Addressing Adherence to Antiretroviral Therapy in Ouagadougou, Burkina Faso: Insights from hospital ethnography

L'épidémie de l'infection au virus de l'immunodéficience humaine (VIH) constitue une crise majeure en santé publique de nos jours. Les efforts de la communauté internationale visent à rendre les traitements antirétroviraux (TARV) plus accessibles aux personnes vivant avec le VIH, particulièrement dans les contextes à ressources limitées. Une observance quasi-parfaite aux TARV est requise pour tirer le maximum de bénéfices thérapeutiques à l'échelle individuelle et à l'échelle populationnelle. Cependant, l’accroissement de la disponibilité des TARV s'effectue dans des pays africains qui disposent de systèmes de santé fragiles et sous-financés. Ceux-ci souffrent également d'une pénurie de personnel de santé, lequel joue un rôle central dans la mise en oeuvre et la pérennité des interventions, notamment celle du soutien à l'observance thérapeutique. La présente étude ethnographique relate l'expérience de personnel de santé dans la fourniture des services de soutien à l'observance dans un contexte de ressources limitées et d'accroissement de l'accès aux TARV. L'étude a été menée dans deux centres hospitaliers de la capitale du Burkina Faso, Ouagadougou. Trois conclusions principales sont mises au jour. Tout d'abord, une bonne organisation – tant logistique que matérielle – dans la provision de services de soutien à l'observance est capitale. L’infrastructure d’observance doit aller au-delà des unités de prise en charge et s’intégrer au sein du système de santé pour assurer un impact durable. De plus, la provision des TARV dans le cadre d'une prise en charge médicale exhaustive est essentielle pour un soutien à l'observance efficace. Ceci implique la présence de professionnelles de santé en nombre suffisant et disposant d‘outils pour soutenir leur pratique clinique (tests de laboratoire, traitements pour infections opportunistes), ainsi que des mécanismes pour leur permettre d’aider les patients à gérer la vie quotidienne (gratuité des services, programmes d’alphabétisation et soutien psychosociale). Enfin, une amélioration de la coordination des programmes VIH au niveau national et international est nécessaire pour assurer une prise en charge cohérente au niveau local. La programmation conçue dans les pays étrangers qui est incomplète et de courte durée a un impact majeur sur la disponibilité de ressources humaines et matérielles à long terme, ainsi que sur les conditions de travail et de prestation de services dans les unités de soins.

Qu’est-ce que le bien des écosystèmes? Fondements philosophiques des notions de fonction écologique et de santé écosystémique

L’objectif de cette thèse est de proposer une caractérisation du bien propre des touts écologiques, comme les communautés biotiques et les écosystèmes, dont peut être dérivée une notion de ce qui est bon pour eux. Ceci vise à défendre les deux principales approches holistes en éthique de l’environnement, c’est-à-dire l’approche pragmatiste défendue par Bryan G. Norton et l’approche écocentriste défendue par J. Baird Callicott, contre certaines objections ayant été soulevées contre elles, faisant valoir l’impossibilité pour les écosystèmes d’avoir un bien propre. Cette thèse répond à ces objections en mobilisant plusieurs ressources théoriques issues de la philosophie de la biologie et de la méta-éthique. Ces ressources sont notamment celles fournies par les discussions sur les notions de fonction et de santé en philosophie de la biologie, celles fournies par les conceptions néo-aristotéliciennes de la normativité en méta-éthique, et celles offertes par les discussions de philosophie de l’écologie sur le holisme et le réductionnisme, sur l’idée d’équilibre de la nature, et sur le concept de santé écosystémique. Cette thèse mobilise ces ressources afin d’élaborer les fondements philosophiques des notions de fonction écologique et de santé écosystémique, desquelles est dérivée une caractérisation du bien propre des écosystèmes.

Studies on the Effects of Bottom Trawling on the Benthic Fauna off Veraval Coast, Gujarat

