Male beach workers and western female tourists : livelihood strategies in Kenya's south coast region

Recent years have seen an emerging knowledge base and increasing public interest and awareness of sexual-economic relationships between local men and Western women, in different touristic regions around the world. However, to date, Western perspectives on the phenomenon make up the bulk of the existent literature. Questioning the dominant discourse of 'romance tourism' and representations of male participants as 'victims-opportunists', this dissertation explores male beach workers' experiences with, and perspectives on sexual-economic relationships between Kenyan men and visiting Western women in Kenya's South Coast region. The men were not considered in isolation; their experiences and perspectives are situated in relation to their family ties, social networks and the political economy of beach tourism. The study shows that locally these relationships are clearly understood as livelihood strategies for the visited. Men seek to establish long-term intimate relationships with female tourists as a means to accessing life's basic necessities for themselves and for their families and overall to improve their standards of living. It is argued that these relationships are a response to the poverty and inequalities generated by socio-economic changes over time. They are also a response to local gender role prescriptions that hinge male social value on men's capacity to marry, procreate and provide intergenerational social and economic support. The men's parallel quest for non-sexual economically motivated friendships with visiting foreign tourists termed "family friends" is a salient finding, that serves to reinforce the finding that the sexual- economic relationships are above all livelihood strategies. Résumé Ces dernières années ont vu l'émergence d'une base de connaissance, ainsi que d'un intérêt et d'une prise de conscience accrue du public, à l'égard des relations économico-sexuelles entre hommes locaux et femmes occidentales, dans différentes régions touristiques du monde. Cependant, à ce jour, des perspectives occidentales sur ce phénomène constituent l'essentiel de la littérature existante. En remettant en question le discours dominant du «romance tourism» (tourisme sentimental) et les représentations qui conçoivent les hommes participants comme étant 'victimes-opportunistes', cette thèse explore les expériences, et les visions qu'ont les travailleurs de plage sur les relations économico-sexuelles entre hommes Kenyans et femmes Occidentales dans la région de la côte sud du Kenya. Les hommes n'ont pas été considérés de manière isolée; leurs expériences et leurs perspectives sont situées par rapport à leur liens familiaux, leur réseaux sociaux et aussi par rapport à l'économie politique du tourisme balnéaire. L'étude montre que sur place ces relations sont clairement conçues comme des stratégies de survie pour les participants hôtes. Les hommes cherchent à établir des relations de long durée avec des femmes touristes comme moyen d'accéder à des biens et des services qui constituent des nécessités de bases, pour eux et pour leur familles et globalement pour relever leur niveau de vie! L'étude fait valoir que ces relations sont une réponse à la pauvreté et aux inégalités sociales crées par des dynamiques socio-économiques au fil du temps. Elles sont aussi une réponse au prescriptions sociales locales par lesquelles la valeur sociale masculine est définie à travers la capacité des hommes à se marier, à procréer et d'assurer un soutien intergénérationnel social et économique. La quête, en parallèle, de relations d'amitiés non-sexuelles à motivation économique, dénommé « family friends », par des hommes, est un résultat saillant de cette étude qui vient renforcer l'observation que les relations économico-sexuelles relèvent avant tout des stratégies de survie.

DNA binding properties of peroxisome proliferator-activated receptor subtypes on various natural peroxisome proliferator response elements. Importance of the 5'-flanking region.

The three subtypes of the peroxisome proliferator-activated receptors (PPARalpha, beta/delta, and gamma) form heterodimers with the 9-cis-retinoic acid receptor (RXR) and bind to a common consensus response element, which consists of a direct repeat of two hexanucleotides spaced by one nucleotide (DR1). As a first step toward understanding the molecular mechanisms determining PPAR subtype specificity, we evaluated by electrophoretic mobility shift assays the binding properties of the three PPAR subtypes, in association with either RXRalpha or RXRgamma, on 16 natural PPAR response elements (PPREs). The main results are as follows. (i) PPARgamma in combination with either RXRalpha or RXRgamma binds more strongly than PPARalpha or PPARbeta to all natural PPREs tested. (ii) The binding of PPAR to strong elements is reinforced if the heterodimerization partner is RXRgamma. In contrast, weak elements favor RXRalpha as heterodimerization partner. (iii) The ordering of the 16 natural PPREs from strong to weak elements does not depend on the core DR1 sequence, which has a relatively uniform degree of conservation, but correlates with the number of identities of the 5'-flanking nucleotides with respect to a consensus element. This 5'-flanking sequence is essential for PPARalpha binding and thus contributes to subtype specificity. As a demonstration of this, the PPARgamma-specific element ARE6 PPRE is able to bind PPARalpha only if its 5'-flanking region is exchanged with that of the more promiscuous HMG PPRE.

