Bullying among adolescents in a sub-Saharan middle-income setting.

PURPOSE: This study explored factors associated with self-reported bullying among adolescents in a sub-Saharan country. METHODS: A cross-sectional sample of adolescents (n = 1,427) in the Seychelles was drawn from the Global School-based Student Health Survey. Bullied adolescents were compared with non-bullied adolescents with respect to several sociodemographic factors. Bivariate and multivariate analyses were performed. RESULTS: Within a 30 day period, 38.8% of adolescents reported being bullied. Bullied youths were more likely to be depressed (adjusted odds ratio [aOR] = 1.63; confidence intervals [CI] = 1.27-1.07) and socially deprived (aOR = 1.85; CI = 1.30-2.61). Being older (aOR = .83; CI = .77-.90) and having close friends (aOR = .53; CI = .31-.91) were protective factors. CONCLUSIONS: The prevalence of bullying in the Seychelles is high, and social correlates are similar to those in industrialized settings. More research is needed to examine bullying patterns outside the school environment.

Chromosomal rearrangement and genetic structure in the shrews of the Sorex araneus group

ABSTRACT The role of chromosomal rearrangements in the speciation process is much debated and many theoretical models have been developed. The shrews of the Sorex araneus group offer extraordinary opportunities to study the relationship between chromosomal variation and speciation. Indeed, this group of morphologically very similar species received a great deal of attention due to its karyotypic variability, which is mainly attributed to Robertsonian fusions. To explore the impact of karyotypic changes on genetic differentiation, we first studied the relationship between genetic and karyotypic structure among Alpine species and among chromosome races of the S. araneus group using Bayesian admixture analyses. The results of these analyses confirmed the taxonomic status of the studied species even though introgression can still be detected between species. Moreover, the strong spatial sub-structure highlighted the role of historical factors (e.g. geographical isolation) on genetic structure. Next, we studied gene flow at the chromosome level to address the question of the impact of chromosomal rearrangements on genetic differentiation. We used flow sorted chromosomes from three different karyotypic taxa of the S. araneus group to map microsatellite markers at the chromosóme arm level. We have been able to map 24 markers and to show that the karyotypic organisation of these taxa is well conserved, which suggests that these markers can be used for further inter-taxa studies. A general prediction of chromosomal speciation models is that genetic differentiation between two taxa should be larger across rearranged chromosomes than across chromosomes common to both taxa. We combined two approaches using mapped microsatellites to test this prediction. First, we studied the genetic differentiation among five shrew taxa placed at different evolutionary levels (i.e. within and among species). In this large scale study, we detected an overall significant difference in genetic structure between rearranged vs. common chromosomes. Moreover, this effect varied among pairwise comparisons, which allowed us to differentiate the role of the karyotypic complexity of hybrids and of the evolutionary divergence between taxa. Secondly, we compared the levels of gene flow measured across common vs. rearranged chromosomes in two karyotypically different hybrid zones (strong vs. low complexity of hybrids), which show similar levels of genetic structure. We detected a significantly stronger genetic structure across rearranged chromosomes in the hybrid zone showing the highest level of hybrid complexity. The large variance observed among loci suggested that other factors, such as the position of markers within the chromosome, also certainly affects genetic structure. In conclusion, our results strongly support the role of chromosomal rearrangements in the reproductive barrier and suggest their importance in speciation process of the S. araneus group. RESUME Le rôle des réarrangements chromosomiques dans les processus de spéciation est fortement débattu et de nombreux modèles théoriques ont été développés sur le sujet. Les musaraignes du groupe Sorex araneus présentent de nombreuses opportunités pour étudier les relations entre les variations chromosomiques et la spéciation. En effet, ce groupe d'espèces morphologiquement très proches a attiré l'attention des chercheurs en raison de sa variabilité caryotypique principalement attribuée à des fusions Robertsoniennes. Pour explorer l'impact des changements caryotypiques sur la différenciation génétique, nous avons tout d'abord étudié les relations entre la structure génétique et caryotypique de races chromosomiques et d'espèces alpine du groupe S. araneus en utilisant des analyses Bayesiennes d' « admixture ». Les résultats de ces analyses ont confirmé le statut taxonomique des espèces étudiées bien que nous ayons détecté de l'introgression entre espèces. L'observation d'une sous structure spatiale relativement forte souligne l'importance des facteurs historiques (telle que l'isolation géographique) sur la structure génétique de ce groupe. Ensuite, nous avons étudié le flux de gène au niveau des chromosomes pour aborder de manière directe la question de l'impact des réarrangements chromosomiques sur la différenciation génétique. En conséquence, nous avons utilisé des tris de chromosomes de trois taxons du groupe S. araneus pour localiser des marqueurs microsatellites au niveau du bras chromosomique. Au cours de cette étude, nous avons pu localiser 24 marqueurs et montrer une forte conservation dans l'organisation du caryotype de ces taxa. Ce résultat suggère que leur utilisation est appropriée pour des études entre taxa. Une prédiction générale à tous les modèles de spéciation chromosomique correspond à la plus grande différenciation génétique des chromosomes réarrangés que des chromosomes communs. Nous avons combiné deux approches utilisant des microsatellites localisés au niveau du bras chromosomique pour tester cette prédiction. Premièrement, nous avons étudié la différenciation génétique entre cinq taxa du groupe S. araneus se trouvant à des niveaux évolutifs différents (i.e. à l'intérieur et entre espèce). Au cours de cette étude, nous avons détecté une différenciation globale significativement plus élevée sur les chromosomes réarrangés. Cet effet varie entre les comparaisons, ce qui nous a permis de souligner le rôle de la complexité caryotypique des hybrides et du niveau de divergence évolutive entre taxa. Deuxièmement, nous avons comparé le flux de gènes des chromosomes communs et réarrangés dans deux zones d'hybridation caryotypiquement différentes (forte vs. Faible complexité des hybrides) mais présentant un niveau de différenciation génétique similaire. Ceci nous a permis de détecter une structure génétique significativement plus élevée sur les chromosomes réarrangés au centre de la zone d'hybridation présentant la plus grande complexité caryotypic. La forte variance observée entre loci souligne en outre le fait que d'autres facteurs, tel que la position du marqueur sur le chromosome, affectent probablement aussi la structure génétique mesurée. En conclusion, nos résultats supportent fortement le rôle des réarrangements chromosomiques dans la barrière reproductive entre espèces ainsi que leur importance dans les processus de spéciation des musaraignes du groupe S. araneus.

