Sufficient Stocks Research Articles

Analysis of Rice Trade and Food Security in Southeast Asian Countries

The rice trade serves to maintain sufficient rice stocks to meet domestic country demands. The world’s main rice exporters and importers are located in the Southeast Asia region, so the volume change of traded rice can affect the flow of trade. Given the strategic importance of rice, numerous nations have stepped in to control the domestic rice market, to ensure political stability as well as food security. This article aims to examine how the rice trade has evolved in Southeast Asia with respect to food security. The study aims are addressed by the application of the descriptive analysis method. The findings indicate that from 110.5 million tones in 2010–2011 to 128.3 million tones in 2021–2022, Southeast Asian countries accounted for 1.22% of global rice imports, >22% of the world’s total rice consumption. In the meantime, the annual growth rate of rice exports was 3.3%. Over the past 10 years, ASEAN’s net rice exports have made up 53.3% of the world’s total and are expected to reach about 54.8%. Southeast Asian countries intervene in the rice market through international trade policies, both in the form of export bans and domestic rice price stabilization policies, to maintain rice stocks to strengthen the level of food security. Southeast Asia’s economic integration through the ASEAN Economy Community is an important moment to become the basis for achieving food security at the regional levels while at the same time making the rice market more open among Southeast Asian countries. Keywords: rice, trade, policy, Southeast Asia

Supply chain risk in grain trading: Inventories as real options for shipping grain

AbstractIntegrating trading and logistics is an important challenge in commodity trading. Trading and logistics are strategic decisions and are integral to most commodities including grain shipping by rail, in addition to other modes (barges, ocean shipping). There are substantial risks, such as the ordering and placement of rail cars. The other risk is having sufficient grain stocks to load rail cars. Alternatives for managing these risks include holding grain inventories and the strategic use of shipping options. The purpose of this study is to develop a model for determining an optimal grain inventory strategy for shippers. The real option methodology is used to value uncertainty in rail car velocity and determine optimal purchases and inventories. The results show the importance of integrating trading and logistics decisions and illustrate that inventories can be interpreted and valued as real options that are affected by uncertainties. Taken together, the real options indicate how much extra inventory shippers should maintain to mitigate risks and maximize profits.

Replacing All Fossil Fuels With Nuclear-Enabled Hydrogen, Cellulosic Hydrocarbon Biofuels, and Dispatchable Electricity

Abstract We describe a roadmap using three sets of technologies to enable base-load nuclear reactors to replace all fossil fuels in a low-carbon world. The technologies integrate nuclear, wind, solar, hydroelectricity and biomass energy sources. Base-load nuclear reactors with large-scale heat storage enable dispatchable electricity to the grid. The low-cost heat storage enables buying excess wind and solar electricity to charge heat storage for later electricity production while providing assured generating capacity. Nuclear hydrogen production facilities at the scale of global oil refineries produce hydrogen to replace natural gas (gaseous fuel) as a chemical feedstock and heat source. Single sites may have tens of modular reactors produced in a local factory to lower costs by converting to a manufacturing model for reactor construction. Nuclear heat and hydrogen convert cellulosic biomass into drop-in liquid hydrocarbon biofuels to replace fossil-fuel gasoline, diesel, jet fuel, and hydrocarbon feed stocks for the chemical industry. External heat and hydrogen inputs increase the quantities of biofuels that can be produced per unit of cellulosic feedstock, thus assuring sufficient biomass feed stocks to replace all crude oil without major impacts on food and fiber prices. The biofuel production system enables the removal of large quantities of carbon dioxide from the atmosphere that is sequestered as carbon char in the soil while recycling plant nutrients (potassium, phosphorous, etc.) to assure agricultural and forest sustainability.

