focal sialadenitis seen with Sjogren’s
syndrome, although it tends to be less
destructive of the glandular architecture
than in Sjogren’s syndrome. Most of the
in ammatory in ltrate is composed
of CD8+ lymphocytes unlike Sjogren’s
which are CD4+. Lymphoepithelial
cysts are frequently observed in the
parotid glands of patients with DILS.
The variation in CD8+ count in the
course of HIV disease is less understood.
The variation in CD8+ lymphocytes is
implicated in the pathogenesis of a
number of clinical manifestations in HIV
diseases including Di use In ltrative
Lymphocytic Syndrome (DILS) and
HIV associated CD8+ lymphocytosis
syndrome. Parotid gland enlargement
in a patient with HIV infection should prompt clinicians to suspect DILS. In addition, clinicians should be aware
that the pulmonary process associated
with DILS may mimic clinically and
radiographically the pneumonic process
caused by pneumocystis carinii. Other
manifestations of DILS to consider
include a severe form of peripheral
neuropathy; lymphocytic in ltration of
the liver, evident as hepatitis; myositis;
and lymphocytic interstitial nephritis.
Management of DILS is determined
by the severity of glandular and extra
glandular features. Data on therapeutic
trials are lacking although there are
isolated reports of good response to
antiretroviral and steroid therapy.
Conclusion: DILS, a subset of HIV
disease manifestation, may present as
parotid gland swellings. In general, an
HIV patient presenting with DILS has a
better prognosis than a patient with HIV
alone. With the high incidence of HIV
in our population it is likely that DILS is
under diagnosed probably due to our
ignorance of this disease. Awareness of
its various presentations may bring to
light undiscovered patients with DILS.
Clinicians should watch for the possible
transformation into B-cell lymphoma.
There is still paucity of data about
this disease from pathophysiology to
treatment to studies correlating the
plasma viral load with CD8+ lymphocyte
count in patients with HIV disease.

BACKGROUND: Diffuse infiltrative lymphocytosis syndrome (DILS) is characterised by a persistent CD8+ lymphocytosis and lymphocytic infiltration of various organs. The exact prevalence isn’t known but some studies have reported between 0.85 – 3%, and appears to be more common in African population. Patients with DILS tend to have higher CD4cell counts and survive longer than those patients without DILS. Most patients present with bilateral parotid gland enlargement and features of the Sicca syndrome. Common sites of extra glandular involvement are the lungs being the most common site, followed by peripheral neuropathy and liver. With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS.
OBJECTIVE: To review pathogenesis, diagnostic approach and current trends in the management of Diffuse interstitial lymphocytic syndrome
DATA SOURCE: Literature review of relevant published literature from both Africa and the rest of the world.
DATA SYNTHESIS:Pathologically, under light microscopy, DILS resembles the focal sialadenitis seen with Sjogren’s syndrome, although it tends to be less destructive of the glandular architecture than in Sjogren’s syndrome. Most of the inflammatory infiltrate is composed of CD8+ lymphocytes unlike Sjogren’s which are CD4+. Lymphoepithelial cysts are frequently observed in the parotid glands of patients with DILS. The variation in CD8 count in the course of HIV disease is less understood. The variation in CD8 lymphocytes is implicated in the pathogenesis of a number of clinical manifestations in HIV diseases including diffuse infiltrative lymphocytic syndrome (DILS) and HIV associated CD8+ lymphocytosis syndrome.Parotid gland enlargement in a patient with HIV infection should prompt clinicians to suspect DILS. In addition, clinicians should be aware that the pulmonary process associated with DILS may mimic clinically and radiographically the pneumonic process caused by Pneumocystis carinii. Other manifestations of DILS to consider include a severe form of peripheral neuropathy; lymphocytic infiltration of the liver, evident as hepatitis; myositis; and lymphocytic interstitial nephritis.Management of DILS is determined by the severity of glandular and extra glandularfeatures.Data on therapeutic trials are lacking although there are isolated reports of good response to antiretroviral and steroid therapy.

CONCLUSION: DILS, a subset of HIV disease manifestation, may present as parotid gland swellings. In general, an HIV patient presenting with DILS has a better prognosis than a patient with HIV alone.With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS. Clinicians should watch for the possible transformation into B-cell lymphoma. There is still paucity of data about this disease from pathophysiology to treatment to studies correlating the plasma viral load with CD8 lymphocyte count in patients with HIV disease.

