Draft biennial programme of regional and international cooperation activities of the Statistical Conference of the Americas of ECLAC, 2007-2009

Includes bibliography

Biennial programme of regional and international cooperation activities of the statistical conference of the Americas of ECLAC, 2007-2009

Includes bibliography

Progress report on the biennial programme of regional and international cooperation activities of the Statistical Conference of the Americas of the Economic Commission for Latin America and the Caribbean (ECLAC), 2007-2009

Includes bibliography

Report on the implementation of the 2009-2011 biennial programme of regional and international cooperation activities of the Statistical Conference of the Americas of ECLAC

Incluye Bibliografía

Draft biennial programme of regional and international cooperation activities of the Statistical Conference of the Americas, 2012-2013

Incluye Bibliografía

Institutionality, logistics and international cooperation for the economic and social development: The case of the Plurinational State of Bolivia

Includes bibliography.

The Role of Non-Governmental Organizations in International Cooperation in Public Health

This article discusses the possibility of the NGOs acting on international health cooperation and how this acting is regulated. Firstly, the international cooperation and its relation with public health is presented. After that, data on Brazilian bilateral health cooperation are brought in, in which it is possible to find the formal recognition of NGOs as partners of States. This allows the consideration of the role of NGOs in health cooperation. Although the action of NGOs is legitimated by international law, their regulation is just beginning. This suggests important issues to be improved in the legal relation between NGOs and States in the field of public health.

Ni una más. International cooperation against gender-based discrimination: the femicide case in Ciudad Juárez, Chihuahua, Mexico

The femicide in Ciudad Juárez is a story made of extreme violence against women for different reasons, by different actors, under different circumstances, and following different behavioural patterns. All within a gender discrimination frame based on the idea that women are inferior, interchangeable and disposable according to the patriarchal hierarchy still present in Mexico, but strongly reinforced by a sort of conspiracy of silence provoked either by the high impunity rate, the governmental incompetence to solve the crimes, or the general indifference of the population. It is the story of hundreds of kidnapped, raped, in many cases tortured, and murdered young women in the border between Mexico and the United States. The murders first came into light in 1993 and up to now young women continue to “disappear” without any hope of bringing the perpetrators to justice, stopping impunity, convicting the assassins, and bringing justice to the families of the deceased girls and women. The main questions about femicide in Ciudad Juárez seem to be: why were they brutally assassinated?, why most of the crimes have not been solved yet?, why and how is Ciudad Juárez different from other border cities with the same characteristics?, which powers are behind those crimes in a city that implies mainly women as its labor force, and which has the lowest unemployment rate in the whole country? But there are also many other questions dealing more with the context, the Juarences’ lifestyles, the eventual hidden powers behind the crimes, the possible murderers’ reasons, the response of the local civil society, or the international community actions to fight against femicide there, among many other things, that are still waiting for an answer and that this paper will ‘narrate’ in order to provide a holistic panorama for the readers. But above all there is the need to remember that every single woman or girl assassinated there had a name, an identity, a family, a story to be told time after time and as many times as necessary, in order to avoid accepting these crimes just as statistics, as cold numbers that might make us forget the human tragedy that has been flagellating the city since 1993. We must remember as well that their deaths express gender oppression, the inequality of the relations between what is male and what is female, a manifestation of domination, terror, social extermination, patriarchal hegemony, social class and impunity. The city is the perfect mirror where all the contradictions of globalization get reflected. It is there where all the globalization evils are present and survive by sucking their women’s blood. It is a city where some concepts such as gender, migration and power are closely related with a negative connotation.