Bottom trawling is one among the most destructive human induced physical disturbances inflicted to seabed and its living communities. The bottom trawls are designed to tow along the sea floor, which on its operation indiscriminately smashes everything on their way crushing, killing, burying and exposing to predators the benthic fauna. Bottom trawling causes physical and biological damages that are irreversible, extensive and long lasting. The commercial trawling fleet of India consists of 29,241 small and medium-fishing boats. The northwest coast of India has the largest fishing fleet consisting of 23,618 mechanized vessels, especially the bottom trawlers. However, attempts were not made to study the impact of bottom trawling along Northwest coast of India. The estimated optimum fleet size of Gujarat is 1,473 mechanised trawlers while 7402 commercial trawlers are operated from the coast of Gujarat. Veraval port was designed initially for 1,200 fishing trawlers but 2793 trawlers are being operated from this port making it the largest trawler port of Gujarat. The aim of this study was to investigate the effects of bottom trawling on the substratum and the associated benthic communities of commercial trawling grounds of Veraval coast. The study compared the differences between the samples collected before and after experimental trawling to detect the impacts of bottom trawling. Attempts were made to assess the possible impact of bottom trawling on:(i) the sediment characteristics (ii)the sediment heavy metals (iii) epifauna (iv) macrobenthos and (v) meiobenthos. This study is expected to generate information on trawling impacts of the studied area that will help in better management of the biological diversity and integrity of the benthic fauna off Veraval coast. An exhaustive review on the studies conducted around the world and in India on impact of bottom trawling on the benthic fauna is also detailed.In the present study, the bottom trawling induced variations on sediment organic matter, epifauna, macrobenthos and meiobenthos were evident. It was also observed that the seasonal/ natural variations were more prominent masking the trawling effect on sediment texture and heavy metals. Enforcement of control of excess bottom trawlers and popularization of semi pelagic trawls designed to operate a little distance above the sea bottom for off bottom resources will minimize disturbance on the sea bottom. Training and creating awareness in responsible fishing should be made mandatory requirements, to the coastal communities. They should be made wardens to protect the valuable resources for the benefit of sustainability. To protect the biodiversity and ecosystem health, the imminent need is to survey and make catalogue, identification of sensitive areas or hot spots and to adopt management strategies for the conservation and biodiversity protection of benthic fauna. The present study is a pioneering work carried out along Veraval coast. This thesis will provide a major fillip to the studies on impact of bottom trawling on the benthic fauna along the coast of India.

La cooperación internacional de la agencia de cooperación técnica alemana, GTZ,con la comunidad indígena de Yanacona. La existencia o inexistencia de factores desostenibilidad

Los múltiples cambios políticos, sociales, económicos y culturales ocurridos en el mundo han reactivado en los últimos años la dinámica de cooperación internacional, como consecuencia de la mundialización y de la internacionalización de las economías.

Indicators of nitrate in wetland surface and soil-waters: interactions of vegetation and environmental factors

This paper describes a new bio-indicator method for assessing wetland ecosystem health: as such, the study is particularly relevant to current legislation such as the EU Water Framework Directive, which provides a baseline of the current status Of Surface waters. Seven wetland sites were monitored across northern Britain, with model construction data for predicting, eco-hydroloplical relationships collected from five sites during 1999, Two new sites and one repeat site were monitored during 2000 to provide model test data. The main growing season for the vegetation, and hence the sampling period, was May-August during both years. Seasonal mean concentrations of nitrate (NO3-) in surface and soil water samples during 1999 ranged from 0.01 to 14.07 mg N 1(-1), with a mean value of 1.01 mg N 1(-1). During 2000, concentrations ranged from trace level (<0.01 m- N 1(-1)) to 9.43 mg N 1(-1), with a mean of 2.73 mg N 1(.)(-1) Surface and soil-water nitrate concentrations did not influence plant species composition significantly across representative tall herb fen and mire communities. Predictive relationships were found between nitrate concentrations and structural characteristics of the wetland vegetation, and a model was developed which predicted nitrate concentrations from measures of plant diversity, canopy structure and density of reproductive structures. Two further models, which predicted stem density and density of reproductive structures respectively, utilised nitrate concentration as one of the independent predictor variables. Where appropriate, the models were tested using data collected during 2000. This approach is complementary to species-based monitoring, representing a useful and simple too] to assess ecological status in target wetland systems and has potential for bio-indication purposes.