Влияние ограничения или отказа от табакокурения на адаптационные возможности организма в условиях антарктической зимовки

The research was conducted by a member of the 60th Russian Antarctic Expedition at the all-yearround Mirny Station. The purpose was to study the effect of changed patterns of tobacco smoking on the adaptive capabilities of polar station staff. Materials and methods. Adaptive capabilities were evaluated using the method of cardio-respiratory synchronism, assessing the index of regulatory and adaptive status (IRAS). It is based on recording the synchronization parameters of controlled high respiratory rate and heart rate. IRAS dynamics was compared in four subjects (three regular smokers and one non-smoker as a control) over the course of one year of wintering. The subjects had comparable anthropometric data, health status and working conditions at the station. They were exposed to a similar amount of adverse environmental factors due to their professional activities and lived according to the station’s standard schedule without any personalized changes in their day regimen. Smoking patterns were determined by independent decisions of each expedition member and by the size of personal stocks of tobacco products prepared for the wintering. Results. In polar expedition members faced with smoking cessation or inability to adequately meet this need, IRAS decrease, being a marker of human adaptive capabilities, allowed us to determine the relationship between pronounced changes in the dynamics of regular tobacco smoking and body’s adaptive capabilities. The authors assume that organizational arrangements (sufficient stocks of nicotine-containing products such as cigarettes and tobacco) at the station as well as educational activities (dissuading expedition members from abrupt non-supervised changes in their smoking patterns during Antarctic wintering and properly explaining the reasons why such actions are undesirable) may contribute to improving the health of expedition members and optimizing their living conditions at the polar station. Completing a smoking cessation programme with medical supervision in advance (while preparing for a polar expedition) as well as upon returning from the station (at the end of the adaptation period) can be recommended.

Incidence of Coronavirus Disease 2019 (COVID-19) among healthcare workers during the first and second wave in the Democratic Republic of the Congo: a descriptive study

BackgroundHealthcare workers (HCWs) are at the frontline of response to the COVID-19 pandemic. Protecting HCWs is of paramount importance to the World Health Organization (WHO). Outbreak investigation which is based on a critical assessment of core components of infection prevention and control (IPC) programs allows for the identification of different sources of exposure to the COVID-19 virus and for informing additional IPC recommendations. To date, the Democratic Republic of the Congo (DRC) is categorized as a high-risk country due to weaknesses in the health system, low capacity for diagnosis, socioeconomic characteristics of the population, and insufficient vaccination coverage.AimTo investigate the burden of COVID-19 among HCWs and identification of IPC gaps to reduce HCWs-associated infection at different levels (facilities, communities, and points of entry) following the WHO strategy for IPC program implementation during the first to the third wave of the pandemic.MethodsA retrospective cohort study was conducted using the DRC National Department of Health (NDOH) database and WHO questionnaire suspected and confirmed COVID-19 cases among HCWs from 10/03/2020 to 22/06/2021. The investigation was conducted by a trained IPC response team to identify the sources of the exposures. The questionnaire included demographics, profession, types of interaction between HCWs and patients, and community-based questions regarding family members and other behaviors. These variables were assessed using a multimodal strategy framework. Knowledge and adherence to IPC gaps using WHO guidelines were performed for each COVID-19-positive or suspected HCW. WHO rapid Scorecard dashboard was conducted for evaluating healthcare facilities (HCFs) performance during the COVID-19 pandemic.ResultsCumulative incidence of positive HCWs was 809 /35,898(2.2%) from the first to the third wave of COVID-19 among 6 provinces of DRC. The distribution of the HCWs infected by COVID-19 was predominated by nurses (42%), doctors (27%), biologists (8%), environmental health practitioners (5%), interns (3%), and other categories (15%). Other categories included nutritionists, physiotherapists, midwives, pharmacists, and paramedics. The investigation revealed that about 32% of HCWs were infected from household contacts, 11% were infected by HCFs, 35% were infected in the community and 22% were infected from unknown exposures. The mean score of IPC performance for all evaluated HCFs was 27/42(64%). This shows that IPC performance was moderate. Lower or minimal performance was noted in the implementation of the IPC program at the national and facility level, triage and screening, isolation handwashing and multimodal strategies of hand hygiene, PPE availability, and rationale, waste segregation, waste disposal, sterilization, and training of HCWs.ConclusionThis study revealed that the prevalence of HCWs who tested positive for the COVID-19 virus was high among frontline healthcare workers from 6 provinces of DRC. A high prevalence of nosocomial infection was correlated with insufficient IPC adherence in the context of COVID-19. Strategies to strengthen IPC capacity building and provide HCWs with sufficient PPE stocks and budgets may improve IPC performance in the Democratic Republic of the Congo. This will further allow for adherence to WHO recommendations for successful program implementation to minimize COVID-19 transmission in HCFs, communities, and public gatherings. And this may be transferable to other infectious diseases.

