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Etude des aspects médico-économiques liés au passage à échelle des interventions de prévention de la transmission mère-enfant du VIH (PTME) dans les pays à ressources limitées / Programs for the prevention of mother-to-child-transmission (PMTCT) of HIV : the economics of scaling upToure, Hapsatou 19 December 2012 (has links)
Chaque année 330 000 (dont 300 000 en Afrique) nouvelles infections à VIH surviennent chez les moins de quinze ans – majoritairement par un mécanisme de transmission verticale d’une mère infectée à son enfant. Pourtant, des interventions efficaces pour réduire la transmission mère-enfant (TME) existent mais ne sont pas toujours disponibles en pratique de routine pour les femmes qui en ont besoin. L’agenda international en cours vise une élimination de l’infection pédiatrique de VIH – et le maintien des mères en vie – à l’horizon 2015. A la lumière de la crise économique mondiale, il apparait opportun de pouvoir juger du montant de ressources nécessaires à la réalisation de cet objectif. Ce travail de thèse dresse le panorama du mode de délivrance des interventions pour la prévention de la TME (PTME) et de la prise en charge des enfants infectés par le VIH dans cinq pays à ressources limitées que sont la Chine, la Côte d’Ivoire, la Namibie, le Rwanda et l’Ukraine. Il apporte une estimation de leur coût et renseigne sur leur efficacité et leur caractère abordable. En outre, une estimation du coût de l’implémentation de potentiels scénarios de passage à échelle des interventions est apportée ; la mesure du nombre de cas (et de décès) non évités sur la période de projection permet de se rendre compte du coût de l’inaction. Enfin, sont discutés deux obstacles majeurs à la diffusion des services de PTME que sont le contexte politique ambiant et l’organisation de l’offre de soins (contrainte en ressources humaines qualifiées notamment). / A decade into the implementation of prevention of mother-to-child HIV transmission (PMTCT) programs, countries are making impressive progress towards fulfilling global commitments and achieving global goals. However, achieving a generation free from HIV will entail sustained effort and commitment in the coming years and estimating the cost of this work is fundamental. In light of the global economic downturn, reliable and up-to-date information on the costs of the dedicated services is needed to estimate the amount of additional resources required to scale up those services within the context of the Millennium Development Goals, and to assist resource-limited countries, external funders and multilateral agencies in planning, identify cost drivers and areas of potential savings. This work pursued the aims (1) to produce a reliable estimation of the costs associated with PMTCT services in five low- and middle-income countries, and (2) to ascertain the range and median unit costs needed for scaling up these services across a prevention, treatment and care continuum. Countries were selected given three key criteria related to their economic level and health spending, the national HIV epidemic status and typology, and the coverage of their maternal, neonatal and child health (MNCH) and PMTCT programs. Data were collected in Cote d’Ivoire, China, Namibia, Rwanda, and Ukraine using a health-care provider perspective from October 2009 to April 2010. In-country samples were designed to reflect publicly funded MNCH facilities that were delivering a define range of PMTCT and pediatric HIV services. The package includes HIV testing and counseling, male partner testing, CD4 testing, antiretroviral prophylaxis provision, community-based activities, HIV-exposed infant prophylaxis, and 2-year post-partum family planning. Additional information on prices and volume of services was collected from national government bodies, international donor partners, and non-governmental organizations. Cost data were then analyzed using a bottom-up approach of "micro-costing" where costs are calculated by identifying the actual resources used for each patient. Primary outcomes are costs per specific end-users and nation-wide total program costs, subdivided by major cost categories. After that, we simulated the expected costs over time according to a scale-up analysis estimating the costs needed to increase service coverage under various scenarios of coverage and antiretroviral protocols. These scenarios are incremental in their content: each subsequent scenario adds components and costs to the previous one. Future costs are discounted at a 3% rate. The affordability of each scenario (compared to the previous one) was concomitantly examined through the generation of incremental cost effectiveness ratios. The cost of inaction, measured in both terms of cases non-averted and deaths non-avoided throughout the scaling-up period, was ultimately assessed.
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Sweden’s foreign aid in Afghanistan from an environmental perspectiveKarlsson, Linnea January 2016 (has links)
Afghanistan has been in armed conflict for over 30 years. The many wars have severely affected the environment negatively. Sweden has between 2010-2015 been allocating 4,7 billion SEK in foreign aid to Afghanistan. This is a qualitative study with the purpose to critically analyse how this foreign aid has contributed to a sustainable environmental development in Afghanistan. To be able to answer this question a review of projects documents and Sida assessment was conducted. This was then supplemented by interviews with 14 people who in different ways had been working with these issues. In the analysis theories connecting to environment, poverty and conflict have been used. Sida is supporting two types of foreign aid in Afghanistan; humanitarian aid and development aid. The study found that the Sida’s humanitarian work in Afghanistan has a clear focus on environmental issues, whereas the development aid overall where lacking a focus on environmental issues. The larger focus within the humanitarian aid was explained by that environmental consideration is a part of the Sida’s strategy for the humanitarian aid in Afghanistan and humanitarian aid’s natural connection to environment, in for instance natural disasters. The lack of environmental focus within the development aid was found to have three explanations; the strategy did not have an environmental focus, the staff lacked the necessary environmental knowledge and environmental issues was not believed to be prioritized in Afghanistan. It was however believed to be possible to have more focus on the environment in Sida’s work in Afghanistan. The study shows that environmental issues are not believed to be a necessary component for creating a sustainable development or peace in Afghanistan. The study is arguing that one way to create more focus on environmental issues within the development aid would be to work closer with the humanitarian aid. The thesis was finally presenting an alternative way to look at environment and sustainable development; to focus on the environmental problems of the current generation and by doing so preserving the nature for the future generations.
