Pathways to adoption and mitigation: A dynamic perspective on good agricultural practices in Rural Malawi.

Many researchers have noted the limited adoption of farming management practices that should increase the resilience of smallholder farmers to weather shocks and mitigate their impact on the changing climate in sub-Saharan Africa. In this paper, we evaluate the dynamics of adopting "good agricultural practices" in Malawi, using data from a three-wave panel collected as part of an impact assessment of the Sustainable Agricultural Production Programme, funded by the International Fund for Agricultural Development. In addition to project impacts, we also evaluate additional mechanisms though which farmers may learn about the costs and benefits of different practices. We also evaluate the extent to which climatic conditions - such as being located in drought-prone or heavy rainfall areas - drive adoption decisions. Given the three waves of data, we first look at the range of adoption pathways observed, through the use of an adoption pathway trees. We identify six pathways, noting that adoption is not continuous for a large percentage of households. We then run a multinomial logit to assess the factors that increase the likelihood of falling into different adoption categories vis-a-vis remaining a never adopter. Results suggest that learning through information dissemination, such as through the SAPP project, and wider learning opportunities significantly increased the likelihood of pursuing different adoption pathways, while climatic conditions and learning through observing have limited impacts. On the other hand, for land-intensive management practices, being located in drought-prone areas or being located in areas prone to heavy rainfall increased the likelihood of pursuing different adoption pathways, as did greater ability to learn by observing. Learning by information sharing had limited impacts for land-intensive adoption pathway decisions. Overall, results suggest that information dissemination is important, though the mechanism differs by type of practice promoted. Flexibility in adoption status is an attribute of this system and there is a need to identify and promote practices that are both flexible and increase resilience to climate change.

Multiple markers of hypercoagulation in patients with history of venous thromboembolic disease.

Markers for hypercoagulation can be used to explain why some patients may have had thromboembolic disease (TED). This information may then be applied to estimate risk for additional TED that may afflict these patients following subsequent surgeries. This investigation was to determine the frequency of hypercoagulation parameters among patients having had TED, and how frequently these occur in multiples. Consulting hematologists were asked to comment upon potential risk for recurrent TED that may be associated with additional surgeries. The consulting hematologist determined which laboratory tests were to be ordered for each patient. This retrospective study probed the hospital computer logs for patients having had homocysteine, protein C, factor V Leiden or anticardiolipin antibodies measured during a 6-year period. The laboratory records for patients having had any one of these tests were then examined further for any additional hypercoagulation laboratory studies performed. Five hundred and twenty patients were identified in this survey. Abnormal diagnostic results were found for 293 (56.3%) of these patients. Two or more abnormalities (up to 5) were found for 103 (35.6%) of these patients. Laboratory explanations for TED may be found in a large proportion of patients with TED. It is not uncommon to find more than one abnormality among these patients. This information may be used in advising patients and their physicians as to the risks of additional TED following future surgical procedures and can be the basis for recommending life style changes.

Failure to lyse venous thrombi because of elevated plasminogen activator Inhibitor 1 (PAI-1) and 4G polymorphism of its promotor genome (The PAI-1/4G Syndrome).

Plasminogen activator Inhibitor 1 (PAI-1) inhibits plasminogen activators leading to decreased fibrinolysis and increased risk of thromboembolic disease (TED). Shifts in PAI-1 promoter genome from normal 5G>5G to 4G>5G or 4G>4G alleles are associated with overexpression of PAI-1. In this study patients with residual venous thrombi were observed to have increased PAI-1 levels and more frequent shifts to 4G alleles. Of the 26, 20 (76.9%) patients with unresolved thrombus had elevated PAI-1 values. 4G genomic shifts were found in 92.9% patients studied. Normal PAI-1 levels were found in 5 patients with 4G polymorphisms. Thus, PAI-1 is often elevated among patients with residual thrombus, with an unexpectedly high prevalence of the 4G polymorphism of the promoter genome. Patients with persistent thrombus should be considered at risk of having constituently increased PAI-1 due to genomic changes in the PAI-1 promoter genome. Hypotheses are proposed to explain those with normal PAI-1, despite having 4G polymorphisms.