Longer term clinical and virological outcome of sub-Saharan African participants on antiretroviral treatment in the Swiss HIV Cohort Study.

OBJECTIVES: Persons from sub-Saharan Africa (SSA) are increasingly enrolled in the Swiss HIV Cohort Study (SHCS). Cohorts from other European countries showed higher rates of viral failure among their SSA participants. We analyzed long-term outcomes of SSA versus North Western European participants. DESIGN: We analyzed data of the SHCS, a nation-wide prospective cohort study of HIV-infected adults at 7 sites in Switzerland. METHODS: SSA and North Western European participants were included if their first treatment combination consisted of at least 3 antiretroviral drugs (cART), if they had at least 1 follow-up visit, did not report active injecting drug use, and did not start cART with CD4 counts >200 cells per microliter during pregnancy. Early viral response, CD4 cell recovery, viral failure, adherence, discontinuation from SHCS, new AIDS-defining events, and survival were analyzed using linear regression and Cox proportional hazard models. RESULTS: The proportion of participants from SSA within the SHCS increased from 2.6% (<1995) to 20.8% (2005-2009). Of 4656 included participants, 808 (17.4%) were from SSA. Early viral response (6 months) and rate of viral failure in an intent-to-stay-on-cART approach were similar. However, SSA participants had a higher risk of viral failure on cART (adjusted hazard ratio: 2.03, 95% confidence interval: 1.50 to 2.75). Self-reported adherence was inferior for SSA. There was no increase of AIDS-defining events or mortality in SSA participants. CONCLUSIONS: Increased attention must be given to factors negatively influencing adherence to cART in participants from SSA to guarantee equal longer-term results on cART.