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Caracterização fitoquímica e efeitos antinociceptivos e anti-inflamatórios de Sida tuberculata R.E. Fries “GUANXUMA” / Phytochemical characterization and antinociceptive and anti-inflammatory effects of Sida tuberculata R.E. Fries "GUANXUMA"Rosa, Hemerson Silva da 10 August 2017 (has links)
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Previous issue date: 2017-08-10 / O presente estudo avaliou os efeitos antinociceptivos e anti-inflamatórios dos extratos obtidos de Sida tuberculata (ST), popularmente conhecida como “guanxuma”, em modelos agudo e crônico em camundongos. Além disso, foram feitas caracterizações fitoquímicas e análises do potencial antioxidante e citotóxico in vitro. De acordo com os dados encontrados, os extratos das folhas e raízes apresentaram um significativo efeito antioxidante (p<0.05) a partir das doses de 0.015 e 0.03 mg.mL-1 respectivamente, porém o extrato das folhas teve uma ação mais pronunciada comparado ao extrato das raízes (<IC50) sendo selecionado para os testes in vivo. Através das análises químicas, foi desenvolvido um método analítico por UHPLC para determinação do marcador fitoquímico, 20-hydroxyecdysone (20-HE), e também foram identificados oito compostos, sendo 20HE o majoritário juntamente com um derivado de Canferol. Nos testes de citotoxicidade in vitro, os extratos metanólicos das folhas (Sida tuberculata leaf extract - STLE) e raízes (Sida tuberculata root extract - STRE) demonstraram uma ação antiproliferativa contra as linhas celulares tumorais HepG2 e MCF-7 (IC50 entre 543.6 - 593.4 μg.mL-1 para STLE, e 397.1 - 493.9 μg.mL-1 para STRE). Também, STLE diminuiu a viabilidade em leucócitos humanos a partir da dose de 10 μg.mL-1. Já os resultados dos ensaios de dor e inflamação in vivo demonstraram que o STLE (10-300 mg.kg-1) administrado pela via oral (v.o.), 1h antes do teste, inibiu significativamente a nocicepção das fases neurogênica e inflamatória para o modelo de formalina (31,3 e 40,1% respectivamente). Do mesmo modo, STLE diminui significativamente as contorções induzidas por ácido acético, chegando a 71,8% de inibição na dose de 100 mg.kg-1. Os experimentos mostraram que, pelo menos em parte, o mecanismo de ação de STLE envolve os sistemas opióides e adenosinérgicos uma vez que seu efeito foi revertido pela Naloxona (inibidor não seletivo dos receptores opióides) e pelo DPCPX (inibidor seletivo do receptor de adenosina A1) no modelo de ácido acético. A avaliação por Docking computacional demonstrou que os compostos Canferol e 20HE, presentes no extrato, podem interagir principalmente com o receptor opióide μ. O pré-tratamento com STLE (100 mg.kg-1) também reduziu a migração celular total, o número de neutrófilos, a atividade da MPO, e o níveis das citocinas IL-1β, IL-6 e TNF-α no fluído peritoneal de animais com peritonite induzida por carragenina. No mesmo modelo foi verificado uma redução dos níveis de TBARS e um
aumento nos níveis de NPSH. Além disso, o tratamento com STLE a 100 mg.kg-1 uma vez ao dia também apresentou efeito antinociceptivo no modelo de dor inflamatória crônica induzida por CFA (i.pl.), como ainda diminuiu o edema de pata após o quinto dia de tratamento. As doses administradas diariamente (100 mg.kg -1 durante 15 dias) não apresentaram alteração macroscópica e nem sobre o peso absoluto e o peso relativo dos órgãos vitais (coração, pulmão, fígado, baço e rins). Portanto, o conjunto de dados apresentados sugerem que ST possui uma significativa atividade antinociceptiva e anti-inflamatória frente a modelos agudo e crônico em camundongos, com mecanismo de ação envolvendo, parcialmente, sua ação antioxidante e a interação sobre o sistema opióide e adenosinérgico, e também ação redutora de mediadores pró-inflamatórios. Desta forma, a espécie ST apresenta uma atividade potencialmente terapêutica que corrobora com seu uso popular. Porém mais estudos são necessários a fim de elucidar mais precisamente seu mecanismo de ação e se o mesmo é atribuído a um ou mais compostos do extrato. / The present study evaluated the antinociceptive and anti-inflammatory effects of extracts obtained from Sida tuberculata (ST), popularly known as "guanxuma", on acute and chronic models in mice. In addition, were performed a phytochemical characterization and antioxidant and cytotoxic analysis in vitro. According to the data, leaf and root extracts presented a significant antioxidant effect (p <0.05) from the 0.015 and 0.03 mg.mL-1 doses respectively, however the leaves extract had a more pronounced action compared to the leaves root extract (<IC50) being selected for in vivo tests. Through the chemical analyzes, an analytical method was developed by UHPLC to determine the phytochemical marker, 20-hydroxyecdysone (20-HE), and eight compounds were identified, being 20HE the major compounds together with a Kaempferol derivative. In cytotoxicity tests, S. tuberculata leaf extract (STLE) and S. tuberculata root extract (STRE) demonstrated antiproliferative