The elements of resilience in the food system and means to enhance the stability of the food supply

Food systems are increasingly exposed to disruptions and shocks, and they are projected to increase in the future. Most recently, the war in Ukraine and Covid-19 pandemic has increased concerns about the ability to secure the availability of food at stable prices. This article presents a food system resilience framework to promote a national foresight system to better prepare for shocks and disruptions. Our study identified four key elements of resilience: system thinking through science and communication; redundancy of activities and networks; diversity of production and partners; and buffering strategies. Three national means to enhance resilience in the Finnish food system included domestic protein crop production, renewable energy production, and job creation measures. Primary production was perceived as the cornerstone for food system resilience, and the shocks and disruptions that it confronts therefore call for a sufficient and diverse domestic production volume, supported by the available domestic renewable energy. A dialogue between different actors in the food system was highlighted to format a situational picture and enable a rapid response. Our study suggests that to a certain point, concentration and interdependence in the food system increase dialogue and cooperation. For critical resources, sufficient reserve stocks buffer disruptions over a short period in the event of unexpected production or market disruptions. Introducing and strengthening the identified resilience elements and means to the food system call for the preparation of a more holistic and coherent food system policy that acknowledges and emphasises resilience alongside efficiency.

Feeding Behaviour of Eurasian Beavers (Castor fiber) Along Small Streams in an Agricultural Landscape

In areas with high population density, the Eurasian beaver may be forced to utilise sparsely forested landscapes where living conditions may not be optimal for the species. Here, we examine the feeding strategy of Eurasian beavers along a number of small (mainly) forested streams in the Czech agricultural landscape. Diet availability in these sparsely forested landscapes is characterised by a lack of woody plants but a large supply of herbaceous vegetation, including agricultural crops grown close to the watercourse. The beaver has adapted to such conditions by building dams on low-water streams, allowing it to move between scattered diet resources. In winter, the main dietary component was woody plants (70% V), with species normally neglected in optimal sites (e.g. Acer negundo, Prunus spp.) taken in the absence of more favoured species (e.g. Salix spp., Populus spp.), the remaining 30%V consisting of herbaceous vegetation. In summer, however, the main component in the diet was herbaceous vegetation (90% F), which included agricultural crops (56% V). Where there were not enough trees, the beaver tended to leave its summer territory and move to stretches with denser tree stands. Thus, beavers in sparsely forested agricultural landscapes have adapted by utilising the diverse supply of herbaceous vegetation, though its continued presence in the landscape is still primarily dependent on sufficient stocks of woody plants, which the beaver needs to survive winter.

Material assets of the mobilization of Armed forces of the Czech Republic at the beginning of the 21st century

This article focuses on the identification of key factors of material resources in the field of equipment, armaments and military vehicles within the Czech state needed for effective mobilization. The primary goal is to answer the question of whether the Army of the Czech Republic still has adequate supplies of these key resources and whether it has the ability to increase these resources in crisis situations without significant dependence on foreign imports. The above analysis revealed mostly sufficient stocks, but at the same time significant limitations were identified in some categories, especially in their technical and moral quality (obsolescence, respectively), especially in most types of military vehicles. The issue of dependence on foreign imports concerning raw materials then changes considerably, from the minimum (combat dress) to the almost maximum (ballistic helmet) level.

COVID-19 convalescent plasma: Evolving strategies for serological screening in France.