Posterior Sub-Tenon Triamcinolone Injection for Chronic Macular Oedema Associated With Non-Ischemic Branch or Central Retinal Vein Occlusion

Aims: To evaluate the effectiveness and safety of Posterior Sub-Tenon (PST) Triamcinolone Acetonide (TA) injection for persistent macular oedema associated with non-ischemic Central Retinal Vein Occlusion (CRVO) or Branch Retinal Vein Occlusion (BRVO) in non-vitrectomized eye. Methods: Fourteen consecutive eyes of 14 patients characterized by macular oedema lasting more than 3 months and with a visual acuity of less than 20/40 were enrolled. Six eyes presented with BRVO, 8 eyes with CRVO. PST injection of 40 mg TA was performed in topical anaesthesia. All patients were phakic, and followed for at least 6 months. Snellen visual acuity converted to LogMAR units and anatomic responses were evaluated before, and at 1, 3, 6, and 12 (if required) months after injections and re-injection considered. Results: In the BRVO group, mean foveal thickness was 548.2±49.50 μm preoperatively, and 452.8±56.2 μm and 280.8±62.5 μm at 1 and 12 month follow-up, respectively. Statistical analysis showed significant differences between preoperative and postoperative measurements (P<.05, paired t test) 3 months after injections. Improvement of visual acuity by at least 0.2 LogMAR was seen in 3(50%) of the 6 eyes. No re-injection was needed. In the CRVO group, mean foveal thickness was 543.7±34.4 μm preoperatively, and 283.0±29.0 μm and 234.8±23.6 μm at 1 and 12 month follow-up, respectively. Statistical analysis showed significant differences between preoperative and postoperative measurements (P<.05, paired t test). Improvement of visual acuity by at least 0.2 LogMAR was seen in 7 eyes (88%). Mean number of re-injection was of 2.1±0.3. Intraocular pressure elevation of 22 mm Hg or higher was found in 2/14 eyes (14%). Cataract progression was noted in 5/14 eyes (36%). Conclusions: PST injection of TA appears to be as safe and effective treatment for chronic macular oedema associated due to both non-ischemic BRVO or CRVO, with a better efficacy in BRVO.

Research and training in medicinal chemistry in south and central american countries and sub-saharan Africa

With the proposal to search for universal cooperation in the field of Medicinal Chemistry, the IUPAC group has elaborated a line of work divided into two phases: a- An Awareness of the true situation of Medicinal Chemistry in the different geographic areas of the world; b- A proposal of actions as to achieve more effective cooperation. This first report presents and discusses the actual situation in South and Central America as well as in sub-Saharan Africa.

Lipid peroxidation and total radical-trapping potential of the lungs of rats submitted to chronic and sub-chronic stress

Exposure to stress induces a cluster of physiological and behavioral changes in an effort to maintain the homeostasis of the organism. Long-term exposure to stress, however, has detrimental effects on several cell functions such as the impairment of antioxidant defenses leading to oxidative damage. Oxidative stress is a central feature of many diseases. The lungs are particularly susceptible to lesions by free radicals and pulmonary antioxidant defenses are extensively distributed and include both enzymatic and non-enzymatic systems. The aim of the present study was to determine lipid peroxidation and total radical-trapping potential (TRAP) changes in lungs of rats submitted to different models of chronic stress. Adult male Wistar rats weighing 180-230 g were submitted to different stressors (variable stress, N = 7) or repeated restraint stress for 15 (N = 10) or 40 days (N = 6) and compared to control groups (N = 10 each). Lipid peroxidation levels were assessed by thiobarbituric acid reactive substances (TBARS), and TRAP was measured by the decrease in luminescence using the 2-2'-azo-bis(2-amidinopropane)-luminol system. Chronic variable stress induced a 51% increase in oxidative stress in lungs (control group: 0.037 ± 0.002; variable stress: 0.056 ± 0.007, P < 0.01). No difference in TBARS was observed after chronic restraint stress, but a significant 57% increase in TRAP was presented by the group repeatedly restrained for 15 days (control group: 2.48 ± 0.42; stressed: 3.65 ± 0.16, P < 0.05). We conclude that different stressors induce different effects on the oxidative status of the organism.