The contribution of the young Cretaceous Caribbean Oceanic Plateau to the genesis of late Cretaceous arc magmatism in the Cordillera Occidental of Ecuador

The eastern part of the Cordillera Occidental of Ecuador comprises thick buoyant oceanic plateaus associated with island-arc tholeiites and subduction-related calc-alkaline series, accreted to the Ecuadorian Continental Margin from Late Cretaceous to Eocene times. One of these plateau sequences, the Guaranda Oceanic Plateau is considered as remnant of the Caribbean-Colombian Oceanic Province (CCOP) accreted to the Ecuadorian Margin in the Maastrichtien. Samples studied in this paper were taken from four cross-sections through two arc-sequences in the northern part of the Cordillera Occidental of Ecuador, dated as (Rio Cala) or ascribed to (Macuchi) the Late Cretaceous and one arc-like sequence in the Chogon-Colonche Cordillera (Las Orquideas). These three island-arcs can clearly be identified and rest conformably on the CCOP. In all four localities, basalts with abundant large clinopyroxene phenocrysts can be found, mimicking a picritic or ankaramitic facies. This mineralogical particularity, although not uncommon in island arc lavas, hints at a contribution of the CCOP in the genesis of these island arc rocks. The complete petrological and geochemical study of these rocks reveals that some have a primitive island-arc nature (MgO values range from 6 to 11 wt.%). Studied samples display marked Nb, Ta and Ti negative anomalies relative to the adjacent elements in the spidergrams characteristic of subductionrelated magmatism. These rocks are LREE-enriched and their clinopyroxenes show a tholeiitic affinity (FeO(1)-TiO(2) enrichment and CaO depletion from core to rim within a single crystal). The four sampled cross-sections through the island-arc sequences display homogeneous initial Nd, and Pb isotope ratios that suggest a unique mantellic source for these rocks resulting from the mixing of three components: an East-Pacific MORB end-member, an enriched pelagic sediment component, and a HIMU component carried by the CCOP. Indeed, the ankaramite and Mg-basalt sequences that form part of the Caribbean-Colombian Oceanic Plateau are radiogenically enriched in (206)Pb/(204)Pb and (207)Pb/(204)Pb and contain a HIMU component similar to that observed in the Gorgona basalts and Galapagos lavas. The subduction zone that generated the Late Cretaceous arcs occurred far from the continental margin, in an oceanic environment. This implies that no terrigenous detrital sediments interacted with the source at this period. Thus, the enriched component can only result from the melting of subducted pelagic sediments. We have thus defined the East-Pacific MORB, enriched (cherts, pelagic sediments) and HIMU components in an attempt to constrain and model the genesis of the studied island-arc magmatism, using a compilation of carefully selected isotopic data from literature according to rock age and paleogeographic location at the time of arc edification. Tripolar mixing models reveal that proportions of 12-15 wt.% of the HIMU component, 7-15 wt.% of the pelagic sediment end-member and 70-75 wt.% of an East-pacific MORB end-member are needed to explain the measured isotope ratios. These surprisingly high proportions of the HIMU/CCOP component could be explained by the young age of the oceanic plateau (5-15 Ma) during the Late Cretaceous arc emplacement. The CCOP, basement of these arc sequences, was probably still hot and easily assimilated at the island-arc lava source. (C) 2008 Elsevier Ltd. All rights reserved,

TRENDS IN HOSPITAL MANAGEMENT OF ACUTE MYOCARDIAL INFARCTION IN SWITZERLAND, 1998 TO 2008 THE REGION MAKES THE DIFFERENCE: DISPARITIES IN MANAGEMENT OF ACUTE MYOCARDIAL INFARCTION WITHIN SWITZERLAND