Quantitation of anti-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) neutralizing antibodies (Nabs) is a key parameter in determining the effective dose for treatment with COVID-19 convalescent plasma (CCP). Interpretation of results from clinical trials conducted worldwide requires comparison of Nabs titres obtained from different methods. As virus neutralization tests (VNTs) are not standardized scalable or commercially available, strategies based on intensity of ELISA (Enzyme Linked Immunosorbent Assay) or chemiluminescent binding serological tests were implemented to allow comparisons and establish criteria for determining 'high-titres' of anti-SARS-CoV-2 antibodies (Abs). To this end, the FDA (Food and Drug Administration) has proposed criteria to define high-titre plasmas using different serological assays, including the one used in France for the CCP SARS-CoV-2 Abs screening (Euroimmun anti-S1 IgG). A retrospective study revealed that when using the FDA criteria (ELISA signal-to-cut-off [S/C ratio] ≥3.5), 91% of CCP had Nabs titres ≥40 as assessed with an in-house VNT. French strategy to ensure sufficient stocks of CCP of increasing titre has evolved over time. Recently, we improved our strategy by collecting only plasma from vaccinated convalescent donors as we confirmed that the mean IgG antibody level (ELISA S/C ratio) was significantly higher in plasma from vaccinated convalescent donors compared to donations from unvaccinated convalescent donors: 9.31 (CI 95%: 8.46-10.16) versus 3.22 (CI 95%: 3.05-3.39) (p < 0.001).

France: Emerging stronger from the pandemic

Improving supply chain efficiency In 2009, for fear of H1N1 flu epidemic, the Health Minister proceeded into the purchase of huge amounts of masks and vaccines. Fortunately, that epidemic proved to be less severe than what was anticipated, and as a result the vast majority of the supplies were idle. Under the harsh criticism of the Press against the misuse of public resources, all the following health ministers were hesitant to maintain sufficient stocks of medical equipment.

A comparative study of blood transfusion services before and during COVID-19 pandemic and the challenges faced: retrospective study done at a tertiary care hospital in North Western India

Background: The aim of blood transfusion services is timely and uninterrupted supply of safe blood. SARS-COV-2 pandemic has created the major disruption worldwide at all levels of health care. Announcement of national lockdown by Government of India and Janta Curfew to control the spread of virus has affected blood bank services majorly. Monitoring of supply and demand was done to maintain sufficient blood stocks to support emergency needs. In this article we have compared the blood bank services provided in the year 2019 to how COVID-19 pandemic has affected blood transfusion services in 2020 with reference to blood collection, blood supply and organization of voluntary blood donation camps.Methods: A retrospective study was carried out in the department of Immunohematology and blood transfusion in a tertiary care hospital in North Western India. In this study blood collection and blood supply data was evaluated retrospectively for 2 years i.e. from January 2019 to December 2020.Results: Total 89948 blood components were supplied in the year 2019 and 55152 in the year 2020. Total blood collection was 51317 units in the year 2019 and 34151 units in 2020 from voluntary and replacement blood donors. Major decline in blood collection and blood supply was observed in the months of April and May.Conclusions: COVID-19 pandemic had a negative impact on blood donation and blood supply and thus adversely affected blood transfusion services.

Drug non-adherence in hypertensive patients in Morocco, and its associated risk factors.

Hypertension is a widespread public health problem; unfortunately, non-adherence to the treatment hinders the control of high blood pressure. Drug non-adherence is the degree to which a patient does not follow the prescription. We aimed to assess the extent of drug non-adherence among hypertensive patients treated in Meknes and identify risk factors associated with inobservance. Between November and December 2017, we conducted a cross-sectional study enrolling 922 hypertensive patients managed at Meknes's primary healthcare facilities (PHCF) using the multistage sampling method. We interviewed patients face to face to collect their socio-demographic characteristics, lifestyle behaviours, clinical parameters, and the relationship between the care system, the patient, and the physician. A multivariate logistic regression analysis highlighted the risk factors associated with drug non-adherence. The prevalence of drug non-adherence was 91% with a mean age of 61 ± 11 years (mean ± standard deviation) and a male/female ratio of 1/3. Risk factors associated with drug non-adherence were: (i) male sex [adjusted odds ratio (AOR) = 2.5, 95% confidence interval (CI) (1.26-5.10)]; (ii) monthly income per household <150$ [AOR = 4.47, 95% CI (1.22-16.34)]; (iii) monthly income per household 150-200$ [AOR = 4.44, 95% CI (1.04-18.93)]; (iv) bad relationship with the healthcare system [AOR = 2.17, 95% CI (1.29-3.67)]; and (v) uncontrolled blood pressure [AOR = 1.87, 95% CI (1.15-3.02)]. The prevalence of drug non-adherence is general among hypertensive patients in Meknes. Prevention should: (i) ensure the availability of adequate stocks of the anti-hypertensive drug at the PHCF; (ii) secure sufficient drug stocks to treat the poorest patients first; and (iii) improve blood pressure control in patients.