Group cognitive behavior therapy for bipolar disorder can improve the quality of life

Bipolar disorder (BD) can have an impact on psychosocial functioning and quality of life (QoL). Several studies have shown that structured psychotherapy in conjunction with pharmacotherapy may modify the course of some disorders; however, few studies have investigated the results of group cognitive behavior therapy (G-CBT) for BD. Our objective was to evaluate the effectiveness of 14 sessions of G-CBT for BD patients, comparing this intervention plus pharmacotherapy to treatment as usual (TAU; only pharmacotherapy). Forty-one patients with BD I and II participated in this study and were randomly allocated to each group (G-CBT: N = 27; TAU: N = 14). Thirty-seven participants completed the treatment (women: N = 66.67%; mean age = 41.5 years). QoL and mood symptoms were assessed in all participants. Scores changed significantly by the end of treatment in favor of the G-CBT group. The G-CBT group presented significantly better QoL in seven of the eight sub-items assessed with the Medical Outcomes Survey SF-36 scale. At the end of treatment, the G-CBT group exhibited lower scores for mania (not statistically significant) and depression (statistically significant) as well as a reduction in the frequency and duration of mood episodes (P < 0.01). The group variable was significant for the reduction of depression scores over time. This clinical change may explain the improvement in six of the eight subscales of QoL (P < 0.05). The G-CBT group showed better QoL in absolute values in all aspects and significant improvements in nearly all subscales. These results were not observed in the TAU control group.

Empathy and Emotion Processing in Mild Head Injury and Sub-clinical Psychopathy

The current study sought to investigate the nature of empathic responding and emotion processing in persons who have experienced Mild Head Injury (MHI) and how this relationship between empathetic responding and head injury status may differ in those with higher psychopathic characteristics (i.e., subclinical psychopathy). One-hundred university students (36% reporting having a previous MHI) completed an Emotional Processing Task (EPT) using images of neutral and negative valence (IAPS, 2008) designed to evoke empathy; physiological responses were recorded. Additionally, participants completed measures of cognitive competence and various individual differences (empathy - QCAE; Reniers, 2011; Psychopathy - SRP-III, Williams, Paulhus & Hare, 2007) and demographics questionnaires. MHI was found to be associated with lower affective empathy and physiological reactivity (pulse rate) while viewing images irrespective of valence, reflecting a pattern of generalized underarousal. The empathic deficits observed correlated with the individual’s severity of injury such that the greater number of injury characteristics and symptoms endorsed by a subject, the more dampened the affective and cognitive empathy reactions to stimuli and the lower his/her physiological reactivity. Importantly, psychopathy interacted with head injury status such that the effects of psychopathy were significant only for individuals indicating a MHI. This group, i.e., MHI subjects who scored higher on psychopathy, displayed the greatest compromise in empathic responding. Interestingly, the Callous Affect component of psychopathy was found to account for the empathic and emotion processing deficits observed for individuals who report a MHI; in contrast, the Interpersonal Manipulation component emerged as a better predictor of empathic and emotion deficits observed in the No MHI group. These different patterns may indicate the involvement of different underlying processes in the manifestation of empathic deficits associated with head injury or subclinical psychopathy. It also highlights the importance of assessing for prior head injury in populations with higher psychopathic characteristics due to the possible combined/enhanced influences. The results of this study have important social implications for persons who have experienced a concussion or limited neural trauma since even subtle injury to the head may be sufficient to produce dampened emotion processing, thereby impacting one’s social interactions and engagement (i.e., at risk for social isolation or altered interpersonal success). Individuals who experience MHI in conjunction with certain personality profiles (e.g., higher psychopathic characteristics) may be particularly at risk for being less capable of empathic compassion and socially-acceptable pragmatics and, as a result, may not be responsive to another person’s emotional well-being.