Nitrogen processes in aquatic ecosystems

Executive summary Nature of the problem (science/management/policy) • Freshwater ecosystems play a key role in the European nitrogen (N) cycle, both as a reactive agent that transfers, stores and processes N loadings from the atmosphere and terrestrial ecosystems, and as a natural environment severely impacted by the increase of these loadings. Approaches • This chapter is a review of major processes and factors controlling N transport and transformations for running waters, standing waters, groundwaters and riparian wetlands. Key findings/state of knowledge • The major factor controlling N processes in freshwater ecosystems is the residence time of water, which varies widely both in space and in time, and which is sensitive to changes in climate, land use and management. • The effects of increased N loadings to European freshwaters include acidification in semi-natural environments, and eutrophication in more disturbed ecosystems, with associated loss of biodiversity in both cases. • An important part of the nitrogen transferred by surface waters is in the form of organic N, as dissolved organic N (DON) and particulate organic N (PON). This part is dominant in semi-natural catchments throughout Europe and remains a significant component of the total N load even in nitrate enriched rivers. • In eutrophicated standing freshwaters N can be a factor limiting or co-limiting biological production, and control of both N and phosphorus (P) loading is oft en needed in impacted areas, if ecological quality is to be restored. Major uncertainties/challenges • The importance of storage and denitrifi cation in aquifers is a major uncertainty in the global N cycle, and controls in part the response of catchments to land use or management changes. In some aquifers, the increase of N concentrations will continue for decades even if efficient mitigation measures are implemented now. • Nitrate retention by riparian wetlands has oft en been highlighted. However, their use for mitigation must be treated with caution, since their effectiveness is difficult to predict, and side effects include increased DON emissions to adjacent open waters, N2O emissions to the atmosphere, and loss of biodiversity. • In fact, the character and specific spatial origins of DON are not fully understood, and similarly the quantitative importance of indirect N2O emissions from freshwater ecosystems as a result of N leaching losses from agricultural soils is still poorly known at the regional scale. • These major uncertainties remain due to the lack of adequate monitoring (all forms of N at a relevant frequency), especially – but not only – in the southern and eastern EU countries. Recommendations (research/policy) • The great variability of transfer pathways, buffering capacity and sensitivity of the catchments and of the freshwater ecosystems calls for site specific mitigation measures rather than standard ones applied at regional to national scale. • The spatial and temporal variations of the N forms, the processes controlling the transport and transformation of N within freshwaters, require further investigation if the role of N in influencing freshwater ecosystem health is to be better understood, underpinning the implementation of the EU Water Framework Directive for European freshwaters.

Large climate-induced changes in ultraviolet index and stratosphere-to-troposphere ozone flux

Now that stratospheric ozone depletion has been controlled by the Montreal Protocol1, interest has turned to the effects of climate change on the ozone layer. Climate models predict an accelerated stratospheric circulation, leading to changes in the spatial distribution of stratospheric ozone and an increased stratosphere-to-troposphere ozone flux. Here we use an atmospheric chemistry climate model to isolate the effects of climate change from those of ozone depletion and recovery on stratosphere-to-troposphere ozone flux and the clear-sky ultraviolet radiation index—a measure of potential human exposure to ultraviolet radiation. We show that under the Intergovernmental Panel on Climate Change moderate emissions scenario, global stratosphere-to- troposphere ozone flux increases by 23% between 1965 and 2095 as a result of climate change. During this time, the clear-sky ultraviolet radiation index decreases by 9% in northern high latitudes — a much larger effect than that of stratospheric ozone recovery — and increases by 4% in the tropics, and by up to 20% in southern high latitudes in late spring and early summer. The latter increase in the ultraviolet index is equivalent to nearly half of that generated by the Antarctic ‘ozone hole’ that was created by anthropogenic halogens. Our results suggest that climate change will alter the tropospheric ozone budget and the ultraviolet index, which would have consequences for tropospheric radiative forcing, air quality and human and ecosystem health.

Global-scale climate impact functions: the relationship between climate forcing and impact

Although there is a strong policy interest in the impacts of climate change corresponding to different degrees of climate change, there is so far little consistent empirical evidence of the relationship between climate forcing and impact. This is because the vast majority of impact assessments use emissions-based scenarios with associated socio-economic assumptions, and it is not feasible to infer impacts at other temperature changes by interpolation. This paper presents an assessment of the global-scale impacts of climate change in 2050 corresponding to defined increases in global mean temperature, using spatially-explicit impacts models representing impacts in the water resources, river flooding, coastal, agriculture, ecosystem and built environment sectors. Pattern-scaling is used to construct climate scenarios associated with specific changes in global mean surface temperature, and a relationship between temperature and sea level used to construct sea level rise scenarios. Climate scenarios are constructed from 21 climate models to give an indication of the uncertainty between forcing and response. The analysis shows that there is considerable uncertainty in the impacts associated with a given increase in global mean temperature, due largely to uncertainty in the projected regional change in precipitation. This has important policy implications. There is evidence for some sectors of a non-linear relationship between global mean temperature change and impact, due to the changing relative importance of temperature and precipitation change. In the socio-economic sectors considered here, the relationships are reasonably consistent between socio-economic scenarios if impacts are expressed in proportional terms, but there can be large differences in absolute terms. There are a number of caveats with the approach, including the use of pattern-scaling to construct scenarios, the use of one impacts model per sector, and the sensitivity of the shape of the relationships between forcing and response to the definition of the impact indicator.