BACKGROUND: Diffuse infiltrative lymphocytosis syndrome (DILS) is characterised by a persistent CD8+ lymphocytosis and lymphocytic infiltration of various organs. The exact prevalence isn’t known but some studies have reported between 0.85 – 3%, and appears to be more common in African population. Patients with DILS tend to have higher CD4cell counts and survive longer than those patients without DILS. Most patients present with bilateral parotid gland enlargement and features of the Sicca syndrome. Common sites of extra glandular involvement are the lungs being the most common site, followed by peripheral neuropathy and liver. With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS.
OBJECTIVE: To review pathogenesis, diagnostic approach and current trends in the management of Diffuse interstitial lymphocytic syndrome
DATA SOURCE: Literature review of relevant published literature from both Africa and the rest of the world.
DATA SYNTHESIS:Pathologically, under light microscopy, DILS resembles the focal sialadenitis seen with Sjogren’s syndrome, although it tends to be less destructive of the glandular architecture than in Sjogren’s syndrome. Most of the inflammatory infiltrate is composed of CD8+ lymphocytes unlike Sjogren’s which are CD4+. Lymphoepithelial cysts are frequently observed in the parotid glands of patients with DILS. The variation in CD8 count in the course of HIV disease is less understood. The variation in CD8 lymphocytes is implicated in the pathogenesis of a number of clinical manifestations in HIV diseases including diffuse infiltrative lymphocytic syndrome (DILS) and HIV associated CD8+ lymphocytosis syndrome.Parotid gland enlargement in a patient with HIV infection should prompt clinicians to suspect DILS. In addition, clinicians should be aware that the pulmonary process associated with DILS may mimic clinically and radiographically the pneumonic process caused by Pneumocystis carinii. Other manifestations of DILS to consider include a severe form of peripheral neuropathy; lymphocytic infiltration of the liver, evident as hepatitis; myositis; and lymphocytic interstitial nephritis.Management of DILS is determined by the severity of glandular and extra glandularfeatures.Data on therapeutic trials are lacking although there are isolated reports of good response to antiretroviral and steroid therapy.

CONCLUSION: DILS, a subset of HIV disease manifestation, may present as parotid gland swellings. In general, an HIV patient presenting with DILS has a better prognosis than a patient with HIV alone.With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS. Clinicians should watch for the possible transformation into B-cell lymphoma. There is still paucity of data about this disease from pathophysiology to treatment to studies correlating the plasma viral load with CD8 lymphocyte count in patients with HIV disease.

BACKGROUND: Diffuse infiltrative lymphocytosis syndrome (DILS) is characterised by a persistent CD8+ lymphocytosis and lymphocytic infiltration of various organs. The exact prevalence isn’t known but some studies have reported between 0.85 – 3%, and appears to be more common in African population. Patients with DILS tend to have higher CD4cell counts and survive longer than those patients without DILS. Most patients present with bilateral parotid gland enlargement and features of the Sicca syndrome. Common sites of extra glandular involvement are the lungs being the most common site, followed by peripheral neuropathy and liver. With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS.
OBJECTIVE: To review pathogenesis, diagnostic approach and current trends in the management of Diffuse interstitial lymphocytic syndrome
DATA SOURCE: Literature review of relevant published literature from both Africa and the rest of the world.
DATA SYNTHESIS:Pathologically, under light microscopy, DILS resembles the focal sialadenitis seen with Sjogren’s syndrome, although it tends to be less destructive of the glandular architecture than in Sjogren’s syndrome. Most of the inflammatory infiltrate is composed of CD8+ lymphocytes unlike Sjogren’s which are CD4+. Lymphoepithelial cysts are frequently observed in the parotid glands of patients with DILS. The variation in CD8 count in the course of HIV disease is less understood. The variation in CD8 lymphocytes is implicated in the pathogenesis of a number of clinical manifestations in HIV diseases including diffuse infiltrative lymphocytic syndrome (DILS) and HIV associated CD8+ lymphocytosis syndrome.Parotid gland enlargement in a patient with HIV infection should prompt clinicians to suspect DILS. In addition, clinicians should be aware that the pulmonary process associated with DILS may mimic clinically and radiographically the pneumonic process caused by Pneumocystis carinii. Other manifestations of DILS to consider include a severe form of peripheral neuropathy; lymphocytic infiltration of the liver, evident as hepatitis; myositis; and lymphocytic interstitial nephritis.Management of DILS is determined by the severity of glandular and extra glandularfeatures.Data on therapeutic trials are lacking although there are isolated reports of good response to antiretroviral and steroid therapy.

CONCLUSION: DILS, a subset of HIV disease manifestation, may present as parotid gland swellings. In general, an HIV patient presenting with DILS has a better prognosis than a patient with HIV alone.With the high incidence of HIV in our population it is likely that DILS is under diagnosed probably due to our ignorance of this disease. Awareness of its various presentations may bring to light undiscovered patients with DILS. Clinicians should watch for the possible transformation into B-cell lymphoma. There is still paucity of data about this disease from pathophysiology to treatment to studies correlating the plasma viral load with CD8 lymphocyte count in patients with HIV disease.