Changes in cortical and sub-cortical patterns of activity associated with aging during the performance of a lexical set-shifting task

Bien que le passage du temps altère le cerveau, la cognition ne suit pas nécessairement le même destin. En effet, il existe des mécanismes compensatoires qui permettent de préserver la cognition (réserve cognitive) malgré le vieillissement. Les personnes âgées peuvent utiliser de nouveaux circuits neuronaux (compensation neuronale) ou des circuits existants moins susceptibles aux effets du vieillissement (réserve neuronale) pour maintenir un haut niveau de performance cognitive. Toutefois, la façon dont ces mécanismes affectent l’activité corticale et striatale lors de tâches impliquant des changements de règles (set-shifting) et durant le traitement sémantique et phonologique n’a pas été extensivement explorée. Le but de cette thèse est d’explorer comment le vieillissement affecte les patrons d’activité cérébrale dans les processus exécutifs d’une part et dans l’utilisation de règles lexicales d’autre part. Pour cela nous avons utilisé l’imagerie par résonance magnétique fonctionnelle (IRMf) lors de la performance d’une tâche lexicale analogue à celle du Wisconsin. Cette tâche a été fortement liée à de l’activité fronto-stritale lors des changements de règles, ainsi qu’à la mobilisation de régions associées au traitement sémantique et phonologique lors de décisions sémantiques et phonologiques, respectivement. Par conséquent, nous avons comparé l’activité cérébrale de jeunes individus (18 à 35 ans) à celle d’individus âgés (55 à 75 ans) lors de l’exécution de cette tâche. Les deux groupes ont montré l’implication de boucles fronto-striatales associées à la planification et à l’exécution de changements de règle. Toutefois, alors que les jeunes semblaient activer une « boucle cognitive » (cortex préfrontal ventrolatéral, noyau caudé et thalamus) lorsqu’ils se voyaient indiquer qu’un changement de règle était requis, et une « boucle motrice » (cortex postérieur préfrontal et putamen) lorsqu’ils devaient effectuer le changement, les participants âgés montraient une activation des deux boucles lors de l’exécution des changements de règle seulement. Les jeunes adultes tendaient à présenter une augmentation de l’activité du cortex préfrontal ventrolatéral, du gyrus fusiforme, du lobe ventral temporale et du noyau caudé lors des décisions sémantiques, ainsi que de l’activité au niveau de l’aire de Broca postérieur, de la junction temporopariétale et du cortex moteur lors de décisions phonologiques. Les participants âgés ont montré de l’activité au niveau du cortex préfrontal latéral et moteur durant les deux types de décisions lexicales. De plus, lorsque les décisions sémantiques et phonologiques ont été comparées entre elles, les jeunes ont montré des différences significatives au niveau de plusieurs régions cérébrales, mais pas les âgés. En conclusion, notre première étude a montré, lors du set-shifting, un délai de l’activité cérébrale chez les personnes âgées. Cela nous a permis de conceptualiser l’Hypothèse Temporelle de Compensation (troisième manuscrit) qui consiste en l’existence d’un mécanisme compensatoire caractérisé par un délai d’activité cérébrale lié au vieillissement permettant de préserver la cognition au détriment de la vitesse d’exécution. En ce qui concerne les processus langagiers (deuxième étude), les circuits sémantiques et phonologiques semblent se fusionner dans un seul circuit chez les individus âgés, cela représente vraisemblablement des mécanismes de réserve et de compensation neuronales qui permettent de préserver les habilités langagières.