The aim of this master's thesis was to assess the ten- year trends and regional differences in management and outcome of acute myocardial infarction (AMI) within Switzerland. The thesis is composed of two articles. First, in the article "Trends in hospital management of acute myocardial infarction in Switzerland, 1998 to 2008" over 102,700 cases of AMI with corresponding management and revascularization procedures were assessed. The results showed a considerable increase in the numbers of hospital discharges for AMI, namely due to the increase of between- hospital transfers. Rates of intensive care unit admissions remained stable. All types of revascularization procedures showed an increase. In particular, overall stenting rates increased with drug-eluting stents partly replacing bare stents. Second, in the article "The region makes the difference: disparities in management of acute myocardial infarction within Switzerland" around 25,600 cases of AMI with corresponding management were assessed for the period of 2007-2008 and according to seven Swiss regions. As reported by our results, considerable regional differences in AMI management were stated within Switzerland. Although each region showed different trends regarding revascularization interventions, Leman and Ticino contrast significantly by presenting the minimum and maximum rates in almost all assessed parameters. As a consequence these two regions differ the most from the Swiss average. The impact of the changes in trends and the regional differences in AMI management on Swiss patient's outcome and economics remains to be assessed. Purpose: To assess ten-year trends in management and outcome of acute myocardial infarction (AMI) in Switzerland. Methods: Swiss hospital discharge database for the 1998 to 2008 period. AMI was defined as a primary discharge diagnosis code I21 according to the CIM-10 classification of the World Health Organization. Management and revascularization procedures were assessed. Results: Overall, 102,729 hospital discharges with a diagnosis of AMI were analyzed. The number of hospital discharges increased almost three-fold from 5530 in 1998 to 13,834 in 2008, namely due to a considerable increase in between-hospital transfers (1352 in 1998, 6494 in 2008). Relative to all hospital discharges, Intensive Care Unit admission rate was 38.0% in 1998 and remained stable (36.2%) in 2008 (p for trend=0.25). Percutaneous revascularization rates increased from 6.0% to 39.9% (p for trend<0.001). Non-drug-eluting stent use increased from 1.3% to 16.6% (p for trend<0.05). Drug eluting stents appeared in 2004 and increased to 23.5% of hospital discharges in 2008 (p for trend=0.07). Coronary artery bypass graft increased from 1.0% to 3.0% (p for trend<0.001). Circulatory assistance increased from 0.2% to 1.7% (p for trend<0.001). Thrombolysis showed no significant changes, from 0.5% to 1.9% (p for trend=0.64). Most of these trends were confirmed after multivariate adjustment. Conclusion: Between 1998 and 2008 the number of hospital discharges for AMI increased considerably in Switzerland, namely due to between-hospital transfers. Overall stenting rates increased, drug-eluting stents partly replacing bare stents. The impact of these changes on outcome and economics remains to be assessed.

Simultaneous identification of multiple mammalian species from mixed forensic samples based on mtDNA control region length polymorphism

Molecular species identification in mixed or contaminated biological material has always been problematic. We developed a simple and accurate method for mammal DNA identification in mixtures, based on interspecific mitochondrial DNA control region length polymorphism. Contrary to other published methods dealing with species mixtures, our protocol requires a single universal primer pair and amplification step, and is not based on a pre-defined panel of species. This protocol has been routinely employed by our laboratory for species identification in dozens of human and animal forensic caseworks. Six representative forensic caseworks involving the specific identification of mixed animal samples are reported in this paper, in order to demonstrate the applicability and usefulness of the method.

Respiratory effects of an exposure to grain dust among grain workers in the Vaud region (Switzerland)

Introduction: Bioaerosols such as grain dust, via biologically active agents, elicit local inflammation and direct immunological reactions within the human respiratory system. Workplace-dependent exposure to grain dust (GD) may thus induce asthma, chronic bronchitis, and hypersensitivity pneumonitis. The aim of this study is to assess the clinical impact of occupational exposure to GD and to determine quantitative biological markers of bioaerosol exposure in grain workers. Methods: This longitudinal study has been conducted from summer 2012, to summer 2013, comprising 6 groups of 30 active workers with different GD exposure patterns (4 groups of grain workers, 2 control groups). After obtaining informed consent, two evaluations at high- and low-exposing seasons take place, during which an occupational history and a detailed medical history are questionnaire-assessed, lung function is evaluated by spirometry, airway inflammation is measured by exhaled nitric oxide (eNO), and specific blood IgG and IgE are titrated. The preliminary results presented hereafter are those of two of the four exposed groups, namely harvesters and mill workers, compared to the control groups, at first assessment (n=100). Results: Mean age is 38.4 [years]; 98% are male. Exposed groups differ from controls (p<0.05) in daily contact with animals (57% vs. 40%) and active smoking (39% vs. 11%). Grain workers have more respiratory (50%), nasal (57%), ocular (45%), dermatologic (36%) and systemic (20%) occupational symptoms than controls (6.4%, 19%, 16%, 6.4%, 1.6% respectively, p<0.05). Lower mean peak-expiratory-flow (PEF) values (96.1 ± 18.9 vs. 108.2 ± 17.4 [% of predicted], p<0.05) and eNO values (13.9 ± 9.6 vs. 20.5 ± 14.7 [ppm], p<0.05) are observed in the exposed groups. Conclusion: Preliminary results show a higher prevalence of clinical symptoms and a lower mean PEF value in the exposed groups. Detailed supplementary analyses are pending.

Glomerular hyperfiltration and increased proximal sodium reabsorption in subjects with type 2 diabetes or impaired fasting glucose in a population of the African region.