International cooperation in endourology: percutaneous and flexible ureteroscopic treatment of lower pole kidney stones

Introduction Lower pole kidney stones represent at time a challenge for the urologist. The gold standard treatment for intrarenal stones <2 cm is Extracorporeal Shock Wave Lithotripsy (ESWL) while for those >2 cm is Percutaneous Nephrolithotomy (PCNL). The success rate of ESWL, however, decreases when it is employed for lower pole stones, and this is particularly true in the presence of narrow calices or acute infundibular angles. Studies have proved that ureteroscopy (URS) is an efficacious alternative to ESWL for lower pole stones <2 cm, but this is not reflected by either the European or the American guidelines. The aim of this study is to present the results of a large series of flexible ureteroscopies and PCNLs for lower pole kidney stones from high-volume centers, in order to provide more evidences on the potential indications of the flexible ureteroscopy for the treatment of kidney stones. Materials and Methods A database was created and the participating centres retrospectively entered their data relating to the percutaneous and flexible ureteroscopic management of lower pole kidney stones. Patients included were treated between January 2005 and January 2010. Variables analyzed included case load number, preoperative and postoperative imaging, stone burden, anaesthesia (general vs. spinal), type of lithotripter, access location and size, access dilation type, ureteral access sheath use, visual clarity, operative time, stone-free rate, complication rate, hospital stay, analgesic requirement and follow-up time. Stone-free rate was defined as absence of residual fragments or presence of a single fragment <2 mm in size at follow-up imaging. Primary end-point was to test the efficacy and safety of flexible URS for the treatment of lower pole stones; the same descriptive analysis was conducted for the PCNL approach, as considered the gold standard for the treatment of lower pole kidney stones. In this setting, no statistical analysis was conducted owing to the different selection criteria of the patients. Secondary end-point consisted in matching the results of stone-free rates, operative time and complications rate of flexible URS and PCNL in the subgroup of patients harbouring lower pole kidney stones between 1 and 2 cm in the higher diameter. Results A total 246 patients met the criteria for inclusion. There were 117 PCNLs (group 1) and 129 flexible URS (group 2). Ninety-six percent of cases were diagnosed by CT KUB scan. Mean stone burden was 175±160 and 50±62 mm2 for groups 1 and 2, respectively. General anaesthesia was induced in 100 % and 80% of groups 1 and 2, respectively. Pneumo-ultrasonic energy was used in 84% of cases in the PCNL group, and holmium laser in 95% of the cases in the flexible URS group. The mean operative time was 76.9±44 and 63±37 minutes for groups 1 and 2 respectively. There were 12 major complications (11%) in group 1 (mainly Grade II complications according to Clavidien classification) and no major complications in group 2. Mean hospital stay was 5.7 and 2.6 days for groups 1 and 2, respectively. Ninety-five percent of group 1 and 52% of group 2 required analgesia for a period longer than 24 hours. Intraoperative stone-free rate after a single treatment was 88.9% for group 1 and 79.1% for group 2. Overall, 6% of group 1 and 14.7% of group 2 required a second look procedure. At 3 months, stone-free rates were 90.6% and 92.2% for groups 1 and 2, respectively, as documented by follow-up CT KUB (22%) or combination of intra-venous pyelogram, regular KUB and/or kidney ultrasound (78%). In the subanalysis conducted comparing 82 vs 65 patients who underwent PCNL and flexible URS for lower pole stones between 1 and 2 cm, intreoperative stone-free rates were 88% vs 68% (p= 0.03), respectively; anyway, after an auxiliary procedure which was necessary in 6% of the cases in group 1 and 23% in group 2 (p=0.03), stone-free rates at 3 months were not statistically significant (91.5% vs 89.2%; p=0.6). Conversely, the patients undergoing PCNL maintained a higher risk of complications during the procedure, with 9 cases observed in this group versus 0 in the group of patients treated with URS (p=0.01) Conclusions These data highlight the value of flexible URS as a very effective and safe option for the treatment of kidney stones; thanks to the latest generation of flexible devices, this new technical approach seems to be a valid alternative in particular for the treatment of lower pole kidney stones less than 2 cm. In high-volume centres and in the hands of skilled surgeons, this technique can approach the stone-free rates achievable through PCNL in lower pole stones between 1 and 2 cm, with a very low risk of complications. Furthermore, the results confirm the high success rate and relatively low morbidity of modern PCNL for lower pole stones, with no difference detectable between the prone and supine position.