The Medical System in Ghana

Ghana is a developing country in West Africa with a population of about 25 million. Medical illnesses in Ghana overlap with those in developed countries, but infection, trauma, and women’s health problems are much more prominent. Medical practice in rural Africa faces extremely limited resources, a multiplicity of languages (hundreds in Ghana), and presentation of severe illnesses at later stages than seen elsewhere. Despite these limitations, Ghana has established a relatively successful national medical insurance system, and the quality of medical practice is high, at least where it is available. Ghana also has a well-established and sophisticated administrative structure for the supervision of medical education and accreditation, but it has proven very difficult to extend medical training to rural areas, where health care facilities are particularly short of personnel. Physicians are sorely needed in rural areas, but there are few because of the working conditions and financial limitations. Hospital wards and clinics are crowded; time per patient is limited. This article details some of the differences between medical practice in Ghana and that in wealthier countries and how it functions with very limited resources. It also introduces the medical education and training system in Ghana. The following article describes an attempt to establish and maintain a residency training program in General Medicine in a rural area of Ghana.     

Uncertainty and sensitivity analysis of West Java Water Sustainability Index – A case study on Citarum catchment in Indonesia

Water sustainability indices have been recently used to measure the sustainability of water resources within a catchment. Developing a sustainability index involves various steps, some of which have uncertainties associated with them. For the recently developed West Java Water Sustainability Index (WJWSI), three sources of uncertainties were identified, namely uncertainties in the thresholds of non-categorical indicators and sub-indicators, in the weighting schemes, and in the aggregation methods. This paper presents the uncertainty and sensitivity analysis of WJWSI, based on the application of WJWSI to Citarum catchment in West Java, Indonesia. The results of the uncertainty analysis, measured by the coefficient of variation of the thresholds and the sub-indices, indicates that minimum thresholds of Land Use Changes, Coverage, Education, Poverty, Health Impact and Sanitation, and the maximum threshold of Water Quality have higher variation when compared to variation of the other thresholds. The results of the sensitivity analysis, measured by the correlation coefficients between the final index and the thresholds, indicate that changes in the thresholds of WJWSI indicators have not significantly affected the sub-index values of most indicators and sub-indicators. The sensitivity analysis also concluded that either the equal or non-equal weighting scheme can be used for future use of the aggregation of WJWSI indicators and sub-indicators, as changes from equal to non-equal weighting scheme did not significantly affect the final index. However, it was found that the final index values were most sensitive to the aggregation method used (i.e. arithmetic and geometric methods), shown by the significant changes in the final index value when the aggregation method was changed from arithmetic to geometric. The uncertainty and sensitivity analysis presented in this study will not just assist in the efficient use of the WJWSI, but will also help undertake similar analysis for other indices.     

Origin of bombesin-like peptides in human fetal lung

Four different forms of bombesin-like immunoreactive peaks were detected in extracts of human fetal lung by the use of reversed-phase high performance liquid chromatography (HPLC). Peaks I, II, III and IV, (increasing retention time), were eluted using a 14-38% of acetonitrile gradient containing 0.1% trifluoroacetic acid (TFA). Peak II was the major material found in the extract of human fetal lung obtained at 16-20 weeks gestation. None of the four compounds contained in the eluted peaks had the same retention time as amphibian bombesin or porcine gastrin releasing peptide (GRP). On reversed-phase HPLC using two different solvent systems TFA or heptafluorobutyric acid (HFBA) as a hydrophobic counter ion, and in gel filtration chromatography, the chromatographic behavior of the main peak (peak II) was the same as that of the carboxyl terminal fragments of GRP, GRP18-27 or GRP19-27. This suggested that the peptide(s) in peak II resembled in composition the carboxy terminal 9 or 10 amino acids of porcine GRP. Following tryptic digestion the material in peak IV was converted to the more polar compound present in peak II. Two other peptide peaks were eluted close to peak II and these were presumed to be a modification of this main peak. One of the possible biosynthetic steps in the formation of bombesin-like peptides in human fetal lung could be a tryptic conversion of a less polar peptide to a more polar form (peak IV to II).     

Morphogenesis of bacteriophage lambda deletion mutants. II. Escherichia coli mutants which prevent maturation of short genomes.