The role of ligneous vegetation for livestock nutrition in the sub-Sahelian and Sudanian zones of West Africa: Potential effects of climate change

Climate change and variability in sub-Saharan West Africa is expected to have negative consequences for crop and livestock farming due to the strong dependence of these sectors on rainfall and natural resources, and the low adaptive capacity of crops farmers, agro-pastoralist and pastoralists in the region. The objective of this PhD research was to investigate the anticipated impacts of expected future climate change and variability on nutrition and grazing management of livestock in the prevailing extensive agro-pastoral and pastoral systems of the Sahelian and Sudanian zones of Burkina Faso. To achieve this, three studies were undertaken in selected village territories (100 km² each) in the southern Sahelian (Taffogo), northern Sudanian (Nobere, Safane) and southern Sudanian (Sokouraba) zone of the country during 2009 and 2010. The choice of two villages in the northern Sudanian zone was guided by the dichotomy between intense agricultural land use and high population density near Safane, and lower agricultural land use in the tampon zone between the village of Nobere and the National Park Kaboré Tambi of Pô. Using global positioning and geographical information systems tools, the spatio-temporal variation in the use of grazing areas by cattle, sheep and goats, and in their foraging behaviour in the four villages was assessed by monitoring three herds each per species during a one-year cycle (Chapter 2). Maximum itinerary lengths (km/d) were observed in the hot dry season (March-May); they were longer for sheep (18.8) and cattle (17.4) than for goats (10.5, p<0.05). Daily total grazing time spent on pasture ranged from 6 - 11 h with cattle staying longer on pasture than small ruminants (p<0.05). Feeding time accounted for 52% - 72% of daily time on pasture, irrespective of species. Herds spent longer time on pasture and walked farther distances in the southern Sahelian than the two Sudanian zones (p<0.01), while daily feeding time was longer in the southern Sudanian than in the other two zones (p>0.05). Proportional time spent resting decreased from the rainy (June - October) to the cool (November - February) and hot dry season (p<0.05), while in parallel the proportion of walking time increased. Feeding time of all species was to a significantly high proportion spent on wooded land (tree crown cover 5-10%, or shrub cover >10%) in the southern Sahelian zone, and on forest land (tree crown cover >10%) in the two Sudanian zones, irrespective of season. It is concluded that with the expansion of cropland in the whole region, remaining islands of wooded land, including also fields fallowed for three or more years with their considerable shrub cover, are particularly valuable pasturing areas for ruminant stock. Measures must be taken that counteract the shrinking of wooded land and forests across the whole region, including also active protection and (re)establishment of drought-tolerant fodder trees. Observation of the selection behaviour of the above herds of cattle and small ruminant as far as browse species were concerned, and interviews with 75 of Fulani livestock keepers on use of browse as feed by their ruminant stock and as remedies for animal disease treatment was undertaken (Chapter 3) in order to evaluate the consequence of climate change for the contribution of browse to livestock nutrition and animal health in the extensive grazing-based livestock systems. The results indicated that grazing cattle and small ruminants do make considerable use of browse species on pasture across the studied agro-ecological zones. Goats spent more time (p<0.01) feeding on browse species than sheep and cattle, which spent a low to moderate proportion of their feeding time on browsing in any of the study sites. As far as the agro-ecological zones were concerned, the contribution of browse species to livestock nutrition was more important in the southern Sahelian and northern Sudanian zone than the southern Sudanian zone, and this contribution is higher during the cold and hot dry season than during the rainy season. A total of 75 browse species were selected on pasture year around, whereby cattle strongly preferred Afzelia africana, Pterocarpus erinaceus and Piliostigma sp., while sheep and goats primarily fed on Balanites aegyptiaca, Ziziphus mauritiana and Acacia sp. Crude protein concentration (in DM) of pods or fruits of the most important browse species selected by goats, sheep and cattle ranged from 7% to 13% for pods, and from 10% to 18% for foliage. The concentration of digestible organic matter of preferred browse species mostly ranged from 40% to 60%, and the concentrations of total phenols, condensed tannins and acid detergent lignin were low. Linear regression analyses showed that browse preference on pasture is strongly related to its contents (% of DM) of CP, ADF, NDF and OM digestibility. Interviewed livestock keepers reported that browse species are increasingly use by their grazing animals, while for animal health care use of tree- and shrub-based remedies decreased over the last two decades. It is concluded that due to climate change with expected negative impact on the productivity of the herbaceous layer of communal pastures browse fodder will gain in importance for animal nutrition. Therefore re-establishment and dissemination of locally adapted browse species preferred by ruminants is needed to increase the nutritional situation of ruminant stock in the region and contribute to species diversity and soil fertility restoration in degraded pasture areas. In Chapter 4 a combination of household surveys and participatory research approaches was used in the four villages, and additionally in the village of Zogoré (southern Sahelian zone) and of Karangasso Vigué (northern Sudanian zone) to investigate pastoralists’ (n= 76) and agro-pastoralists’ (n= 83) perception of climate change, and their adaptation strategies in crop and livestock production at farm level. Across the three agro-ecological zones, the majority of the interviewees perceived an increase in maximum day temperatures and decrease of total annual rainfall over the last two decades. Perceptions of change in climate patterns were in line with meteorological data for increased temperatures while for total rainfall farmers’ views contrasted the rainfall records which showed a slight increase of precipitation. According to all interviewees climate change and variability have negative impacts on their crop and animal husbandry, and most of them already adopted some coping and adaptation strategies at farm level to secure their livelihoods and reduce negative impacts on their farming system. Although these strategies are valuable and can help crop and livestock farmers to cope with the recurrent droughts and climate variability, they are not effective against expected extreme climate events. Governmental and non-governmental organisations should develop effective policies and strategies at local, regional and national level to support farmers in their endeavours to cope with climate change phenomena; measures should be site-specific and take into account farmers’ experiences and strategies already in place.