This article deals with participatory forest management (PFM) in Tanzania, Mozambique, and Laos, focusing on the degree to which the legislation supports local communities' security of rights to the forest resources and access to resource benefits, as well as the degree to which the legislation is implemented. The findings are that local communities' security of rights and access to benefits differ markedly among the three countries, whereas there is a striking similarity in the absence of efforts to implement PFM, in particular in areas with valuable timber resources. The underlying reasons for the differences are poor institutional setups and conflicting economic interests at various levels. We argue that the approach to support PFM should acknowledge differences between countries and areas, and that, under all conditions, assistance to communities in building advocacy organizations that can assert their legal rights and demand commitment of national governments is a fundamental prerequisite for success.

The purpose of the study was to develop an in-depth  understanding of reactions of 40 urban and rural HIV-infected Kenyan women to HIV diagnosis. We employed narrative inquiry principles to guide this qualitative cross-sectional study. We conducted individual in-depth interviews using open- ended questions in April and May 2006. In this article we focus on women

This article demonstrates that whistleblowing often receives little attention in public administration due to ambivalence regarding administrative roles held by public administrators, the fluid scalar chain and horizontal linkages, and competitive and intricate public, organisational and private interests. Drawing on comparative analysis to elucidate the broader scope of anti-corruption reforms and whistleblowing in public administration, the article explores the influence of the administrative culture on the relationship between whistleblowing behaviours and implementation of anti-corruption reforms in public administration in Kenya. It illustrates how bureaucratic oversight mechanisms such as internal auditing procedures and ethical guidelines tend to underperform where administrative environments largely feature autocratic bureaucratic authority, parochial management styles and centralised decision-making processes. Despite the functional specialty of public institutions, these cultural composites potentially elicit administrative behaviours that generally make whistleblowing anti-organisational, anti-social and an outright illegality in public administration. The absence of whistleblowing legislation or weak whistleblowing laws exacerbate these conditions. Whistleblowing becomes even more complex at the local-state level as social networks and working groups tend to be strengthened by the collectivist associational culture in public administration. Consequently, non-performance of anti-corruption reforms were found to stem from the collective chastisement of whistleblowing practices in public organisations in Kenya. Furthermore, institutional deficits typical in local-state administration seemingly made it riskier for potential whistleblowers to come forth, mainly attendant to loose and inconsistent legislation on corruption. Therefore, to enhance whistleblowing, there is a need to insulate potential whistleblowers from legal retaliation, including cultural retaliations that come in forms of emotional and professional ‘attacks’.

No abstract available.

In Kenya, trade policy reforms in the cereals sector were initiated as a key component of the economy-wide structural adjustment programmes (SAPs) during the mid 1980s. The SAPs were later strengthened and made irreversible by Kenya’s commitments at the multilateral trade negotiations. However, the welfare effects of these trade policy reforms remain controversial. This paper to quantifies the market and welfare impacts of trade liberalization in Kenya’s maize sector using a partial equilibrium model with market interrelationships at the farm, wholesale and retail levels. The model is calibrated to simulate a 24 percent reduction in maize import tariffs and a complete abolition of tariffs. The simulations results suggest that tariff reductions yield price decreases across the three market levels. The declining prices increase maize consumption but reduce domestic production. Consequently, consumer surplus increases while producer surplus decreases. However, the gain in consumer surplus is not sufficient to compensate the loss in producer surplus. Thus, the implementation of the multilateral agricultural trade agreement is likely to leave Kenya’s maize sector worse off and cannot be considered as a viable policy based on the compensation principle.

In recent years, Internet connectivity has greatly improved across the African continent. This article examines the consequences that this shift has had for East African firms that are part of global value chains (GVCs). Prior work yielded contradictory expectations: firms might benefit from connectivity through increased efficiencies and improved access to markets, although they might also be further marginalized through increasing control of lead firms. Drawing on extensive qualitative research in Kenya and Rwanda,including 264 interviews, we examine 3 sectors (tea, tourism, and business process outsourcing) exploring overarching, cross-cutting themes. The findings support more pessimistic expectations: small African producers are only thinly digitally integrated in GVCs. Moreover, shifting modes of value chain governance, supported by lead firms and facilitated by digital information platforms and data standards are leading to new challenges for firms looking to digitally integrate. Nevertheless, we also find examples in these sectors of opportunities where small firms are able to cater to emerging niche customers, and local or regional markets. Overall, the study shows that improving connectivity does not inherently benefit African firms in GVCs without support for complementary capacity and competitive advantages.

