Humans, dogs and parasitic zoonoses - Unravelling the relationships in a remote endemic community in Northeast India using molecular tools

Canine parasitic zoonoses pose a continuing public health problem, especially in developing countries and communities that are socioeconomically disadvantaged. Our study combined the use of conventional and molecular epidemic, logical tools to determine the role of dogs in transmission of gastrointestinal (GI) parasites such as hookworms, Giardia and Ascaris in a parasite endemic teagrowing community in northeast India. A highly sensitive and specific molecular tool was developed to detect and differentiate the zoonotic species of canine hookworm eggs directly from faeces. This allowed epidemiological screening of canine hookworm species in this community to be conducted with ease and accuracy. The zoonotic potential of canine Giardia was also investigated by characterising Giardia duodenalis recovered from humans and dogs living in the same locality and households at three different loci. Phylogenetic and epidemiological analysis provided compelling evidence to support the zoonotic transmission of canine Giardia. Molecular tools were also used to identify the species of Ascaris egg present in over 30% of dog faecal samples. The results demonstrated the role of dogs as a significant disseminator and environmental contaminator of Ascaris lumbricoides in communities where promiscuous defecation practices exist. Our study demonstrated the usefulness of combining conventional and molecular parasitological and epidemiological tools to help solve unresolved relationships with regards to parasitic zoonoses.

Ten-year risk of first recurrent stroke and disability after first-ever stroke in the Perth Community Stroke Study

Background and Purpose-Limited information exists on the long-term prognosis after first-ever stroke. We aimed to determine the absolute frequency of first recurrent stroke and disability and the relative frequency of recurrent stroke over 10 years after first-ever stroke in Perth, Western Australia. Methods-For a 12-month period beginning February 1989, all individuals with suspected acute stroke or transient ischemic attack who lived in a geographically defined and representative region of Perth were registered prospectively. Patients with a definite first-ever stroke were followed up 10 years after the index event. Results-Over 10 years of follow-up, the cumulative risk of a first recurrent stroke was 43% (95% confidence interval [CI], 34 to 51). After the first year after first-ever stroke, the average annual risk of recurrent stroke was approximate to4%. Case fatality at 30 days after first recurrent stroke was 41%, which was significantly greater than the case fatality at 30 days after first-ever stroke (22%) (P=0.003). For 30-day survivors of first-ever stroke, the 10-year cumulative risk of death or new institutionalization was 79% (95% CI, 73 to 85) and of death or new disability was 87% (95% CI, 81 to 92). Conclusions-Over 10 years of follow-up, the risk of first recurrent stroke is 6 times greater than the risk of first-ever stroke in the general population of the same age and sex, almost one half of survivors remain disabled, and one seventh require institutional care. Effective strategies for prevention of stroke need to be implemented early, monitored frequently, and maintained long term after first-ever stroke.

Patents and the CGIAR system of International Agricultural Research Centres' germplasm collections under the International Treaty on Plant Genetic Resources for Food and Agriculture

A key controversy in negotiating the International Treaty on Plant Genetic Resources for Food and Agriculture, and the likely long-term effectiveness of the agreement, is the way in which the intellectual property provisions are interpreted and applied to the key genetic resources forming the Consultative Group on International Agricultural Research (CGIAR) system of International Agricultural Research Centres' (IARC) collections. This paper reviews the intellectual property provisions in the treaty and examines the likely consequences from patenting under the Patents Act 1990 over materials derived from these collections. The consequence is argued to be significant and, over time, these practices are likely to deplete the usefulness of these collections and undermine the relevance of the treaty. The paper concludes that Australia's interests might best be served by arguing that access to these collections, and the other materials under the treaty, be subject to a non-exclusive, royalty free licence for any use of the derived materials to develop useful new plant varieties.

Epidemiological and molecular evidence supports the zoonotic transmission of Glardia among humans and dogs living in the same community

Giardia duodenalis isolates recovered from humans and clogs living in the same locality in a remote tea-growing community of northeast India were characterized at 3 different loci; the SSU-rDNA, elongation factor 1-alpha (ef1-alpha) and triose phosphate isomerase (tpi) gene. Phylogenetic analysis of the SSU-rDNA and ef1-alpha genes provided poor genetic resolution of the isolates within various assemblages, stressing the importance of using multiple loci when inferring genotypes to Giardia. Analysis of the tpi gene provided better genetic resolution and placed canine Giardia isolates within the genetic groupings of human isolates (Assemblages A and B). Further evidence for zoonotic transmission was supported by epidemiological data showing a highly significant association between the prevalence of Giardia in humans and presence of it Giardia-positive dog in the same household (odds ratio 3.01, 95%) CI, 1.11, 8.39, P = 0.0000).