Behavioral differences in violence: the case of intra-group differences of paramilitaries and guerrillas in Colombia

In most studies on civil wars, determinants of conflict have been hitherto explored assuming that actors involved were either unitary or stable. However, if this intra-group homogeneity assumption does not hold, empirical econometric estimates may be biased. We use Fixed Effects Finite Mixture Model (FE-FMM) approach to address this issue that provides a representation of heterogeneity when data originate from different latent classes and the affiliation is unknown. It allows to identify sub-populations within a population as well as the determinants of their behaviors. By combining various data sources for the period 2000-2005, we apply this methodology to the Colombian conflict. Our results highlight a behavioral heterogeneity in guerrilla’s armed groups and their distinct economic correlates. By contrast paramilitaries behave as a rather homogenous group.

De Generalista a Especialista : Motivações para a formação especializada em enfermagem : o caso das organizações de saúde públicas, na sub-região oeste do distrito de Lisboa

O presente estudo, enquadrado na área de gestão de recursos humanos, tem como principal objectivo identificar os factores motivacionais que orientam a adesão à especialização, no grupo profissional dos enfermeiros. Trata-se de um estudo de natureza exploratória, transversal, descritivo, analítico, comparativo e quantitativo. A população do estudo foi o grupo de enfermeiros portugueses, sendo a sua amostra composta por 150 enfermeiros. Este grupo foi seleccionado a partir de um processo de amostragem probabilística estratificada, sem reposição. O instrumento de recolha de dados foi o inquérito por questionário. Para o efeito usou-se o questionário da motivação para a formação (QMF) de Carré (2001), tendo sido já adaptado para a população portuguesa por Correia (2009). A formação contínua é uma condição importante no desenvolvimento do indivíduo, quer a nível pessoal, quer a nível profissional; assim como no desempenho da organização onde o indivíduo exerce a sua profissão. O presente trabalho pretende, assim, identificar os factores motivacionais na função de enfermeiro, e que conduzem à adesão da especialização, em particular ao Curso de Pós-Licenciatura em Enfermagem. Numa primeira parte, faz-se a definição e avaliação da função, desenhando-se um mapa de competências; identificando-se, em paralelo, os motivos/expectativas que levam estes profissionais da saúde à especialização desta mesma escala. Decorrente dos resultados obtidos, o presente trabalho conclui que as duas principais motivações dos enfermeiros para a frequência do CPLEE são a motivação extrínseca Operacional Pessoal e a motivação extrínseca Operacional Profissional. Foi ainda possível determinar que a idade, o género, o vínculo à instituição e a situação financeira também têm um papel decisivo no que concerne à motivação dos enfermeiros para a frequência do CPLEE. Este estudo permitiu ainda consolidar o questionário da motivação para a formação desenvolvido por Philippe Carré, aplicado à população portuguesa, de forma a analisar a motivação dos enfermeiros portugueses para a frequência do CPLEE. Quanto às implicações práticas, pretende-se contribuir para o desenvolvimento e melhoria das práticas de recursos humanos no sector da saúde. Balança-se aqui, consequentemente, um equilíbrio entre o diagnóstico organizacional, e a prescrição prática. Potencialmente, poderá servir de roadmap para áreas como o recrutamento e selecção, gestão de carreiras, formação e desenvolvimento, desenho de trabalho e de funções; e, adicionalmente, para uma melhor gestão académica do ensino pós-graduado, na carreira da enfermagem.