Kenya, like many developing nations, continues to experience high childhood mortality in spite of the many efforts put in place by governments and international bodies to curb it. This study sought to investigate the barriers to accessing healthcare services for children aged less than five years in Butere District, a rural district experiencing high rates of mortality and morbidity despite having relatively better conditions for child survival. Methods: Exit interviews were conducted among caregivers seeking healthcare for their children in mid 2007 in all the 6 public health facilities. Additionally, views from caregivers in the community, health workers and district health managers were sought through focus group discussions (FGDs) and key informant interviews (KIs). Results: Three hundred and ninety-seven respondents were surveyed in exit interviews while 45 respondents participated in FGDs and KIs. Some practices by caregivers including early onset of child bearing, early supplementation, and utilization of traditional healers were thought to increase the risk of mortality and morbidity, although reported rates of mosquito net utilization and immunization coverage were high. The healthcare system posed barriers to access of healthcare for the under fives, through long waiting time, lack of drugs and poor services, incompetence and perceived poor attitudes of the health workers. FGDs also revealed wide-spread concerns and misconceptions about health care among the caregivers. Conclusion: Caregivers’ actions were thought to influence children’s progression to illness or health while the healthcare delivery system posed recurrent barriers to the accessing of healthcare for the under-fives. Actions on both fronts are necessary to reduce childhood mortality

Kenya, like many developing nations, continues to experience high childhood mortality in spite of the many efforts put in place by governments and international bodies to curb it. This study sought to investigate the barriers to accessing healthcare services for children aged less than five years in Butere District, a rural district experiencing high rates of mortality and morbidity despite having relatively better conditions for child survival. Methods: Exit interviews were conducted among caregivers seeking healthcare for their children in mid 2007 in all the 6 public health facilities. Additionally, views from caregivers in the community, health workers and district health managers were sought through focus group discussions (FGDs) and key informant interviews (KIs). Results: Three hundred and ninety-seven respondents were surveyed in exit interviews while 45 respondents participated in FGDs and KIs. Some practices by caregivers including early onset of child bearing, early supplementation, and utilization of traditional healers were thought to increase the risk of mortality and morbidity, although reported rates of mosquito net utilization and immunization coverage were high. The healthcare system posed barriers to access of healthcare for the under fives, through long waiting time, lack of drugs and poor services, incompetence and perceived poor attitudes of the health workers. FGDs also revealed wide-spread concerns and misconceptions about health care among the caregivers. Conclusion: Caregivers’ actions were thought to influence children’s progression to illness or health while the healthcare delivery system posed recurrent barriers to the accessing of healthcare for the under-fives. Actions on both fronts are necessary to reduce childhood mortality

In Sub Saharan Africa, surgical conditions account for a significant disease burden. Surgical workforce is however inadequate, and thus strategies such as attracting medical students to surgical specialties could avert the situation. This study determined the proportion of students interested in pursuing surgical career and factors that influence choice of this specialty. Although surgery is the most preferred specialty among medical students at the University of Nairobi, there appears to be a declining interest among the clinical students. In order to attract and maintain student interest in the specialty, there is need for early and active mentoring.

Abstract An influenza pandemic caused by a novel influenza virus A(H1N1)pdm09 spread worldwide in 2009 and is estimated to have caused between 151,700 and 575,400 deaths globally. While whole genome data on new virus enables a deeper insight in the pathogenesis, epidemiology, and drug sensitivities of the circulating viruses, there are relatively limited complete genetic sequences available for this virus from African countries. We describe herein the full genome analysis of influenza A(H1N1)pdm09 viruses isolated in Kenya between June 2009 and August 2010. A total of 40 influenza A(H1N1)pdm09 viruses isolated during the pandemic were selected. The segments from each isolate were amplified and directly sequenced. The resulting sequences of individual gene segments were concatenated and used for subsequent analysis. These were used to infer phylogenetic relationships and also to reconstruct the time of most recent ancestor, time of introduction into the country, rates of substitution and to estimate a time-resolved phylogeny. The Kenyan complete genome sequences clustered with globally distributed clade 2 and clade 7 sequences but local clade 2 viruses did not circulate beyond the introductory foci while clade 7 viruses disseminated country wide. The time of the most recent common ancestor was estimated between April and June 2009, and distinct clusters circulated during the pandemic. The complete genome had an estimated rate of nucleotide substitution of 4.9 × 10− 3 substitutions/site/year and greater diversity in surface expressed proteins was observed. We show that two clades of influenza A(H1N1)pdm09 virus were introduced into Kenya from the \{UK\} and the pandemic was sustained as a result of importations. Several closely related but distinct clusters co-circulated locally during the peak pandemic phase but only one cluster dominated in the late phase of the pandemic suggesting that it possessed greater adaptability.