action against HepG2 and MCF-7 tumor cell lines (IC50 between 543.6 - 593.4 μg.mL-1 for STLE, and 397.1 - 493.9 mg.mL-1 for STRE). Besides, STLE decreased human leukocytes viability from dose of 10 μg.mL-1. In vivo assays demonstrated that STLE (10-300 mg.kg-1) given orally (p.o.) 1 h before the test, significantly inhibited the neurogenic and inflammatory phases in the formalin model (31.3 and 40.1% respectively). Likewise, STLE significantly decreased the contortions induced by acetic acid, reaching 71.8% inhibition at the dose of 100 mg.kg-1. The experiments showed, at least in part, the STLE mechanism of action involves the opioid and adenosinergic systems since its effect was reversed by Naloxone (non-selective opioid receptor inhibitor) and DPCPX (selective A1 adenosine receptor inhibitor) in acetic acid model. The evaluation by computational docking demonstrated that Kaempferol and 20HE compounds might interact primarily with the μ opioid receptor. Pretreatment with STLE (100 mg.kg-1) also reduced total cell migration, neutrophil number, MPO activity, and levels of IL-1β, IL-6 e TNF-α cytokines in the peritoneal fluid of animals submitted to carrageenan-induced peritonitis. In the same model, there was a reduction of TBARS levels and an increase in NPSH levels. In addition, treatment with STLE at 100 mg.kg-1 once daily also presented antinociceptive effect in chronic inflammatory pain model induced by CFA (i.pl.), and paw edema decreased after the fifth day of treatment. The doses administered daily (100 mg.kg-1 for 15 days) did not present macroscopic alteration and
did not change the absolute weight and organs relative weight (heart, lung, liver, spleen and kidneys). Therefore, the data presented suggest that ST has a significant antinociceptive and anti-inflammatory activity against acute and chronic models in mice, with a mechanism of action involving, partially, its antioxidant action and the interaction on the opioid and adenosinergic system, as well as reducing action of pro-inflammatory mediators. Thus, the ST species presents a potential therapeutic action that corroborates with its popular use. However, more studies are needed in order to elucidate more precisely its mechanism of action and whether it is attributed to one or more compounds in the extract.
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Doença do armazenamento lisossomal induzida pelo consumo de Sida carpinifolia (Malvaceae) em herbívoros no Rio Grande do Sul / Lysosomal storage disease induced by the consumption of Sida carpinifolia (Malvaceae) in herbivores in Rio Grande do SulPedroso, Pedro Miguel Ocampos January 2010 (has links)
Descrevem-se os achados epidemiológicos, clínico-patológicos, ultra-estruturais e lectino-histoquímicos de herbívoros intoxicados naturalmente por Sida carpinifolia no Estado do Rio Grande do Sul, Brasil. Este estudo incluiu a elaboração de três artigos. Foi realizado um estudo retrospectivo de intoxicação natural por Sida carpinifolia em bovinos no Rio Grande do Sul, outro relata pela primeira vez uma intoxicação natural por esta planta em um animal silvestre e o terceiro artigo relata os achados patológicos observados em fetos de fêmeas caprina e bovina que foram intoxicadas experimentalmente e naturalmente respectivamente por Sida carpinifolia. No primeiro artigo foram afetados cinco bovinos entre os anos de 2001 a 2008. O quadro clínico foi caracterizado por emagrecimento, incoordenação, dificuldade de locomoção, tremores generalizados, quedas frequentes e morte. Microscopicamente as principais alterações foram vacuolização dos neurônios de Purkinje do cerebelo, vacuolização das células acinares do pâncreas e das células foliculares da tireoide. No segundo artigo, o cervídeo desenvolveu uma síndrome neurológica caracterizada por fraqueza muscular, tremores de intensão, déficit visual, quedas, postura e comportamento anormal. Os principais achados microscópicos foram vacuolização citoplasmática nos neurônios de Purkinje do cerebelo. No terceiro artigo duas cabras prenhes foram intoxicadas experimentalmente com Sida carpinifolia nas doses de 10 e 13 g/kg respectivamente durante 30 dias e foram acompanhados durante 15 dias após o consumo da planta. Após este período foram eutanasiadas e necropsiadas. Adicionalmente foi incluído um feto bovino no qual a mãe havia sido intoxicada naturalmente por S. carpinifolia. As principais alterações microscópicas observadas nos fetos foram vacuolização do epitélio dos túbulos renais, das células foliculares da tireoide e cerebelo com discreta vacuolização dos neurônios de Purkinje. Na microscopia eletrônica de todos os casos foi observado vacúolos contendo material finamente granulado e delimitado por membrana. Na lectinahistoquímica dos bovinos, do cervídeo e dos fetos observou-se marcação em neurônios com as lectinas Concanavalia ensiformis (Con-A), Triticum vulgaris (WGA) e Succinyl WGA (sWGA). / Describes the epidemiological, clinical, pathological, ultrastructural and lectinhistochemical