Identify association of appropriate technological application with per capita income of small scale fishing household - a case of Jaffna small scale fishing community, Srilanka

Fishing is vital not only for nutrition supplementary but also livelihood of millions of people. Uninterrupted supply of sufficient and quality fish stocks without affecting marine eco system is ideal for sustainability fishing. However, balancing between sustainability of marine ecosystem, market equilibrium and livelihood of fishing and fishing dependent community is a challenge. Technological application is one of approach to overcome the sustainability of fishing activities. Technological applications are diversified as 1) technology in fishing vessels, fishing gears, equipment and so on. 2) Technology application in information sharing and digital applications such as Global Positioning System (GPS), mobile phone application under Global System of Mobile Communication and 3) Technological application in fishing infrastructure such as cold room, transport equipment and so on. Small scale fishing community depends on labour intensive whereas large scale commercial fishing industries attribute on capital deepening. Adaptation of technology depends on several factors such as financial capability and technology know how. The study examined which technological application is appropriate to small scale fishing activities in Sri Lanka since 90 percent of fishing were carried out by small scale fishers (Fisheries Year Book 2018/19). Primary sample data were collected by structured interview from household level fishing community in Jaffna, North of Sri Lanka. Data were analyzed using descriptive and correlation statistical techniques. The study revealed that information technology especially application of GPS, Internet and mobile coverage in order to obtain fish catch and market information followed by digital sensor application in fishing gear had positive impact on maintain sustainable fishing catches of small-scale fishing activities. In addition, strict law enforcement and monitoring of poaching vessels such as Indian trawlers using radar technology with coordination of fisheries cooperative societies was an essential requirement of small-scale fishing community as external support with regard to sustain fishing stock of the region and their livelihood.

Development of a highly effective low-cost vaporized hydrogen peroxide-based method for disinfection of personal protective equipment for their selective reuse during pandemics

BackgroundPersonal Protective Equipment (PPE) is required to safely work with biological agents of bacterial (i.e. Mycobacterium tuberculosis) or viral origin (Ebola and SARS). COVID-19 pandemic especially has created unforeseen public health challenges including a global shortage of PPE needed for the safety of health care workers (HCWs). Although sufficient stocks of PPE are currently available, their critical shortage may develop soon due to increase in demand and depletion of existing supply lines. To empower our HCWs and ensure their continued protection, proactive measures are urgently required to develop procedures to safely decontaminate the PPEs to allow their “selective reuse” during contingency situations.MethodsHerein, we have successfully developed a decontamination method based on vaporized hydrogen peroxide (VHP). We have used a range of concentration of hydrogen peroxide to disinfect PPE (coveralls, face-shields, and N-95 masks). To ensure a proper disinfection, we have evaluated three biological indicators namely Escherichia coli, Mycobacterium smegmatis and spores of Bacillus stearothermophilus, considered as the gold standard for disinfection processes. We next evaluated the impact of repeated VHP treatment on physical features, permeability, and fabric integrity of coveralls and N-95 masks. Next, we performed Scanning Electron Microscopy (SEM) to evaluate microscopic changes in fiber thickness of N-95 masks, melt blown layer or coverall body suits. Considering the fact that any disinfection procedure should be able to meet local requirements, our study included various regionally procured N-95 masks and coveralls available at our institute All India Institute of Medical Sciences (AIIMS), New Delhi, India. Lastly, the practical utility of VHP method developed herein was ascertained by operationalizing a dedicated research facility disinfecting used PPE during COVID-19.ResultsOur prototype studies show that a single VHP cycle (7–8% Hydrogen peroxide) could disinfect PPE and PPE housing room of about 1200 cubic feet (length10 ft × breadth 10 ft × height 12 ft) in less than 10 min, as noted by a complete loss of B. stearothermophilus spore revival. The results are consistent and reproducible as tested in over 10 cycles in our settings. Further, repeated VHP treatment did not result in any physical tear, deformity or other appreciable change in the coverall and N-95 masks. Our permeation tests evaluating droplet penetration did not reveal any change in permeability post-VHP treatments. Also, SEM analysis indeed revealed no significant change in fiber thickness or damage to fibers of coveralls or melt blown layer of N-95 masks essential for filtration. There was no change in user comfort and experience following VHP treatment of PPE. Based on results of these studies, and parameters developed and optimized, an institutional research facility to disinfect COVID-19 PPE is successfully established and operationalized with more than 80% recovery rate for used PPE post-disinfection.ConclusionsOur study, therefore, successfully establishes the utility of VHP to effectively disinfect PPE for a possible reuse as per the requirements. VHP treatment did not damage coveralls, cause physical deformity and also did not alter fabric architecture of melt blown layer. We observed that disinfection process was successful consistently and therefore believe that the VHP-based decontamination model will have a universal applicability and utility. This process can be easily and economically scaled up and can be instrumental in easing global PPE shortages in any biosafety facility or in health care settings during pandemic situation such as COVID-19.

