High blood pressure in Sub-Saharan Africa: why prevention, detection, and control are urgent and important

In 2010, hypertension in Sub-Saharan Africa was theleading risk for death, incr easing by 67% since 1990.Hypertension was estimated to cause more than500,000 deaths and 10 million years of life lost in2010 in Sub-Saharan Africa. It was also the sixthleading risk for disability (contributing to more than 11million disability-adjusted life years).3In Sub-Saharan Africa, stroke, the major clinical outcome of uncon-trolled hypertension, has increased 46% since 1990 tobecome the fifth leading risk for death.

Clinico-Pathological discrepancies in the Diagnosis of Causes of Maternal Death in Sub-Saharan Africa: Retrospective Analysis

Background Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. Methods and Findings A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n ¼ 139) during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death). Major diagnostic errors were detected in 56 (40.3%) maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%), pyogenic bronchopneumonia (35.3%), pyogenic meningitis (40.0%), and puerperal septicemia (50.0%). Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%). Conclusions Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality.

Clinico-Pathological discrepancies in the Diagnosis of Causes of Maternal Death in Sub-Saharan Africa: Retrospective Analysis

Background Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies. Clinical diagnostic errors may play a significant role in this problem and might also have major implications for the evaluation of current estimations of causes of maternal death. Methods and Findings A retrospective analysis of clinico-pathologic correlation was carried out, using necropsy as the gold standard for diagnosis. All maternal autopsies (n ¼ 139) during the period from October 2002 to December 2004 at the Maputo Central Hospital, Mozambique were included and major diagnostic discrepancies were analyzed (i.e., those involving the cause of death). Major diagnostic errors were detected in 56 (40.3%) maternal deaths. A high rate of false negative diagnoses was observed for infectious diseases, which showed sensitivities under 50%: HIV/AIDS-related conditions (33.3%), pyogenic bronchopneumonia (35.3%), pyogenic meningitis (40.0%), and puerperal septicemia (50.0%). Eclampsia, was the main source of false positive diagnoses, showing a low predictive positive value (42.9%). Conclusions Clinico-pathological discrepancies may have a significant impact on maternal mortality in sub-Saharan Africa and question the validity of reports based on clinical data or verbal autopsies. Increasing clinical awareness of the impact of obstetric and nonobstetric infections with their inclusion in the differential diagnosis, together with a thorough evaluation of cases clinically thought to be eclampsia, could have a significant impact on the reduction of maternal mortality.

Stable isotopes unveil habitat partitioning among the marine mammals off NW Africa and reveal unique trophic niches for two globally threatened species.

Stable isotope abundances of carbon (δ13C) and nitrogen (δ15N) in the bone of 13 species of marine mammals from the northwest coast of Africa were investigated to assess their positions in the local trophic web and their preferred habitats. Also, samples of primary producers and potential prey species from the study area were collected to characterise the local isotopic landscape. This characterisation indicated that δ13C values increased from offshore to nearshore and that δ15N was a good proxy for trophic level. Therefore, the most coastal species were Monachus monachus and Sousa teuszii, whereas the most pelagic were Physeter macrocephalus and Balaenoptera acutorostrata. δ15N values indicated that marine mammals located at the lowest trophic level were B. acutorostrata, Stenella coeruleoalba and Delphinus sp., and those occupying the highest trophic level were M. monachus and P. macrocephalus. The trophic level of Orcinus orca was similar to that of M. monachus, suggesting that O. orca preys on fish. Conservation of coastal and threatened species (M. monachus and S. teuszii) off NW Africa should be a priority because these species, as the main apex predators, cannot be replaced by other marine mammals.

Farmer-Managed Natural Regeneration Enhances Rural Livelihoods in Dryland West Africa

Declining agricultural productivity, land clearance and climate change are compounding the vulnerability of already marginal rural populations in West Africa. 'Farmer-Managed Natural Regeneration' (FMNR) is an approach to arable land restoration and reforestation that seeks to reconcile sustained food production, conservation of soils and protection of biodiversity. It involves selecting and protecting the most vigorous stems regrowing from live stumps of felled trees, pruning off all other stems, and pollarding the chosen stems to grow into straight trunks. Despite widespread enthusiasm and application of FMNR by environmental management and development projects, to date, no research has provided a measure of the aggregate livelihood impact of community adoption of FMNR. This paper places FMNR in the context of other agroforestry initiatives, then seeks to quantify the value of livelihood outcomes of FMNR. We review published and unpublished evidence about the impacts of FMNR, and present a new case study that addresses gaps in the evidence base. The case study focuses on a FMNR project in the district of Talensi in the semi-arid Upper East Region in Ghana. The case study employs a Social Return on Investment (SROI) analysis, which identifies proxy financial values for non-economic as well as economic benefits. The results demonstrate income and agricultural benefits, but also show that asset creation, increased consumption of wild resources, health improvements and psycho-social benefits created more value in FMNR-adopting households during the period of the study than increases in income and agricultural yields.