herbivore naturally poisoned by Sida carpinifolia in Rio Grande do Sul, Brazil. This study included the preparation of three articles. We conducted a retrospective study of natural poisoning by Sida carpinifolia in cattle in Rio Grande do Sul and the other reports for the first time a natural poisoning by this plant in a wild animal. The third article reports the pathologic findings observed in fetuses of female goats and cattle that were naturally and experimentally poisoned by Sida carpinifolia respectively. In the first paper were affected five cattle between the years 2001 to 2008. The clinical picture was characterized by weight loss, incoordination, difficulty walking, generalized tremors, frequent falls and death. Microscopically the main changes were vacuolation of the Purkinje neurons of cerebellum, vacuolization of acinar cells of the pancreas and thyroid follicular cells. In the second paper, the deer developed a neurological syndrome characterized by muscular weakness, intention tremors, visual and standing-up deficits, falls, and abnormal behavior and posture. The main microscopic findings were vacuolation in Purkinje neurons of cerebellum. In the third paper were two pregnant goats experimentally poisoned with Sida carpinifolia in doses of 10 and 13 g / kg for 30 days and were followed for 15 days after consumption of the plant. Additionally included a bovine fetus where the mother had been poisoned by S. carpinifolia. The main microscopic changes observed in the fetuses were vacuolation of the epithelium of renal tubules, thyroid follicular cells in the cerebellum and mild vacuolation of Purkinje neurons. On electron microscopy all cases was observed vacuoles containing finely granular material and bordered by membrane. In lectin-histochemistry of cattle, the deer and fetuses was observed in neurons marking to lectins Concanavalia ensiformis (Con-A), Triticum vulgaris (WGA) e Succinyl WGA (sWGA).
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Partnerskap och paternalism : En studie av Sida och Afrikagruppernas utvecklingssamarbete i Sydafrika med fokus på hiv och aids. / Partnership and paternalism : A study on Sida and the Africa Groups of Sweden´s development work in South Africa with focus on HIV/AIDS.Carlsson, Lena, Lindqvist Karlsson, Charlotta January 2005 (has links)
<p>Syftet med studien är att undersöka och problematisera hur Sida och Afrikagrupperna arbetar med hiv och aids i Sydafrika utifrån den postkoloniala kritik som riktats mot denna typ av arbete. Fokus ligger på de problem och dilemman som finns i utvecklingssamarbetet med Sydafrika. För att få en djupare förståelse och ytterligare ett perspektiv sammanför vi den postkoloniala teorin med teorier om hälsa. I det postkoloniala kapitlet behandlas bland andra Maria Eriksson Baaz och Pal Ahluwalias teorier om hur kolonialismen har skapat strukturer som påverkar Afrikabilden både i västvärlden och i Afrika idag. I teorin om hälsa utgår vi ifrån bland andra Deborah Lupton som menar att folkhälsa har en stark inverkan på politiska och sociala strukturer som fungerar som ett moraliserande system och påverkar hur vi ser på oss själva. För att få en förståelse och kunna problematisera ämnet ytterligare har vi tagit del av de dokument och policys som ligger till grund för Sida och Afrikagruppernas hiv och aidsarbete i Sydafrika. Dessa dokument analyseras och sammanförs med de intervjuer som har genomförts med Sidas och Afrikagruppernas anställda både i Sverige och i Sydafrika. Studien har, förutom att tydliggöra utvecklingssamarbetets komplexitet, också bland annat visat på att de strukturer skapade utifrån bilden av Afrika fortfarande påverkar biståndsarbetet på olika sätt och att västvärldens syn på hälsa i sin tur påverkar synen på Afrika. Sverige har definierat sitt utvecklingsarbete som ett partnerskap och studien visar att Sverige i jämförelse med andra länder ligger långt fram i detta arbete, men att det fortfarande finns brister.</p> / <p>The purpose of the study is to examine and problemize how Sida and the Africa Groups of Sweden´s work with HIV/AIDS in South Africa considering the post-colonial critique that has been directed at this type of work. Focus is on the problems and dilemmas that exist is the development work with South Africa. To get a deeper understanding and further perspectives we bring the post-colonial theory together with health theories. In the post-colonial chapter are Maria Eriksson Baaz and Pal Ahluwalias theories about how the colonial era has created structures that influence how one look at Africa today being discussed. In the health theory Deborah Lupton, amongst others, argues that public health has a strong effect on political and social structures that functions as a norm building system and influence how we view ourselves. To get an understanding and to be able to further problemize the material we have examined documents and policies that are the basis for Sida and the Africa Groups of Sweden´s work with HIV and AIDS in South Africa. These documents are being analysed and brought together with interviews that have been conducted with employees of Sida and the Africa Groups of Sweden in both Sweden and South Africa. The study has, except to elucidate the complexity of the development work, also shown, among other things, that the structures created due to the image of Africa still effects the aid work on different levels and that the western view on public health influence the image of Africa. The Swedish development work has been defined as a partnership and the study shows that Sweden, in comparison with other countries lies far ahead in this work, but that there still are shortages.</p>