Optimal inventory control and design refresh selection in managing part obsolescence

We study a joint decision making of part inventory control and product design refresh planning for a manufacturer facing the part obsolescence problem, whereby the supply of a certain part stops early in the life cycle of a product. The part is used in both product assembly and warranty claims fulfillment, and spare part demand in warranty service is dependent on past sales. Design refresh and inventory control are two solutions proposed to resolve the obsolescence problem. In design refresh, alternative parts with ample supply are used as substitutes for obsolete parts; inventory control ensures sufficient stocks with approaches such as last-time buy (the final order delivered by the supplier). We formulate an optimal stopping model with additional decisions to investigate when design refresh should be initiated and how part procurement and inventory should be managed during the product life cycle after obsolescence. We establish the optimality of a threshold policy for the design refresh choice; well-structured policies, including target interval policies, are optimal for part inventory control. Through extensive analytical and numerical analyses, we discover that inventory control targets increases when more products are being used, and these targets are more sensitive to changes in more recently product sales. We also numerically identify the extra profits that a firm can earn by allowing for design refresh, and we develop a heuristic policy based on simple myopic decision rules, which exhibits good performance under various parameter settings.

Are health workers reduced to being drug dispensers of antiretroviral treatment? A randomized cross-sectional assessment of the quality of health care for HIV patients in northern Uganda.

High quality of care (QoC) for antiretroviral treatment (ART) is essential to prevent treatment failure. Uganda, as many sub-Saharan African countries, increased access to ART by decentralizing provision to districts. However, little is known whether this rapid scale-up maintained high-quality clinical services. We assess the quality of ART in the Acholi and Lango sub-regions of northern Uganda to identify whether the technical quality of critical ART sub-system needs improvement. We conducted a randomized cross-sectional survey among health facilities (HF) in Acholi (n = 11) and Lango (n = 10). Applying lot quality assurance sampling principles with a rapid health facility assessment tool, we assessed ART services vis-à-vis national treatment guidelines using 37 indicators. We interviewed health workers (n = 21) using structured questionnaires, directly observed clinical consultations (n = 126) and assessed HF infrastructure, human resources, medical supplies and patient records in each health facility (n = 21). The district QoC performance standard was 80% of HF had to comply with each guideline. Neither sub-region complied with treatment guidelines. No HF displayed adequate: patient monitoring, physical examination, training, supervision and regular monitoring of patients’ immunology. The full range of first and second line antiretroviral (ARV) medication was not available in Acholi while Lango had sufficient stocks. Clinicians dispensed available ARVs without benefit of physical examination or immunological monitoring. Patients reported compliance with drug use (>80%). Patients’ knowledge of preventing HIV/AIDS transmission concentrated on condom use; otherwise it was poor. The poor ART QoC in northern Uganda raises major questions about ART quality although ARVs were dispensed. Poor clinical care renders patients’ reports of treatment compliance as insufficient evidence that it takes place. Further studies need to test patients’ immunological status and QoC in more regions of Uganda and elsewhere in sub-Saharan Africa to identify topical and geographical areas which are priorities for improving HIV care.

