“Se querem que façamos algo pela floresta tem que nos pagar”: As lógicas da participação dos camponeses nos Comités de Gestão dos Recursos Naturais nos distritos de Palma e Mocimboa da Praia em 2009: Relatório do trabalho de campo em Namiune, Nkonga e 5º Congresso, Maputo, Dezembro de 2010

Our study considers the natural resources of the Miombo forests in Cabo Delgado from a broad ecosystems perspective. Thus, our view goes beyond the disciplinary approaches of forestry, agronomy, biology or zoology, and also of the social sciences, namely anthropology, history, sociology, political science or economics. The present study aims to establish a dialogue and create synergies between Miti Ltd. – the logging company and owner of the forest concessions – as well as government and state structures at the various levels and the communities – through the Committees on Natural Resources – in order to promote the sustainable use of resources and ecosystems. The research methodology we used can broadly be described as moderated transdisciplinary interaction for action-research based on the approach known as Learning for Sustainability (LforS, http://www.cde.unibe.ch/Pages/Project/2/14/Learning-for-Sustainability-Extension-Approach.aspx). The research methods used include: LforS seminars; field work; forests observations focusing, among others, on ecosystems, trees, wildlife, and burned areas; visits to farms; and interviews. We conducted both collective interviews and individual interviews, including with key informants. The main results indicate that members of the Committee on Natural Resources have a dual attitude: their statements defend the paradigm of sustainable use of natural resources as well as their own immediate monetary gain. They are willing to apply the values, concepts and theories of sustainable development that underpin the establishment of Committees on Natural Resources if they are paid for their work or if they can derive direct benefits from it, i.e. if they can earn a salary or allowance. If this does not happen, however, they are willing to allow actors to engage in illegal hunting or logging activities. This dual attitude also exists in relation to forestry operators. If the concession workers pay the committee members in cash or provide goods, they can run their business even if they violate the law. Natural forest regeneration in Nkonga and Namiune already shows the impact of such use. Although there are many saplings that could basically ensure continuous regeneration under sustainable management, repeated burning is damaging the young trees, deforming them and killing a great number of them. Campaigns against uncontrolled fires are ineffective because the administrative and political authorities have a dual attitude as well and are also part of the group that uses resources to their own profit and benefit. There are institutional structures within the administration, populations, and communities to perform regulating functions, create and implement rules, punish offenders, and oversee resource use. However, they feel that since they are not paid for performing these functions, they do not have to do so. This attitude shows a lack of awareness, but also indicates a situation where everyone seeks to derive maximum benefits from existing resource use patterns. Anything goes.

Stent-Retriever Thrombectomy after Intravenous t-PA vs. t-PA Alone in Stroke

Background Among patients with acute ischemic stroke due to occlusions in the proximal anterior intracranial circulation, less than 40% regain functional independence when treated with intravenous tissue plasminogen activator (t-PA) alone. Thrombectomy with the use of a stent retriever, in addition to intravenous t-PA, increases reperfusion rates and may improve long-term functional outcome. Methods We randomly assigned eligible patients with stroke who were receiving or had received intravenous t-PA to continue with t-PA alone (control group) or to undergo endovascular thrombectomy with the use of a stent retriever within 6 hours after symptom onset (intervention group). Patients had confirmed occlusions in the proximal anterior intracranial circulation and an absence of large ischemic-core lesions. The primary outcome was the severity of global disability at 90 days, as assessed by means of the modified Rankin scale (with scores ranging from 0 [no symptoms] to 6 [death]). Results The study was stopped early because of efficacy. At 39 centers, 196 patients underwent randomization (98 patients in each group). In the intervention group, the median time from qualifying imaging to groin puncture was 57 minutes, and the rate of substantial reperfusion at the end of the procedure was 88%. Thrombectomy with the stent retriever plus intravenous t-PA reduced disability at 90 days over the entire range of scores on the modified Rankin scale (P<0.001). The rate of functional independence (modified Rankin scale score, 0 to 2) was higher in the intervention group than in the control group (60% vs. 35%, P<0.001). There were no significant between-group differences in 90-day mortality (9% vs. 12%, P=0.50) or symptomatic intracranial hemorrhage (0% vs. 3%, P=0.12). Conclusions In patients receiving intravenous t-PA for acute ischemic stroke due to occlusions in the proximal anterior intracranial circulation, thrombectomy with a stent retriever within 6 hours after onset improved functional outcomes at 90 days.