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À propos des femmes et du VIH/sida au Sénégal : un nouveau regard, une analyse femme/genre et développement = rethinking women and HIV/AIDS in Senegal : a woman/gender and development analysisShip, Susan Judith January 2009 (has links) (PDF)
Cette thèse explore la féminisation du VIH/sida au Sénégal et l'approche sénégalaise étatiste de lutte contre le sida. Elle remet en question l'idée reçue voulant que ce soit un modèle en matière de prévention du VIH, en matière de soins des personnes vivant avec le VIH/sida (PVVIH) et en tant que cadre institutionnel. En concevant 'les femmes et le VIH/sida' à partir d'une perspective féministe, elle présente une approche Femme/genre et développement qui pose les femmes et les relations de genre au centre d'une analyse de genre du contexte politique, économique, social et culturel qui sous-tend l'épidémie du VIH/sida au Sénégal et les politiques d'État en matière de VIH/sida. L'examen porte sur les multiples dimensions du phénomène de la féminisation du sida; la vulnérabilité sociale des femmes, le statut social et économique des femmes séropositives et leur accès aux soins et à du soutien et le rôle des femmes en tant que prestataires des soins aux PVVIH. Ceci est relié à une analyse des politiques étatiques et du rôle des groupements de femmes dans l'empowerment et à leur plaidoyer en faveur des femmes dans le contexte du VIH/sida. Il s'agit d'une recherche empirique avec un objectif pratique. Cette étude de cas se base principalement sur la recherche qualitative et une approche plurivariée qui comprend l'observation, la recherche d'archives, l'analyse des politiques et des entrevues semi-structurées avec des représentant-e-s de divers groupes d'acteurs sociaux pertinents dans le domaine du VIH/sida. Sont mises en rapport l'analyse féministe sociologique basée sur l'intersectionalité des oppressions du genre, et de la classe sociale et des relations nord-sud en ce qui a trait au VIH/sida et l'analyse politique féministe de l'État comme «hiérarchie genré» afin de révéler son rôle contradictoire dans la reproduction des inégalités de genre (hommes-femmes). L'analyse dégage le contexte des politiques étatiques sénégalaises en matière de VIH/sida et le cadre institutionnel d'élaboration de politiques qui limite son efficacité dans la lutte contre la féminisation du sida. La thèse démontre comment les rapports inégaux de genre dans la sphère privée, touchant la sexualité, le mariage et la famille expliquent en partie le risque élevé des femmes face au VIH, en soulignant que la classe sociale, le statut matrimonial et l'âge dans un contexte d'inégalités nord-sud différencient en termes de vulnérabilité sociale les diverses catégories de femmes. Cette recherche révèle les insuffisances de l'approche genre en matière de prévention du VIH qui résident dans l'accès inégal des femmes à l'éducation, aux techniques de dépistage du VIH et au condom féminin, conséquence des rapports inégaux de genre dans leur interaction avec d'autres inégalités sociales ainsi que du peu de programmes axés sur le renforcement de la capacité des femmes de négocier des rapports sexuels sécuritaires et l'utilisation du condom. La 'protection de la femme' plutôt que 'l'empowerment des femmes' est la conséquence de modèle de prévention 'ABC.' Il est démontré également comment les inégalités de genre se reproduisent dans les situations économiques et sociales dans lesquelles les femmes séropositives vivent. Elles se retrouvent davantage en dessous du seuil de la pauvreté et elles sont responsables du bien-être et du soutien économique de leurs enfants. Elles font face à une double discrimination en tant que femmes et séropositives. Des inégalités de genre, de classe sociale et de provenance (selon la région et selon la division nord-sud) façonnent leur accès aux soins médicaux et au soutien psychosocial. Les femmes portent le fardeau de la maladie en tant que prestataires de soins non-rémunérés aux personnes et familles atteintes et affectées par la maladie et elles subventionnent les insuffisances dans les services communautaires et étatiques. Ceci démontre comment les rapports inégaux de genre sont reproduits dans le modèle sénégalais de soins et soutien qui est basé sur une conception neutre selon le genre (gender-neutral) des PVVIH.
