Indigenous land reconfiguration and fragmented institutions: a historical political ecology of Tsimane’ lands (Bolivian Amazon)

Lands inhabited by indigenous peoples often have low population density but abundant natural resources. For those reasons, many actors have historically attempted to occupy those lands or use the resources in them. Increasing pressures over lands occupied by indigenous peoples have resulted in the awakening of indigenous peoples over their rights to land and resources generating many debates over indigenous peoples' rights to land and self-governance. In this article, we provide a historical and geographical overview of territorial and governance issues among the Tsimane', an indigenous group native to the Bolivian Amazon. We examine how the Bolivian state economic policies implemented during the 20th century affected the Tsimane' ancestral lands, and how – over the late-20th century – the Bolivian state accommodated Tsimane' claims to lands in between multiple interests. We show how national policies led to the reconfiguration of Tsimane' territoriality and to a fragmented institutional representation. Current indigenous territories and indigenous political representation are an expression of conflictive policies that have involved multiple actors and their specific interests on indigenous lands and its resources.

Long-term outcome of patients with spinal myxopapillary ependymoma: treatment results from the MD Anderson Cancer Center and institutions from the Rare Cancer Network.

BACKGROUND Spinal myxopapillary ependymomas (MPEs) are slowly growing ependymal gliomas with preferential manifestation in young adults. The aim of this study was to assess the outcome of patients with MPE treated with surgery, radiotherapy (RT), and/or chemotherapy. METHODS The medical records of 183 MPE patients (male: 59%) treated at the MD Anderson Cancer Center and 11 institutions from the Rare Cancer Network were retrospectively reviewed. Mean patient' age at diagnosis was 35.5 ± 15.8 years. Ninety-seven (53.0%) patients underwent surgery without RT, and 86 (47.0%) were treated with surgery and/or RT. Median RT dose was 50.4 Gy. Median follow-up was 83.9 months. RESULTS Fifteen (8.2%) patients died, 7 of unrelated cause. The estimated 10-year overall survival was 92.4% (95% CI: 87.7-97.1). Treatment failure was observed in 58 (31.7%) patients. Local failure, distant spinal relapse, and brain failure were observed in 49 (26.8%), 17 (9.3%), and 11 (6.0%) patients, respectively. The estimated 10-year progression-free survival was 61.2% (95% CI: 52.8-69.6). Age (<36 vs ≥36 y), treatment modality (surgery alone vs surgery and RT), and extent of surgery were prognostic factors for local control and progression-free survival on univariate and multivariate analysis. CONCLUSIONS In this series, treatment failure of MPE occurred in approximately one third of patients. The observed recurrence pattern of primary spinal MPE was mainly local, but a substantial number of patients failed nonlocally. Younger patients and those not treated initially with adjuvant RT or not undergoing gross total resection were significantly more likely to present with tumor recurrence/progression.