Research and training in medicinal chemistry in south and central american countries and sub-saharan Africa

With the proposal to search for universal cooperation in the field of Medicinal Chemistry, the IUPAC group has elaborated a line of work divided into two phases: a- An Awareness of the true situation of Medicinal Chemistry in the different geographic areas of the world; b- A proposal of actions as to achieve more effective cooperation. This first report presents and discusses the actual situation in South and Central America as well as in sub-Saharan Africa.

Cultural Diffusion Was the Main Driving Mechanism of the Neolithic Transition in Southern Africa

It is well known that the Neolithic transition spread across Europe at a speed of about 1 km/yr. This result has been previously interpreted as a range expansion of the Neolithic driven mainly by demic diffusion (whereas cultural diffusion played a secondary role). However, a long-standing problem is whether this value (1 km/yr) and its interpretation (mainly demic diffusion) are characteristic only of Europe or universal (i.e. intrinsic features of Neolithic transitions all over the world). So far Neolithic spread rates outside Europe have been barely measured, and Neolithic spread rates substantially faster than 1 km/yr have not been previously reported. Here we show that the transition from hunting and gathering into herding in southern Africa spread at a rate of about 2.4 km/yr, i.e. about twice faster than the European Neolithic transition. Thus the value 1 km/yr is not a universal feature of Neolithic transitions in the world. Resorting to a recent demic-cultural wave-of-advance model, we also find that the main mechanism at work in the southern African Neolithic spread was cultural diffusion (whereas demic diffusion played a secondary role). This is in sharp contrast to the European Neolithic. Our results further suggest that Neolithic spread rates could be mainly driven by cultural diffusion in cases where the final state of this transition is herding/pastoralism (such as in southern Africa) rather than farming and stockbreeding (as in Europe)

Mobile technology, gender and development in Africa, India and Bangladesh

Presenting

A long way to the rainbow country : understanding the foreign market expansion process of Finnish corporations into the Republic of South Africa between 1999 and 2005

De afrikanska ekonomierna växer med nära fyra procent per år och detta är en god indikation på kontinentens växande betydelse. Under kalla kriget hade afrikanska regeringar haft ett begränsat utrymme för opportunistisk köpslående, och därmed även en marginal att positionera sig strategiskt. Alltför ofta uppmuntrade och beskyddade stormakterna diktatorer och små lokala eliter som främst ville berika sig själv. I och med att globaliseringen tog fart och USA allt mera kom att dominera globalt, började en ny era i fråga om förändringar. Trots dessa förändringar på den globala arenan, har Afrika som kontinent hamnat i bakgrunden och jämfört med andra utvecklingsländer har Afrika attraherat ett fåtal utländska investeringar. Fortfarande, speciellt i Norden, finns det lite kunskap om hur utländska företag expanderar sin affärsverksamhet på den afrikanska kontinenten. Det råder brist på empiriska undersökningar om vilken inverkan afrikanska institutionella förändringar och lokala affärsmiljöer har på internationaliseringen och på de utländska företagens affärsutvecklingsstrategier på den afrikanska kontinenten. Med denna avhandling vill jag lyfta fram ett exempel på ett land (Sydafrika), som har lyckat dra nytta av de förändringar som 1990-talet förde med sig. I denna avhandling har jag intervjuat olika personer i ledande positioner inom olika finländska företag i Finland och i Sydafrika. Avhandlingen skapar en referensram för att öka förståelse och fördjupa analys av hur en kombination av olika interna och externa resurser ökar företagens konkurrenskraft och på det sättet bidrar till en framgångsrik affärsutveckling i Afrika. De politiska och sociala aktörerna samt aktörerna inom affärslivet besitter resurser som ambitiösa företag kan dra nytta av i sin strävan att erövra de nya framgångsrika marknaderna i Afrika. Gradvis ökar finländska företag sina insatser på den afrikanska kontinenten i strävan att skapa mervärde för sina kunder. Den värdeskapande processen gör att parterna måste närma sig varandra utgående från sina egna strategiska målsättningar. Hittills har finländska företag varit intresserad att sälja till Afrika men inte intresserad att köpa därifrån. Förutom de praktiska råden till olika företag, föreslår avhandlingen hur den finska staten och den sydafrikanska staten kunde agera tillsammans för att främja ömsesidigt handelsutbyte.

Travels in various countries of Europe, Asia and Africa : Part the third : Scandinavia : Section the second : by Edward Daniel Clarke.

Digital reproduction, The National Library of Finland, Centre for Preservation and Digitisation, Mikkeli