Despite the growing interest in Ecosystem-based Adaptation, there has been little discussion of how this approach could be used to help smallholder farmers adapt to climate change, while ensuring the continued provision of ecosystem services on which farming depends. Here we provide a framework for identifying which agricultural practices could be considered 'Ecosystem-based Adaptation' practices, and highlight the opportunities and constraints for using these practices to help smallholder farmers adapt to climate change. We argue that these practices are (a) based on the conservation, restoration or management of biodiversity, ecosystem processes or services, and (b) improve the ability of crops and livestock to maintain crop yields under climate change and/or by buffering biophysical impacts of extreme weather events or increased temperatures. To be appropriate for smallholder farmers, these practices must also help increase their food security, increase or diversify their sources of income generation, take advantage of local or traditional knowledge, be based on local inputs, and have low implementation and labor costs. To illustrate the application of this definition, we provide some examples from smallholders' coffee management practices in Mesoamerica. We also highlight three key obstacles that currently constrain the use of Ecosystem-based Adaptation practices (i) the need for greater understanding of their effectiveness and the factors that drive their adoption, (ii) the development supportive and integrated agriculture and climate change policies that specifically promote them as part of a broader agricultural adaptation program; and (iii) the establishment and maintaining strong and innovative extension programs for smallholder farmers. Our framework is an important starting point for identifying which Ecosystem-based Adaptation practices are appropriate for smallholder farmers and merit attention in international and national adaptation efforts. (Résumé d'auteur

For the first time in the country, a national baseline prevalence survey using a well-defined sampling design such as a stratified two-step systematic cluster sampling was conducted in 2005 to 2008. The purpose of the survey was to stratify the provinces according to prevalence of schistosomiasis such as high, moderate, and low prevalence which in turn would be used as basis for the intervention program to be implemented. The national survey was divided into four phases. Results of the first two phases conducted in Mindanao and the Visayas were published in 2008. Data from the last two phases showed three provinces with prevalence rates higher than endemic provinces surveyed in the first two phases thus changing the overall ranking of endemic provinces at the national level. Age and sex distribution of schistosomiasis remained the same in Luzon and Maguindanao. Soil-transmitted and food-borne helminthes were also recorded in these surveys. This paper deals with the results of the last 2 phases done in Luzon and Maguindanao and integrates all four phases in the discussion.

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Objective: To identify whether the use of prophylactic intrasite vancomycin as an adjuvant is a protective factor against deep tissue infection of the surgical site. Methods: Retrospective, descriptive, case-control study evaluating 210 patients, of whom 70 received intrasite vancomycin (case group) and 140 were controls. It was made a follow up for at least one year, reviewing the physical and electronic records. Data were tabulated in spreadsheets (Excel) including all variables and the statistical analysis was made with Epi InfoTM 7 to calculate the odds ratio. Results: Seven cases of deep infection occurred in the control group and none was found in the case group (odds ratio [95% confidence interval]: 0.1262 [0.007-2.24], P = 0.1585). Among the predisposing factors, diabetes and surgical time were the most relevant. Conclusions: Intrasite use of vancomycin has a protective effect against deep infection in patients undergoing lumbar fusion surgery without presenting considerable side effects.

The aim of this study was to compare the efficacy, safety and reinfection rates at 6 and 12 months after treatment of schistosomiasis with praziquantel 60 mg/kg single dose, as compared to the standard 40 mg/kg single dose regimen. A school-based randomized, double blind, experimental drug trial was implemented in Bunawan and Trento, in the province of Agusan del Sur, Philippines. The Kato Katz technique was used for quantitative assessment of Schistosoma japonicum infection. Follow-up visits were done 21, 180 and 360 days post-treatment. Efficacy, safety and reinfection rates of the two treatment regimens were compared using Student's t-test, Chi-square/Fisher's exact test and analysis of variance. There were 102 and 101 patients assigned to the 40 mg/kg and 60 mg/kg treatment groups, respectively. On day 21 post-treatment, 95% and 98.0% of the patients were cured, with egg reduction rates were of 99.9% and 99.99%, respectively. Remaining infections were of light intensity. On days 180 and 360, infection rates increased, with re-emergence of moderate and heavy intensity infections. On treatment day, the cumulative prevalence of adverse events in the 60 mg/kg treatment group was significantly higher than in the 40 mg/kg treatment group (P = 0.002). In conclusion, praziquantel 40 mg/kg and 60 mg/kg single dose therapy had comparable efficacy. A significantly higher prevalence of adverse events, mostly mild and transient, was observed in the 60 mg/kg regimen. The 40 mg/kg regimen is recommended for the treatment of schistosomiasis. High reinfection rates suggest the need to re-examine behavioral and environmental factors in the community.