The bacteriophage population is large, dynamic, ancient, and genetically diverse. Limited genomic information shows that phage genomes are mosaic, and the genetic architecture of phage populations remains ill-defined. To understand the population structure of phages infecting a single host strain, we isolated, sequenced, and compared 627 phages of Mycobacterium smegmatis. Their genetic diversity is considerable, and there are 28 distinct genomic types (clusters) with related nucleotide sequences. However, amino acid sequence comparisons show pervasive genomic mosaicism, and quantification of inter-cluster and intra-cluster relatedness reveals a continuum of genetic diversity, albeit with uneven representation of different phages. Furthermore, rarefaction analysis shows that the mycobacteriophage population is not closed, and there is a constant influx of genes from other sources. Phage isolation and analysis was performed by a large consortium of academic institutions, illustrating the substantial benefits of a disseminated, structured program involving large numbers of freshman undergraduates in scientific discovery.

Despite the focus on the importance of trees in Africa and the many projects that try to improve their management, there is very little research and few development projects which address tree related problems in a holistic manner. With respect to forest management arrangements, focus tends to be either exclusively on community forestry, or on private tree planting. Such a divided focus makes it difficult to understand the complementarities and possible synergetic effects of these two approaches in solving common problems and improving local livelihoods. The present article argues that interdisciplinary projects are needed to develop a holistic approach to tree management and to improve the use of trees. This argument builds on the results from the PETREA (People, Trees and Agriculture) research programme in Majawanga (Gairo, Tanzania). In this village, private and collective tree management is characterized by very different uses, opportunities and problems. Common woodlands play an important role in providing villagers with Non-Timber Forest Products (NTFP) from indigenous species that are important for local livelihoods as they provide food, medicine, and grazing areas. The constraints linked to the management of common woodlands pertain to group dynamics and resemble, at first glance, a “tragedy of the commons” as described by Hardin (1968). Private tree planting, on the other hand, provides both local services (including providing fruits, firewood or securing boundaries between fields) and cash from the selling of poles. The constraints characterizing private tree management are linked to land-tenure, tree seedling cost and season for planting. Land tenure is of paramount importance as trees cannot be planted on borrowed or rented land, or at the expense of cropland needed to sustain the household. The season for planting seedlings is a constraint because of a conflict with labour demands for crops needed to survive. Despite being characterized by very different uses and constraints, the management of private and common trees also share common constraints as both require that grazing is under control and that there exist clear rules and efficient institutions able to solve management conflicts. Both types of management should therefore be analyzed together as improving one can help relieve the pressure on the other.

Why do many smallholder farmers fail to adopt improved land management practices which can improve yields and incomes? The reason is not always because these practices are uneconomical but sometimes it is because resource poverty prevents farmers from taking advantage of yield and income enhancing agricultural practices. In this study we examine the relative merits of using a carbon payment scheme compared to a subsidy policy to help reduce the cost of specific land management practices with productivity and ecosystem benefits such as carbon sequestration. Using a 30-year crop simulation model, we examine the impacts of different soil fertility management treatments (SFTs) on yields and soil carbon and proceed to compute discounted incremental revenue streams over the same period. We find that the SFTs simulated are on average profitable given the conditions assumed in our DSSAT simulations. When carbon was priced at $8 or $12/t CO2e, the increase in incremental incomes generated from a carbon payment were invariably higher than those imputed from a 50% fertilizer subsidy. When carbon was priced at $4/Co2e, the increase was almost similar and sometimes higher than that from the imputed income transfer from a 50% subsidy. If these indications hold in further research, it could imply that using fertilizer subsidies as the sole mechanism for stimulating adoption of improved soil fertility management practices may unnecessarily forgo other complementary and possibly superior alternatives. Depending on the specific economic equity considerations, we conclude that either of these instruments can be used to help farmers break through resource barriers that prevent them from adopting productivity-enhancing and environmentally beneficial agricultural practices. However, given the fiscal burden on public finances and possible opportunity costs of any substantial subsidy program, it is possible that a carbon payment system can be a reasonable alternative assuming the range of carbon prices used in this study and especially if accompanied by measures to ameliorate the costs of fertilizer to farmers.