L'État sénégalais n'as pas de politique efficace en matière de genre et de VIH/sida car des relations de genre inégales et une culture politique de la domination masculine se reproduisent à l'intérieur du programme national de lutte contre le sida et des structures d'élaboration de politiques qui marginalisent les questions de genre et limitent la capacité des groupements de femmes de plaider en faveur des femmes. L'absence d'engagement face à une perspective de genre se manifeste dans la sous-représentation des femmes et experts de genre dans les structures et processus d'élaboration de politiques, dans la marginalisation des questions femmes et de genre dans les discours de politique en matière de VIH/sida, dans l'intégration inégale (mainstreaming) du genre dans les orientations stratégiques, priorités politiques et les cibles en ce qui concerne la prévention, les soins et le soutien des PVVIH, la recherche, les questions d'éthique et de droits humains, la surveillance et évaluation des mesures appliquées. Cette étude de cas démontre les insuffisances du modèle sénégalais et souligne la nécessité de mettre les questions de genre de l'avant dans les politiques, la recherche et les programmes en matière de VIH/sida. ______________________________________________________________________________ MOTS-CLÉS DE L’AUTEUR : Femmes, VIH/sida, Genre et développement, Sénégal, État et politiques
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Efterlevnaden av Förordningen (2007:603) om intern styrning och kontroll : En fallstudie av ledningens arbete inom SidaDzafic, Nerina, Törnqvist, Linnéa January 2010 (has links)
Bakgrund/problem: På senare år har förtroendet för styrningen i ett flertal statliga och privata organisationer ifrågasätts. Kontrollen och ansvaret inom organisationerna har varit otydlig. Förordningen om intern styr-ning och kontroll är en åtgärd som tagits fram för att regeringen ska kunna säkerställa den interna styrningen och kontrollen inom myndigheter genom ett förtydligande av ansvaret. I förordningen stadgas att det inom myndigheten är ledningen som bär ansvaret för en betryggande intern styrning och kontroll. Fokus i denna studie läggs på att undersöka hur ledningen inom Sida efterlever förordningen. Syfte: Huvudsyftet med studien är att kartlägga hur förordningen om intern styrning och kontroll efterlevs i Sidas organisation. Ett del-syfte är att belysa eventuella brister som förekommit i samband med tillämpningen av förordningen. Metod: För att uppnå syftet har en fallstudie genomförts. Fallstudien har genomförts med hjälp av kvalitativ data som består av dokumen-tation i form av rapporter från Riksrevisionen, ESV och Sida samt en genomförd intervju med två revisorer från Riksrevisionen. Slutsats: Sida brister i efterlevnaden av förordningen och detta är främst en följd av ledningens bristande ansvar och kontroll, dålig förbere-delse inför införandet av förordningen samt kulturen på myndig-heten med den passiva inställningen till intern styrning och kon-troll. Ledningen brister inom samtliga ansvarstyper och kontroller vil-ket leder till negativa konsekvenser. Konsekvenserna har innebu-rit brister i effektivitet kring användandet av de ekonomiska med-len vilket delvis har uppstått till följd av bristande uppföljning av budgeten. Eftersom inte verksamhetens mål då kunnat uppnås fullt ut brister myndigheten i sitt ansvar gentemot regeringen samt samhället och dess medborgare. / Background/problem: In recent years has the trust for the management in several author-ities decreased. The control and responsibility within the organi-zations have been vague. The regulation of internal management and control (FISK) is an action created by the government to en-sure the internal control within the authority. The management within the authority is the one responsible reassuring the internal control. The study is focusing on how the organization within Si-da is observing the regulation. Purpose: The main purpose of the study is to identify how the management of Sida observes the regulation of internal management and con-trol. Another purpose is to highlight if there is any deficiencies that have when applying the regulation. Method: To reach the purpose a case study has been done. The case study has been done using qualitative data consisting documents in form of reports from The Swedish National Audit Office (SNAO), ESV and Sida, and an interview with two auditors from the SNAO. Conclusion: Sida deficit in the observance of following the regulations of in-ternal management and control and this mainly due to the man-agement lack of responsibility and control, poor preparation be-fore the introduction of the regulation, and the culture within the authority with its passive attitude to internal management and control. The management deficiencies within all types of responsibilities and controls leading to negative consequences. The consequences have resulted in reduced efficiency regarding the use of the finan-cial resources due to lack of follow-up of the budget. Since the goal of the authority therefore has not been achieved the authority deficiencies in its responsible towards the government and the community and its citizens.
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Aiding science : Swedish research aid policy 1973-2008 / Att bistå vetenskap : Svensk forskningsbiståndspolicy 1973-2008Brodén Gyberg, Veronica January 2014 (has links)
The purpose of research aid is to contribute to development in different ways through the use of research. Sarec (the Swedish Agency for Research Cooperation with Developing Countries) was one of the pioneers within state research aid, and existed between 1975 and 2008. This dissertation studies Sarec’s policy from a historical perspective with the help of official documents and interviews with former directors. Discourse theory together with concepts from Science and Technology Studies comprise the theoretical framework of the study. One of the central questions asked is how the view of the relationship between research and development has changed over time. One of the conclusions is that there are two main policy discourses that are established early on and that can be traced throughout the entire period studied. The two discourses share the starting point that modern science can contribute to development and that national research capacity is an important component in this. The localist discourse represents a more multifaceted view of how research can contribute to development, and what that development consist of. It is more explicitly anti-colonialist and to a greater degree prioritizes the local context as basis for decisions regarding support. The universalist discourse places less emphasis on where knowledge is produced since it can be used anywhere, as long as the right structures and priorities are in place. The discourses reflect different views of knowledge and development. Some decades one discourse dominates over the other, and other decades they are more equal. / Forskningsbistånd har som syfte att bidra till att forskning på olika sätt leder till utveckling. Sarec (the Swedish Agency for Research Cooperation with Developing Countries) var en av pionjärerna inom statligt forskningsbistånd och existerade mellan 1975 och 2008. I denna avhandling studeras Sarecs policy ur ett historiskt perspektiv med hjälp av offentliga dokument och intervjuer med före detta chefer. Diskursteori tillsammans med begrepp från teknik- och vetenskapsstudier utgör det teoretiska ramverket för studien. Frågor som ställs är till exempel hur synen på relationen mellan forskning och utveckling har förändrats över tid. En av slutsatserna är att det finns två stora policydiskurser som etableras tidigt och som går att följa under hela perioden. Båda innefattar en stark tro på modern vetenskap och dess möjlighet att bidra till utveckling, samt på att forskningskapacitet är en viktig komponent i detta. Den lokalistiska diskursen representerar en mer mångfacetterad syn på hur forskning kan bidra till utveckling samt vad denna utveckling är. Den är mer explicit antikolonialistisk i sin ansats och prioriterar i högre grad den lokala kontexten som grund för beslut kring stöd. Den universalistiska diskursen betonar att det spelar mindre roll var kunskapen produceras eftersom den kan nyttjas varsomhelst, bara rätt strukturer och prioriteringar finns på plats. Diskurserna speglar olika syn på kunskap och utveckling. Vissa årtionden dominerar en diskurs över den andra, och andra årtionden är de mer jämbördiga.