Access to treatment among persons with hemophilia: A spatial analysis assessment in the Rhone-Alpes region, France

ObjectivesIn France, only hospital pharmacies can dispense clotting factor concentrates to persons with hemophilia, which limits the access to care for the treatment and the prevention of bleeding episodes. Moreover, the cost of clotting factor concentrates may restrain the maintenance of sufficient stocks in hospital pharmacies. The aim of this study was to investigate the accessibility of clotting factor concentrates to persons with hemophilia in the context of long-term prophylaxis and emergency treatment in the Rhone-Alpes region of France. MethodsA geographic information system was used for evaluating accessibility of clotting factor concentrates. Persons with hemophilia and hospital pharmacies were geolocalized with the use of postal data, and the evaluation of accessibility was based on the road network. ResultsApproximately 72% of the study area was accessible in less than 30 minutes to a hospital pharmacy. Eighty-five percent of persons with hemophilia had access to clotting factor concentrates for prophylactic treatment in less than 20 minutes. Most of them were patients with severe or moderate hemophilia. Regarding emergency doses, factor VIII was accessible in less than 30 minutes in 45.6% of the study area, and factor IX in 30.5%. ConclusionThis study highlights that spatial access to clotting factor concentrates by persons with hemophilia in the Rhône-Alpes region is good for prophylactic treatment but is more uneven for emergency doses.

Impact of planted hedgerow fallows on nutrient balances in a groundnut/maize/cassava intercrop

ABSTRACTTo assess if the nutrient supply through planted tree fallows meets crop nutrient uptake and export, N, P, K, Ca and Mg uptake and export by a groundnut/maize/cassava intercrop was compared with the nutrient uptake by three planted fallow systems (Senna spectabilis, Flemingia macrophylla, Dactyladenia barteri) and a no-tree control. Three cycles of two years fallow and one year cropping on Ultisol in southern Cameroon were studied. Fallows were slashed and burned. The fallow system had no consistent effect on nutrient uptake by individual crops. Crop nutrient uptake was most often highest in the S. spectabilis system. Nitrogen balances were generally negative due to N loss in the burn. Across three cropping cycles, the balance of fallow nutrient uptake versus total crop nutrient uptake was only in the S. spectabilis system positive for all nutrients. Nutrient export by all crops (mean of three years) was unaffected by fallow systems. The fallow nutrient uptake versus crop nutrient export balance was positive for all nutrients and systems. Planted fallows appear capable of acquiring sufficient nutrient stocks during fallow phases, covering the crops’ demand. Fallow N and K uptake and crop export declined with every fallow/cropping cycle.

Oilseed market: global trends

According to FAO estimates, the world food products markets still remain fairly balanced, which is due to sufficient stocks of wheat and corn and the recovery of oilseeds production. The value of oilseeds in the national economy is almost impossible to overestimate, since their food and non-food role in the world is constantly increasing. Vegetable oils obtained from oilseeds form the basis of human nutrition, they are widely used in various types of industry. The increasing role of oilseeds is also due to their use as a raw material for the production of biodiesel. The paper additionally considers the specificity of the market oilseeds. The main regions are the producers of individual oilseeds and major oilseeds in the world. The analysis of the production of major oilseeds, their production structure and global trends, which allowed to determine the main factors influencing the market of oilseeds. The composition of the countries-exporters and importers in the market of oil seeds and their share is given. The vector in the development of the world oilseed market and the role of alternative oilseeds on it are also reviewed in the paper.

Access to Essential Medications and Equipment for Obstetric and Neonatal Primary Care in Bombali District, Sierra Leone

The increased demand for basic emergency obstetric and neonatal care (BEmONC) services in Sierra Leone since the launch of the nationwide free maternity care initiative in 2010 has strained the capacity of the system to provide high‐quality care. In 2014, members of our research team visited all 97 functioning primary health‐care facilities in Bombali district in the Northern Province of Sierra Leone to evaluate gaps in access to BEmONC. Although most facilities had the equipment necessary for maternal and neonatal care, these were often not in satisfactory condition. Most of the facilities did not stock all of the essential medicines for BEmONC, and less than 10 percent of the facilities had sufficient stocks of unexpired and properly stored medications. Stronger supply chains will be necessary to improve health system performance in Sierra Leone, reduce maternal mortality, increase neonatal survival, and achieve targets associated with the Sustainable Development Goals (SDGs).