Country risk, national cultural differences between partners and survival of international joint ventures in Brazil

This article aims to identify the main and interaction effects of two country-level variables, namely national distance and country risk, on the survival of international joint ventures in emerging markets. Research hypotheses predicting the negative impact of national distance and country risk on survival of international joint ventures are formulated in this article. These research hypotheses are examined in a sample of 234 international joint ventures formed in Brazil between 1973 and 2004. These international joint ventures were subjected to an event history analysis over a period of time ranging from 1973 to 2006. The empirical results show that large national cultural differences between local and foreign partners increase the instability of international joint ventures, whereas the survival of these alliances does not seem to be affected either by the economic and political uncertainty of Brazil. Furthermore, the national distance between local and foreign partners has effects on survival that are variable according to the life cycle of international joint ventures. (C) 2007 Elsevier Ltd. All rights reserved.

Transfer and Reverse Transfer of Knowledge of International Acquisitions: the case of the acquisition of the Perez Companc by Petrobras in Argentina

The objective of this article was to analyze the processes of transfer and reverse trans fer of knowledge following. international acquisitions made by Brazilian multinational companies. Reverse transfer is understood,as the process of transferring knowledge from the acquired company to the acquirer. Therefore, a case study was conducted on the acquisition of the Perez Companc group by Petrobras in Argentina. The study is qualitative. Primary data were obtained and eight members of the international managing board of Petrobras were interviewed. After the first moment of integration, reported as conflictive, there was a better integration of the companies, mainly in the technical areas of, the oil and gas exploration activities. The size of Perez Companc, its aim (a company of energy, not only oil and gas company) and the length of time were critical factors for the transfer of best practices between the companies. The expatriation of the employees is seen as a key-tool, as well as the technical visits, for the transfer of knowledge.. An. additional contribution of the study was to present the results of the research on the process of transfer and reverse transfer of knowledge in Brazilian multinational companies, since most studies on the theme focus on the motivators and challenges concerning these processes.

Are health assessments in the community acceptable to those involved? Yes, Yes and maybe

Aim: To test the acceptability of a comprehensive health assessment program (CHAP) in adults with an intellectual disability (ID). Method: We interviewed adults with ID, their general practitioners (GPs) and caregivers (healthcare triad), before and after the intervention period as part of a clustered randomised controlled trial to test the use of the CHAP tool in adults with ID. A content and thematic analysis of these interviews will be presented. Results: We found adults with ID were unable to recall the health assessment consultation or differentiate this consultation from the usual contact with their GP. GPs and residential staff where largely supportive of the process and considered it did improve the care they could provide to AWID. They also considered that the intervention helped other members of the healthcare triad. Conclusions: The CHAP was found to be acceptable to caregivers and GPs however further work is needed to ascertain the views of adults with ID.

Program sustainability of a community-based intervention to prevent falls among older Australians

Multi-strategy interventions have been demonstrated to prevent falls among older people, but studies have not explored their sustainability. This paper investigates program sustainability of Stay on Your Feet (SOYF), an Australian multi-strategy falls prevention program (1992-1996) that achieved a significant reduction in falls-related hospital admissions. A series of surveys assessed recall, involvement and current falls prevention activities, 5 years post-SOYF in multiple original SOYF stakeholder groups within the study area [general practitioners (GPs), pharmacists, community health (CH) staff shire councils (SCs) and access committees (ACs)]. Focus groups explored possible behavioural changes in the target group. Surveys were mailed, except to CH staff and ACs. who participated in guided group sessions and were contacted via the telephone, respectively. Response rates were: GPs. 67% (139/209); pharmacists, 79% (53/67); CH staff, 63% (129/204); SCs, 90% (9/10); ACs, 80% (8/10). There were 73 older people in eight focus groups. Of 117 GPs who were practising during SOYF 80% recalled SOYF and 74% of these reported an influence on their practice. Of 46 pharmacists operating a business during SOYF, 45% had heard of SOYF and 79% of these reported being 'somewhat' influenced. Of 76 community health staff (59%) in the area at that time, 99% had heard of SOYF and 82% reported involvement. Four SCs retained a SOYF resource, but none thought current activities were related. Seven ACs reported involvement, but no activities were sustained. Thirty-five focus group participants (48%) remembered SOYF and reported a variety of SOYF-initiated behaviour changes. Program sustainability was clearly demonstrated among health practitioners. Further research is required to assess long-term effect sustainability.

ICRAM (the International Campaign to Revitalise Academic Medicine): Agenda setting

Following die launch by the BMJ and others of the campaign to promote academic medicine, a working party of 20 medical academics from all over the world was convened to develop a plan of action.