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Estudios biofísicos de péptidos sintéticos de la proteína de envoltura E1 del GBV-C/HGV y su relación con el VIHSánchez Martín, Ma. Jesús 04 July 2011 (has links)
El virus C (GBV-C) o virus de la hepatitis G (HGV) está relacionado con el virus de la hepatitis C (HCV) ya que tiene una organización genómica y una homología en la secuencia muy próxima pero, sin embargo, no parece causar hepatitis ni ningún otro tipo de patología. En los últimos años, se han publicado numerosos trabajos en los que se asocia la co-infección del GBV-C/HGV y el virus de la inmunodeficiencia humana (VIH) con una menor progresión de la enfermedad causada por el virus VIH así como con una mayor supervivencia de los pacientes una vez que el SIDA se ha desarrollado.
Basándonos en un modelo de co-infección, existen diversas teorías de cómo el virus de la hepatitis G puede influir en la enfermedad del VIH, se cree que puede inducir las quemoquinas, regular negativamente los co-receptores del VIH, así como provocar otros efectos indefinidos en los linfocitos huésped. Pero el mecanismo responsable del efecto beneficioso que el GBV-C/HGV tiene sobre el curso de la infección causada por VIH no está todavía definido.
Teniendo en cuenta el posible uso de los péptidos sintéticos, el objetivo de la actual tesis doctoral es llevar a cabo la selección de péptidos de la proteína de envoltura E1 del GBV-C/HGV con potencial capacidad de inhibición del péptido de fusión del VIH-1, mediante la síntesis múltiple en paralelo de secuencias peptídicas lineales que cubren la totalidad de la estructura primaria de esta proteína y su posterior evaluación mediante ensayos biofísicos. Con ello se pretende plantear la utilización de péptidos sintéticos del GBV-C/HGV en el diseño de inhibidores de la entrada del VIH en la célula huésped. Se pretende así tratar de comprender mejor el efecto de la presencia de anticuerpos anti-GBV-C/HGV en la progresión de la enfermedad causada por la infección del VIH y de profundizar en el conocimiento actual acerca de la interacción entre estos dos virus.
Se realiza la síntesis en fase sólida de 58 péptidos correspondientes a la proteína de envoltura E1 del GBV-C/HGV y mediante el ensayo de liberación de contenidos vesiculares se seleccionan 5 péptidos capaces de inhibir la capacidad del péptido de fusión (PF) del VIH-1 de formar poros en las membranas.
Se realizan estudios detallados de los péptidos y de la inhibición del proceso de fusión, inducido por el péptido de fusión del VIH-1, por parte de secuencias del GBV-C/HGV. Para ello se realizan estudios de citotoxicidad, ensayos de hemólisis, estudio de la estructura mediante dicroísmo circular, ensayos de agregación de liposomas inducida por los péptidos y ensayos de transferencia de energía por resonancia. Por otra parte se realizan ensayos utilizando monocapas de extensión como modelos de membrana mediante la técnica de Langmuir-Blodgett, y se calculan las concentraciones superficial de exceso y las de saturación, información que servirá para conocer la capacidad de los péptidos para formar monocapas estables en la interfase aire/agua.
Los diferentes ensayos muestran una interacción de los péptidos de la proteína E1 con el péptido de fusión del VIH-1, dando lugar a una inhibición de la actividad que el péptido de fusión del VIH-1 tiene sobre las membranas lipídicas. Esto sugiere que estos péptidos pueden ser candidatos para ser utilizados en futuras terapias antivirales. / "BIOPHYSICAL STUDIES OF SYNTHETIC PEPTIDES OF THE ENVELOPE PROTEIN E1 OF GBV-C/HGV AND ITS RELATIONSHIP WITH HIV"
The virus C (GBV-C) or hepatitis G virus (HGV) is related to hepatitis C virus (HCV) because it has similar genome organization and sequence homology; however, it does not seem to cause hepatitis or any other pathology. In recent years, there have been several studies in which the GBV-C/HGV and human immunodeficiency virus (HIV) co-infection is associated with less progression of the disease caused by HIV as well as improved survival of patients after AIDS has developed. Based on a model of co-infection, there are several theories of how the hepatitis G virus can affect HIV disease: it could induce chemokines, negatively regulate the HIV co-receptors and cause other undefined effects in the host cell. But the mechanism responsible for the beneficial effect that GBV-C/HGV has over the course of infection by HIV is not yet defined.
Taking into account the possible use of synthetic peptides, the aim of the present thesis is to carry out the selection of peptides from the envelope protein E1 of GBV-C/HGV with potential ability to inhibit the HIV-1fusion peptide. The aim is to better understand the effect of the presence of antibodies anti-GBV-C/HGV in the progression of AIDS and to study the interaction between these two viruses.