Reforesting degraded agricultural landscapes with Eucalypts: effects on carbon storage and soil fertility after 26years

In the Western Australian wheatbelt, the restoration of native eucalypt forests for managing degraded agricultural landscapes is a critical part of managing dryland salinity and rebuilding biodiversity. Such reforestation will also sequester carbon. Whereas most investigative emphasis has been on carbon stored in biomass, the effects of reforestation on soil organic carbon (SOC) stores and fertility are not known. Two 26 year old reforestation experiments with four Eucalyptus species (E. cladocalyx var nana, E. occidentalis, E. sargentii and E. wandoo) were compared with agricultural sites (Field). SOC stores (to 0.3 m depth) ranged between 33 and 55 Mg ha−1, with no statistically significant differences between tree species and adjacent farmland. Farming comprised crop and pasture rotations. In contrast, the reforested plots contained additional carbon in the tree biomass (23–60 Mg ha−1) and litter (19–34 Mg ha−1), with the greatest litter accumulation associated with E. sargentii. Litter represented between 29 and 56% of the biomass carbon and the protection or utilization of this litter in fire-prone, semi-arid farmland will be an important component of carbon management. Exch-Na and Exch-Mg accumulated under E. sargentii and E. occidentalis at one site. The results raise questions about the conclusions of SOC sequestration studies following reforestation based on limited sampling and reiterate the importance of considering litter in reforestation carbon accounts.

Avaliação da atividade turística sobre a composição e a distribuição das macroalgas marinhas nos recifes de Pirangi (Rio Grande do Norte, Brasil)

The reef area of Pirangi beach has been experiencing antropogenic actions, mainly due to tourism activity. In order to evaluate these effects, surveys on seaweeds were conducted at nine stations located over the fringing reef. Benthic community (seaweeds/corals) were identified using the photoquadrat method, with 50 meters random transects located paralleled to the coast. The general categories evaluated in each transect were: rock, sand, seaweeds, corals and mollusks. Data achieved were processed at Coral Point Count with Excel Extensions software. A total of 30 seaweed species, 5 coral species and 1 mollusk species were identified. There was a high dominance of short algae at stations with high tourism pressure, whereas frondose algae usually occurred at places without human interference. Seaweeds with the highest percent cover were composed by Sargassum vulgare (59%), Caulerpa racemosa (47%) and Dictyopteris delicatula (33%). Cluster analyses considering benthic organisms revealed five benthic features: (1) submersed area characterized by a diversified marine flora; (2) area with dominance of Caulerpa racemosa and presence of Millepora alcicornis; (3) area with high cover of Sargassum vulgare; (4) trampling area characterized by bare rocks, short algae and Zoanthus sociatus and (5) area with high coverage of Palythoa caribaeroum. Obtained data suggest that the studied area has been damaged by tourism activities. Furthermore, observed differences in algal communities may be a good indicator of ecosystem health of Pirangi reefs

Consumo regular de suco de laranja vermelha em portadores de hepatite C crônica

Pós-graduação em Alimentos e Nutrição - FCFAR

Origem e dinâmica do mercúrio em sistemas de transformação latossolo-espodossolo na bacia do Rio Negro, Amazonas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A gestão de doenças infecto-contagiosas: o impacto do dengue na saúde pública

Os vírus do dengue possuem quatro sorotipos distintos (DENV 1-4) e a infecção por um sorotipo confere imunidade específica em longo prazo apenas para aquele sorotipo. O declínio e a reemergência de epidemias de dengue estão intimamente relacionadas com a migração populacional, o intercâmbio e a introdução de sorotipos, o aumento da população, a urbanização descontrolada, o aumento da infestação por mosquitos do gênero Aedes, que são vetores dos vírus e por mudanças na conjuntura política dos municípios. A doença configura-se como um grande problema de saúde pública e cerca de três bilhões de pessoas encontram-se em risco de contrair o vírus e, anualmente, milhões de casos de dengue são notificados, com aproximadamente 500 mil internações. O impacto econômico da doença não está direcionado apenas aos gastos diretamente relacionados ao tratamento, mas também, ao controle e à prevenção. Além disto, outros desdobramentos podem ocorrer, como gastos gerados por afastamento do trabalho no período de convalescença e por morte devido à infecção pelo vírus. As constantes trocas de equipes de prevenção e controle podem impactar negativamente a doença, favorecendo a dispersão do vetor e a manutenção do dengue no ambiente. Desta forma, o objetivo do trabalho é sistematizar as informações sobre o impacto do dengue na gestão dos recursos destinados a doenças infecto-contagiosas.

Pneumonia and bacteremia in a golden-headed lion tamarin (Leontopithecus chrysomelas) caused by Klebsiella pneumoniae subsp pneumoniae during a translocation program of free-ranging animals in Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)