Young caregivers in the context of the HIV/AIDS pandemic in sub-Saharan Africa

Against a background of rising adult mortality and morbidity in the context of the HIV/AIDS pandemic in sub-Saharan Africa, this paper provides both quantitative and qualitative evidence for the existence of a largely neglected group of young people with increased responsibility for caregiving. Using questionnaire surveys, focus groups, storyboards and in-depth interviews in three studies across Southern and Eastern Africa some young people in Lesotho, Tanzania and Zimbabwe are found to devote considerable time and energy to caring for sick members of their households. Examination of the tasks carried out by these youngsters finds them to be burdened beyond usual familial and societal expectations of children's 'normal' contributions to the reproduction of households via domestic chores and suchlike. It is concluded that these young people can be described as 'young carers'. The three studies are presented to illuminate different sociospatial aspects of caregiving by young people. First, using qualitative data from Lesotho the range of caring tasks young caregivers; perform for care recipients - usually a grandmother, parent, or sibling - is identified. Second, the impact caregiving responsibilities have on children's primary school attendance is examined using survey data from Tanzania. Third, the wider negative and positive impacts of caregiving including loss of friends and gaining of emotional maturity for young carers and their households is explored with in-depth individual interviews from Zimbabwe. Finally, suggestions are made for further research to deepen understanding of the geographies of caring within the context of the population geographies of the HIV/AIDS pandemic in sub-Saharan Africa and beyond. Copyright (c) 2006 John Wiley & Sons, Ltd.

Effect of hyaluronidase on ocular motility and eyelid function in sub-Tenon's anaesthesia: randomised controlled trial

Purpose: To assess the effect of hyaluronidase on eye and eyelid movements when used as an adjunct in sub-Tenon's anaesthesia. Methods: A total of 60 patients who had sub-Tenon's anaesthesia prior to phacoemulsification surgery were divided into two equal groups in a double-masked randomised controlled fashion. Of these, Group A had 4 ml lignocaine 2%, while Group B had 4ml lignocaine 2% with the addition of sodium hyaluronidase 75 IU/ml. Ocular motility, levator, and orbicularis oculi function were measured in all patients at 5 and 8 min. Levator function was scored from 0 (no function) to 3 (complete function) while orbicularis function was scored from 0 to 2. The score for ocular motility was the sum in four positions of gaze, each position scoring from 0 to 2. Results were compared using a nonparametric test. Results Group B achieved significantly better ocular and lid akinesia than Group A both at 5 and 8 min with P < 0.01. The median scores for levator function at 5 and 8 min were 2 for Group A and 0 for Group B. For orbicularis function, the median scores at both time intervals were 2 for Group A and 1 for Group B. For ocular motility, the median score for Group A at 5 min was 3 and at 8 min was 2.5; for Group B at 5 min was 0.5 and at 8 min was 0. Conclusions: The addition of hyaluronidase in sub-Tenon's anaesthesia has a significant effect in improving ocular and lid (levator and orbicularis) akinesia.