Resistance to the antifolate sulfadoxine–pyrimethamine (SP), the current mass-treatment antimalarial drug, is associated with selection of point mutations in dihydrofolate reductase and dihydropteroate synthase. Among these mutations, the leucine 164 dihydrofolate reductase mutation (Leu-164) is associated with higher levels of SP resistance; this mutation is also associated with a decrease in the efficacy of chlorproguanil/dapsone, a newly developed antifolate antimalarial drug. Leu-164 has been detected in Southeast Asia and South America, regions where SP is no longer effective. Surprisingly, this mutation has not yet been detected in Africa, using the standard protocol based on PCR–RFLP, despite high SP resistance. In this paper, we discuss briefly the reasons why Leu-164 has not yet been selected in Africa and we propose a means that may slow down the selection of this mutation.

45 Kenyan traditional healers were interviewed with respect to the diagnosis and treatment of eye diseases. Traditional management of eye diseases is based on the healers' concept of the disease causation as well as their knowledge of the herbal, animal and chemical substances that possess (or are reported to possess) remedial effect on the disease. While many of the healers interviewed failed to give a clear distinction between the various eye conditions, diseases such as cataract, foreign bodies and injuries were recognized easily. In almost all cases the medicinal substances were first diluted in water before they were applied to the eyes. Human milk, blood and the white of the egg were the animal substances listed as medicinal to various eye conditions. A solution of sugar was one of the chemical substances used in the treatment of specific eye conditions. Given correct information, some of these healers could f

Nature, through balancing mechanisms, provides ecosystem services, comprising provisioning, regulating, cultural and supporting services for the survival of mankind (MEA, Ecosystems and human well-being: biodiversity synthesis. World Resources Institute, Washington, DC, 2005). The balance and stability is usually upset by interventions or development activities, thereby threatening survival. Maintaining the balance guarantees sustainable development. Pests and disease regulation provides one component of managing the ecosystem. This chapter highlights why pest and disease regulation is important in contributing to sustainable agricultural production and development. Continued multidisciplinary research efforts are needed to enable understanding of the biological interactions between pests, beneficial and host communities on one hand and the interactions between and among cost-effective pest management methods, soil health, climate change, food security and human well-being on the other hand. The holistic approach in developing the understanding of the role of pest and disease regulation in the ecosystem will ultimately contribute to the development of appropriate strategies for the achievement of human well-being

Despite abundant literature on the social and economic benefits of encouraging tiny "informal" firms, scholars generally agree that larger enterprises create more unskilled jobs, use resources more efficiently, and are better at building technological capacity. Yet majority of firms will never grow beyond six workers. This paper argues that one very significant reason why small firms stay small is risk. In Nairobi, the economic and social consequences of business failure are extremely high. Entrepreneurs therefore to protect themselves from failure and, in the process, ensure that their firms remain small. Our research identified four risk-management strategies that work separately and together to discourage firm growth.• First, many entrepreneurs manage risk through flexibility. By working in rent-free quarters, using family labour and little capital, they minimise fixed costs and maximise opportunities for additional income. Second, many small manufacturers also avoid risk by manufacturing standard products for a known market. Third, successful entrepreneurs frequently diversify their income and assetsrather than expanding a single enterprise. Finally, most prefer to preserve their land and other assets unencumbered by debt. These rational responses to a risky 90 business environment ensure that most firms stay small and in the process work against formation of a dynamic manufacturing sector. Policy-makers are challenged to improve the "enabling environment" creating broad policies conducive to firm growth and by targeting specific policies and programmes to small-scale industry. Kenya needs macroeconomic and social policies that indirectly encourage firm growth by removing or reducing business and background risks. It also needs an industrial policy that provides positive incentives for enterprising business owners willing to expand employment, improve efficiency, and upgrade technology and their workers skills

The influence of climatic, policy and institutional-related (infrastructure, technology, institutional support) factors on the decline in maize output and yields and the subsequent deepening and broadening of food poverty in Kenya is discussed. This chapter provides lessons to enable a re-focusing of attention on ways to achieve sustainable investment in agriculture in order to improve the livelihoods of the majority of households in Kenya.

The influence of climatic, policy and institutional-related (infrastructure, technology, institutional support) factors on the decline in maize output and yields and the subsequent deepening and broadening of food poverty in Kenya is discussed. This chapter provides lessons to enable a re-focusing of attention on ways to achieve sustainable investment in agriculture in order to improve the livelihoods of the majority of households in Kenya.

In order for organisations to generate competitive advantages from big data investments, they need to acquire a unique blend of technology, human skills, financial resources and a data-driven culture. Organisations need to measure their big data analytics capability in order to yield competitive performance. This study sought to examine the relationship between a firms big data analytics capability (BDAC) and competitive performance through mediating role of dynamic and operational capabilities. To test the proposed research model, we used survey data from 110 employees across 54 insurance companies in Kenya. Using partial least squares structural equation modelling, the results provide evidence that BDAC leads to superior firm performance. Various resources that form big data analytics (BDA) capability have been identified and an instrument to measure BDAC proposed. The findings from this study provides a roadmap strategy for implementing BDA projects.