BACKGROUND. Glomerular hyperfiltration (GHF) is a well-recognized early renal alteration in diabetic patients. As the prevalence of GHF is largely unknown in populations in the African region with respect to normal fasting glucose (NFG), impaired fasting glucose (IFG) and type 2 diabetes [diabetes mellitus (DM)], we conducted a cross-sectional study in the Seychelles islands among families including at least one member with hypertension. METHODS. The glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and proximal tubular sodium reabsorption were measured using inulin, p-aminohippurate (PAH) and endogenous lithium clearance, respectively. Twenty-four-hour urine was collected on the preceding day. RESULTS. Of the 363 participants (mean age 44.7 years), 6.6% had IFG, 9.9% had DM and 63.3% had hypertension. The prevalence of GHF, defined as a GFR >140 ml/min, was 17.2%, 29.2% and 52.8% in NFG, IFG and DM, respectively (P trend <0.001). Compared to NFG, the adjusted odds ratio for GHF was 1.99 [95% confidence interval (CI) 0.73-5.44] for IFG and 5.88 (2.39-14.45) for DM. Lithium clearance and fractional excretion of lithium were lower in DM and IFG than NFG (P < 0.001). CONCLUSION. In this population of African descent, subjects with impaired fasting glucose or type 2 diabetes had a high prevalence of GHF and enhanced proximal sodium reabsorption. These findings provide further insight on the elevated incidence of nephropathy reported among African diabetic individuals.

Characterization of magmatic sulfur in the Aegean island arc by means of the δ34S values of fumarolic H2S, elemental S, and hydrothermal gypsum from Nisyros and Milos islands

A delta(34)S value of +6.3 +/- 1.5% was estimated for the rhyodacitic degassing magma present underneath the hydrothermal system of Nisyros, based on the S isotope ratios of H2S in fumarolic vapors. This value was estimated by modeling the irreversible water-rock mass transfers occurring during the generation of the hydrothermal liquid which separates these fumarolic vapors. The S isotope ratio of the rhyodacitic degassing magma of Nisyros is consistent with fractional crystallization of a parent basaltic magma with an initial delta(34)S value of +4% (+/-at least 1.5%). This positive value could be explained by mantle contamination due to by either transference of fluids derived from subducted materials or involvement of altered oceanic crust, whereas contribution of biogenic sulfides from sediments seems to be negligible or nil. This conclusion agrees with the lack of N-2 and CO2 from thermal decomposition of organic matter contained in subducted sediments, which is a characteristic of the whole Aegean arc system. Since hydrothermal S at Milos and Santorini has isotope ratios similar to those determined at Nisyros, it seems likely that common controlling processes are active throughout the Aegean island arc. (C) 2002 Elsevier, Science B.V. All rights reserved.

Risk factors of stroke mortality in the African region: a cohort study

Background: Population-based cohort studies of risk factors of stroke are scarce in developing countries and none has been done in the African region. We conducted a longitudinal study in the Seychelles (Indian Ocean, east of Kenya), a middle-income island state where the majority of the population is of African descent. Such data in Africa are important for international comparison and for advocacy in the region. Methods: Three examination surveys of cardiovascular risk factors were performed in independent samples representative of the general population aged 25-64 in 1989, 1994 and 2004 (n=1081, 1067, and 1255, respectively). Baseline risk factors data were linked with cause-specific mortality from vital statistics up to May 2007 (all deaths are medically certified in the Seychelles and kept in an electronic database). We considered stroke (any type) as a cause of death if the diagnosis was reported in any of the 4 fields in the death certificates for underlying and concomitant causes of death. Results. Among the 2479 persons aged 35-64 at baseline, 280 died including 56 with stroke during follow up (maximum: 18.2 years; mean: 10.2 years). In this age range, age-adjusted mortality rates (/100'000/year) were 969 for all cause and 187 for stroke; age-adjusted prevalence of high blood pressure (≥140/90 mmHg) was 48%. In multivariate Cox survival time regression, stroke mortality was increased by 18% and 35% for a 10-mmHg increase in systolic, respectively diastolic BP (p<0.001). Stroke mortality was also associated with age, smoking ≥5 cigarettes vs. no smoking (HR: 2.4; 95% CI: 1.2-4.8) and diabetes (HR: 1.9; 1.02-3.6) but not with sex, LDL-cholesterol intake, alcohol intake and professional occupation. Conclusion. This first population-based cohort study in the African region demonstrates high mortality rates from stroke in middle-aged adults and confirms associations with high BP and other risk factors. This emphasizes the importance of reducing BP and other modifiable risk factors in high risk individuals and in the general population as a main strategy to reduce the burden of stroke.