We have isolated mutants of Escherichia coli which severely reduce the growth of bacteriophage lambda carrying the b221 deletion. Some of the bacterial strains also cause a moderate reduction in the growth of wild-type phage. In the mutant hosts tested, the growth of λb221 is restored by chromosomal alterations producing a non-specific increase in genome length. Thus the defect in growth can be attributed to the physical size of the genome, rather than a genetic effect of the b221 deletion. Our experiments show that the failure to grow results from a block to head morphogenesis and that growth can be restored by mutations in at least two phage head genes. In the accompanying paper we have shown that even in the normal bacterium, the process of packing and cutting the λb221 genome is perturbed as a result of its small size. The block to morphogenesis in the bacterial mutant we have studied most extensively appears to result from an enhancement of the same effect. The experiments described support the hypothesis that there is host participation in the cutting of encapsulated lambda DNA, although it is not yet clear if this involves the direct participation of a host gene product.     

New records for prehistoric introduction of Neotropical mammals to the West Indies: evidence from Carriacou,Lesser Antilles

Aim This paper investigates the prehistoric introduction of five mammalian taxa to Carriacou (Lesser Antilles) and refines the known anthropogenic ranges for these fauna in the pre‐Columbian West Indies. The importance of such records for understanding the region’s historical biogeography and ecology is considered. Location Carriacou Island, Grenada (12°28′ N, 61°26′ W). Methods Zooarchaeological assemblages from Carriacou’s earliest documented prehistoric sites, Grand Bay and Sabazan, were analysed, and exotic taxa were identified and quantified. The timing of introductions was established based on multiple radiocarbon assays, including three new accelerator mass spectrometry (AMS) direct dates obtained on the bone of exotic taxa. Source species and location(s) are considered and compared with known prehistoric records for the Caribbean to synthesize anthropogenic distributions for the pre‐Columbian period. The contexts of the zooarchaeological remains are evaluated to better understand the nature and purpose of introductions. Results Zooarchaeological investigation on Carriacou reveals the occurrence of multiple mammal introductions from South American between c. ad 700 and ad 1400. This paper presents the first records for guinea pig (Cavia sp.), armadillo (Dasypus sp.), peccary (Tayassu/Pecari sp.), opossum (Didelphis sp.) and agouti (Dasyprocta sp.) from the island. Human‐mediated transport of these taxa is indicated by their absence from the record prior to human settlement of Carriacou. Several translocated species are either rare or entirely unknown for the region, and overall West Indian distributions are temporally and spatially discontinuous. Archaeological contexts indicate that mammalian introductions arose from human subsistence needs, but other social factors may have shaped the dispersal of these fauna. Main conclusions The taxonomic combination and richness of Carriacou’s introduced fauna are unusual within the region. Importantly, the new records significantly improve the known pre‐Columbian geographic range for peccary, guinea pig and armadillo. Integrated with regional records, these data augment our understanding of the Caribbean’s historical biogeography, and have the potential to improve our understanding of human mobility and anthropogenic environmental impacts in the West Indies prior to the arrival of Europeans.     

Milk: the new white gold? Milk production options for smallholder farmers in Southern Mali

Until the turn of the century, farmers in West Africa considered cotton to be the ‘white gold’ for their livelihoods. Large fluctuations in cotton prices have led farmers to innovate into other business including dairy. Yet the productivity of cows fed traditional diets is very poor, especially during the long dry season. This study combines earlier published results of farmer participatory experiments with simulation modelling to evaluate the lifetime productivity of cows under varying feeding strategies and the resulting economic performance at farm level. We compared the profitability of cotton production to the innovation of dairy. The results show that milk production of the West African Méré breed could be expanded if cows are supplemented and kept stall-fed during the dry season. This option seems to be profitable for better-off farmers, but whether dairy will replace (some of) the role of cotton as the white gold for these smallholder farmers will depend on the cross price elasticity of cotton and milk. Farmers may (partly) replace cotton production for fodder production to produce milk if the price of cotton remains poor (below US$0.35/kg) and the milk price relatively strong (higher than US$0.38/kg). Price ratios need to remain stable over several seasons given the investments required for a change in production strategy. Furthermore, farmers will only seize the opportunity to engage in dairy if marketing infrastructure and milk markets are further developed.