Nutrient value assessments and ethnobotanical studies of three wild edible fruit species [Ziziphus spina-christi (L.) Desf., Balanites aegyptiaca (L.) Del., Grewia flavescens A. Juss.], were carried out from October 2009 through June 2010 in east Shewa Zone, Ethiopia. Field data collection was combined with laboratory food content analyses with the aim of identifying promising wild edible fruit plants. Also, optimal use of preferred wild edibles particularly in addressing future food security issues of rural people in the drylands was assessed. Composite fruit samples randomly collected in six sites of Fantalle and Boosast districts were subjected to standard laboratory chemical analyses. Values for total carbohydrates, crude protein, crude lipid, moisture and total ash contents of the fruit pulps ranged from 76.67-86.12%, 1.45-4.20%, 3.58-4.02%, 35.18-57.41%, 8.11-16.40% for Z. spina-christi, 85.55-89.61%, 0.001-003, 49.03-68.26%, 10.18-12.88% for B. aegyptiaca; 83.74-93.68%, 0.64-3.14%, 18.90-61.35%, 3.16-7.25% for G. flavescens, respectively. The calculated energy (based on total carbohydrates) was highest for G. flavescens (373.6 Kcal/100 g), followed by B. aegyptiaca (354.24) and Z. spina-christi (344.48 Kcal/100 g). The results indicated that these fruit species, which are popularly used by the local communities, contain appreciable amounts of nutrients and energy and thus are useful food supplements. These species should be integrated into dryland agroforestry systems for sustainable use and conservation, as well as, preservation of the associated knowledge through the positive practice of the indigenous bio-cultural knowledge. In this case, lessons can be drawn from some farmers of Boosat District, who are currently using two of the species in traditional agroforestry practices.

The co-management approach of managing natural resources has increasingly become popular among conservationists and development practitioners since it overcomes the shortcomings of both the centralised management and community-based approaches that hinder harmonization of conflicting interests among diverse stakeholder groups. Considering criteria developed from theoretical advancements on co-management and drawing on empirical studies conducted in Kenya, the paper examines how successful the co-management approach has been in terms of meeting the needs and interests of local communities and conservationists. Further, it analyses some of the factors or conditions that contribute towards the emergence and subsequent adoption of the co-management approach in the conservation and management of wildlife. These factors, which may also be important in other developing countries, include the provision of a favourable policy framework, institutional capacity of organized user groups to co-manage wildlife resources, land tenure conditions and accessibility to wildlife resources. It is emphasised that the co-management approach has had, so far, mixed results and there are certain important factors challenging its successful implementation in Kenya.

The earliest records of the particular affinity for wildlife that existed amongst Laikipia’s people date back to the mid 1920’s in the minutes of Laikipia Farmers’ Committee meetings. During that time, large tracts of Kenya, including the Central highlands, Kisii highlands and the Lake Victoria basin were teeming with wildlife. The above areas and much of Kenya lost all their wildlife, other than those which came under state protection in National Parks. Laikipia is one of the most notable exceptions to this trend. This conservation ethic preceded the Laikipia Wildlife Forum, so ours has just been an attempt to give it some structure, hence the Laikipia Wildlife Conservation Strategy. It has now come to be, and with it we hope to open a new era in practice and study of wildlife conservation. I would like to acknowledge the efforts made by Dr. Max Graham and the conservation committee in compiling and synthesizing all the views and information needed in such a strategy. The Laikipia Wildlife Forum does not expect this document to be a prescription of how we are going to preserve wildlife in Laikipia, but a guideline on the issues that will form a basis for the conservation partnerships we must forge for the future of people and wildlife in Laikipia County. Laikipia’s wildlife has always been a challenge, a source of pride, and asset to many people at many levels. However, since this wildlife lives in and amongst people, the context of conservation in Laikipia is wider than what is generally acknowledged. It involves a constant state of negotiations over multiple aspects, including pasture sharing, water sharing, use of forests, crop damage, livestock loss, and security. Over 60% of the issues to be dealt with do not involve any direct dealings with wild animals- they are issues that arise amongst people. The implementation of this strategy therefore will be a process of managing partnerships with ranchers, farmers, law enforcement officers, water users, tourism businesses, scientists and others. Laikipia is changing rapidly, with a high rate of settlement, housing development and land subdivision, forcing people and wildlife into adjustments to meet the reduced availability of resources. The Laikipia Wildlife Forum now faces the task of implementing this strategy. Through this process, we expect that valuable lessons will be learnt by all, resulting in a more cohesive society, environmentally responsible population, secure in their pursuits of various livelihoods. This is the reason why we regard this document as a guideline. It will necessarily evolve as it is implemented, because a static tool cannot ‘repair’ a dynamic problem.