The solid phase synthesis of 58 peptides corresponding to the envelope protein E1 of GBV-C/HGV was made and 5 peptides capable of inhibiting the ability of the fusion peptide (FP) of HIV-1 to form pores in membranes were selected by means of the leakage of vesicular contents assay.
Detailed studies of the E1 peptides and their ability to inhibit the fusion process induced by the fusion peptide of HIV-1 were done. Monolayers and liposomes were used as model membranes. The different tests show an interaction of the E1 peptides with the HIV-1fusion peptide, resulting in an inhibition of the activity that the fusion peptide has on lipid membranes. This suggests that these peptides could be good candidates for future antiviral therapies.
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Doença do armazenamento lisossomal induzida pelo consumo de Sida carpinifolia (Malvaceae) em herbívoros no Rio Grande do Sul / Lysosomal storage disease induced by the consumption of Sida carpinifolia (Malvaceae) in herbivores in Rio Grande do SulPedroso, Pedro Miguel Ocampos January 2010 (has links)
Descrevem-se os achados epidemiológicos, clínico-patológicos, ultra-estruturais e lectino-histoquímicos de herbívoros intoxicados naturalmente por Sida carpinifolia no Estado do Rio Grande do Sul, Brasil. Este estudo incluiu a elaboração de três artigos. Foi realizado um estudo retrospectivo de intoxicação natural por Sida carpinifolia em bovinos no Rio Grande do Sul, outro relata pela primeira vez uma intoxicação natural por esta planta em um animal silvestre e o terceiro artigo relata os achados patológicos observados em fetos de fêmeas caprina e bovina que foram intoxicadas experimentalmente e naturalmente respectivamente por Sida carpinifolia. No primeiro artigo foram afetados cinco bovinos entre os anos de 2001 a 2008. O quadro clínico foi caracterizado por emagrecimento, incoordenação, dificuldade de locomoção, tremores generalizados, quedas frequentes e morte. Microscopicamente as principais alterações foram vacuolização dos neurônios de Purkinje do cerebelo, vacuolização das células acinares do pâncreas e das células foliculares da tireoide. No segundo artigo, o cervídeo desenvolveu uma síndrome neurológica caracterizada por fraqueza muscular, tremores de intensão, déficit visual, quedas, postura e comportamento anormal. Os principais achados microscópicos foram vacuolização citoplasmática nos neurônios de Purkinje do cerebelo. No terceiro artigo duas cabras prenhes foram intoxicadas experimentalmente com Sida carpinifolia nas doses de 10 e 13 g/kg respectivamente durante 30 dias e foram acompanhados durante 15 dias após o consumo da planta. Após este período foram eutanasiadas e necropsiadas. Adicionalmente foi incluído um feto bovino no qual a mãe havia sido intoxicada naturalmente por S. carpinifolia. As principais alterações microscópicas observadas nos fetos foram vacuolização do epitélio dos túbulos renais, das células foliculares da tireoide e cerebelo com discreta vacuolização dos neurônios de Purkinje. Na microscopia eletrônica de todos os casos foi observado vacúolos contendo material finamente granulado e delimitado por membrana. Na lectinahistoquímica dos bovinos, do cervídeo e dos fetos observou-se marcação em neurônios com as lectinas Concanavalia ensiformis (Con-A), Triticum vulgaris (WGA) e Succinyl WGA (sWGA). / Describes the epidemiological, clinical, pathological, ultrastructural and lectinhistochemical herbivore naturally poisoned by Sida carpinifolia in Rio Grande do Sul, Brazil. This study included the preparation of three articles. We conducted a retrospective study of natural poisoning by Sida carpinifolia in cattle in Rio Grande do Sul and the other reports for the first time a natural poisoning by this plant in a wild animal. The third article reports the pathologic findings observed in fetuses of female goats and cattle that were naturally and experimentally poisoned by Sida carpinifolia respectively. In the first paper were affected five cattle between the years 2001 to 2008. The clinical picture was characterized by weight loss, incoordination, difficulty walking, generalized tremors, frequent falls and death. Microscopically the main changes were vacuolation of the Purkinje neurons of cerebellum, vacuolization of acinar cells of the pancreas and thyroid follicular cells. In the second paper, the deer developed a neurological syndrome characterized by muscular weakness, intention tremors, visual and standing-up deficits, falls, and abnormal behavior and posture. The main microscopic findings were vacuolation in Purkinje neurons of cerebellum. In the third paper were two pregnant goats experimentally poisoned with Sida carpinifolia in doses of 10 and 13 g / kg for 30 days and were followed for 15 days after consumption of the plant. Additionally included a bovine fetus where the mother had been poisoned by S. carpinifolia. The main microscopic changes observed in the fetuses were vacuolation of the epithelium of renal tubules, thyroid follicular cells in the cerebellum and mild vacuolation of Purkinje neurons. On electron microscopy all cases was observed vacuoles containing finely granular material and bordered by membrane. In lectin-histochemistry of cattle, the deer and fetuses was observed in neurons marking to lectins Concanavalia ensiformis (Con-A), Triticum vulgaris (WGA) e Succinyl WGA (sWGA).
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