The latest edition of Williams Textbook of Endocrinology edited by Drs. Shlomo Melmed, Kenneth S. Polonsky, P. Reed Larsen, and Henry M. Kronenberg, helps you diagnose and treat your patients effectively with up-to-the minute, practical know-how on all endocrine system disorders. Comprehensive yet accessible, this extensively revised 12th Edition updates you on diabetes, metabolic syndrome, obesity, thyroid disease, testicular disorders, and much more so you can provide your patients with the most successful treatments. Find scientific insight and clinical data interwoven in every chapter, reflecting advances in both areas of this constantly changing discipline, and presented in a truly accessible format. You’ll also access valuable contributions from a dynamic list of expert authors and nearly 2.000 full-color images to help you with every diagnosis. This title has everything you need to manage any and all the clinical endocrinopathies you may encounter. Rely on the one reference that integrates rapidly evolving basic and clinical science in a cohesive, user-friendly format, definitively addresses every topic in the field, and has remained a standard for more than half a century.Update your know-how and skills to diagnose and treat your patients most effectively with exhaustively revised content on diabetes, metabolic disease, thyroid cancer, fertility problems, testicular problems, weight issues, and much more. Apply reliable guidance on endocrine conditions of growing interest like hypothyroidism and testicular disorders, with dedicated new chapters that expound on the latest research findings. Overcome any clinical challenge with comprehensive and easy-to-use coverage of everything from hormone activity, diagnostic techniques, imaging modalities, and molecular genetics, to total care of the patient. Apply the latest practices with guidance from expert authors who contribute fresh perspectives on every topic.

Antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) have demonstrated efficacy as new human immunodeficiency virus-1 (HIV-1) prevention approaches for HIV-1 serodiscordant couples. METHODS: Among Kenyan HIV-1 serodiscordant heterosexual couples participating in a clinical trial of PrEP, we conducted a cross-sectional study and used descriptive statistical methods to explore couples' willingness to use antiretrovirals for HIV-1 prevention. The study was conducted before July 2011, when studies among heterosexual populations reported that ART and PrEP reduced HIV-1 risk. RESULTS: For 181 couples in which the HIV-1-infected partner had a CD4 count ≥350 cells per microliter and had not yet initiated ART (and thus did not qualify for ART under Kenyan guidelines), 60.2% of HIV-1 infected partners (69.4% of men and 57.9% of women) were willing to use early ART (at CD4 ≥350 cells per microliter) for HIV-1 prevention. Among HIV-1 uninfected partners, 92.7% (93.8% of men and 86.1% of women) reported willingness to use PrEP. When given a hypothetical choice of early ART or PrEP for HIV-1 prevention, 52.5% of HIV-1-infected participants would prefer to initiate ART early and 56.9% of HIV-1-uninfected participants would prefer to use PrEP. CONCLUSIONS: Nearly 40% of Kenyan HIV-1-infected individuals in known HIV-1 serodiscordant partnerships reported reservations about early ART initiation for HIV-1 prevention. PrEP interest in this PrEP-experienced population was high. Strategies to achieve high uptake and sustained adherence to ART and PrEP for HIV-1 prevention in HIV-1 serodiscordant couples will require responding to couples' preferences for prevention strategies.

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Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products.
This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.

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Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products.
This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.

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Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products.
This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.

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Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products.
This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.

Colonial policy makers argued that they were  bringing civilization and better standards of living to Africans.  One perceived problem they had to contend with  was the “ignorance” of their subject peoples.  In health delivery, in particular, colonial administrators believed that ignorance accounted for the poor levels of health among Africans, and that knowledge and that knowledge and other preventive measures would greatly enhance standards of living, for instance, among urban Africans. In this paper we test this philosophy against colonial urban health policy’s and show that racism in the delivery of services  greatly undermined African and Asian health in order to afford  high quality services for Europeans in Nairobi.

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Products of gene modification have vast implications. Creating public awareness and disseminating information on the subject seeks to demystify some of the widely held falsehoods regarding genetically modified products.
This is an informative, thorough and easy to understand guidebook that aims to enlighten and debunk some of the commonly held misconceptions on products of gene modification and to give the reader a better understanding of the role genetic modification will play. The review sheds light on the safety, and application of these products in medicine, the food industry and other areas, especially those where genetic modification may represent a cheap, faster, credible, viable alternative in achieving sustainable development among resource-poor communities.