O parênquima pulmonar periférico tem sido estudado como um componente da resposta inflamatória na asma. Durante uma constrição induzida, a resistência do tecido aumenta em diferentes modelos de asma. Aproximadamente 60% dos pacientes asmáticos possuem respostas imediata e tardia. A resposta tardia é caracterizada por obstrução mais grave de vias aéreas. No presente estudo, foi avaliada a mecânica de fatias de parênquima pulmonar em cobaias sensibilizadas com ovoalbumina (OVA), tentando reproduzir ambas as repostas imediata e tardia. A mecânica oscilatória de fatias pulmonares foi realizada em um grupo controle (C), em um grupo de resposta imediata (IM) e em dois grupos de resposta tardia: 17 (T1) e 72 (T2) horas após o último desafio com ovoalbumina. Medidas de resistência (R) e elastância (E) foram obtidas antes e depois do desafio com OVA nos grupos C e IM e antes e depois do desafio com Acetilcolina (ACh) em todos os grupos. Com o uso de morfometria, foram avaliadas as densidades de eosinófilos e de células musculares lisas, assim como o conteúdo de colágeno e elastina nas fatias pulmonares. Os valores de R e E basais e pós-agonista estão aumentados nos grupos IM, T1 e T2 quando comparados com o grupo C (p = 0.001). A análise morfométrica mostrou um aumento na densidade de eosinófilos nas fatias de tecido periférico dos grupos IM e T2 quando comparados com o grupo C (p < 0.05). Houve uma correlação positiva significante entre a densidade de eosinófilos nas fatias de parênquima dos grupos C, T1 e T2 e os valores de R e E pós-ACh (r = 0,71, p = 0.001 e r = 0,74, p < 0.001, respectivamente). Os resultados mostram que o parênquima pulmonar está envolvido na resposta tardia deste modelo de inflamação alérgica crônica e que a resposta constritora nesta fase está relacionada à inflamação eosinofílica. / The peripheral lung parenchyma has been studied as a component of the asthmatic inflammatory response. During induced constriction, tissue resistance increases in different asthma models. Approximately 60% of the asthmatic patients show early and late responses. The late response is characterized by more severe airway obstruction. In the present study, we evaluated lung parenchymal strips mechanics in ovalbumin-sensitized guinea pigs, trying to reproduce both early and late inflammatory responses. Oscillatory mechanics of lung strips were performed in a control group (C), in an early response group (ER), and in two late response groups: 17 (L1) and 72 (L2) hours after the last ovalbumin challenge. Measurements of resistance and elastance were obtained before and after ovalbumin challenge in C and ER groups and before and after Acetylcholine challenge in all groups. Using morphometry, we assessed the density of eosinophils and smooth muscle cells, as well as collagen and elastin content in lung strips. The baseline and post-agonist values of resistance and elastance were increased in ER, L1 and L2 groups compared with C (p = 0.001). The morphometric analysis showed an increase in alveolar eosinophil density in ER and L2 groups compared with C group (p < 0.05). There was a significant correlation between eosinophil density in parenchymal strips of C, L1 and L2 groups and values of resistance and elastance post-Acetylcholine (r = 0.71, p = 0.001 and r=0.74, p < 0.001, respectively). The results show that the lung parenchyma is involved in the late response of this guinea pig model of chronic allergic inflammation and the constriction response in this phase is related to the eosinophilic inflammation.

O objetivo da pesquisa foi de analisar a alternativa de Produção de Biodiesel na Guiné-Bissau, tendo como base a transposição do aprendizado construído pelo Programa de Produção e Uso do Biodiesel no Brasil – PNPB, analisar a realidade do PNPB no Brasil, verificar a percepção de viabilidade junto aos agentes do governo guineense, associação de classe de agricultores e construir um modelo preliminar do Quadro Institucional do Programa de Biodiesel na Guiné, como alternativa para promover ascensão econômica e desenvolvimento regional. O êxito do PNPB foi evidenciado pelos benefícios proporcionados na economia brasileira. Até 2010 o Brasil já deixou de gastar U$ 2,84 bilhões com importação de diesel. Com a adição de B10, o Brasil não precisaria mais importar diesel. Para ampliar a produção do biodiesel até 2020, projeta-se investimento de R$ 7,36 bilhões, o que geraria 531.045 empregos diretos e 6 milhões indiretos. A Guiné-Bissau enfrenta problema da pobreza extrema e economia baseada na monocultura de caju. Os gastos com combustível fóssil em 2015 representaram 30% de total das importações do país, contribuindo fortemente para o déficit na balança comercial do país e no enfraquecimento da economia já fragilizada pela pobreza. A escassez da energia impulsionou as empresas locais a utilizarem geradores movidos a óleo diesel para suprir esta demanda. Apesar da evidência dos esforços governamentais no fornecimento da energia, o preço praticado não tem a mesma proporção com a condição econômica do país. Neste sentido, o Programa de Biodiesel na Guiné-Bissau – PNBGB se caracteriza num mecanismo proeminente para alavancar a economia daquele país, por ser uma atividade com elo na agricultura e com potencial de geração de emprego e renda no campo e redução das emissões de gases de efeito estufa – GEE na atmosfera. Para alcançar os objetivos da pesquisa foi utilizada a metodologia de pesquisa exploratória. Os dados foram coletados em Bissau, Guiné-Bissau, inicialmente por entrevistas pelo Skype e finalizados com aplicação de questionários por e-mail. As entrevistas contaram com a participação do Ministro da Economia e Finanças e pelo Ministério da Agricultura e Desenvolvimento Rural da Guiné-Bissau, por um conjunto de técnicos e especialistas da área. Os resultados demonstraram que a Guiné-Bissau apresenta grande potencial de produção de biodiesel a partir de oleaginosas existentes no país como jatropha curcas, palma de dendê, algodão e mamona. No entanto, a planta indicada pelo Ministério da Agricultura é a jatropha. Com isso, foi realizada uma projeção da demanda e oferta de biodiesel até 2031, o que permitiu verificar que a escala viável economicamente para Guiné-Bissau inicia com o nível de mistura compulsória de 5% – B5, equivalente ao volume de 4.091,14 m³/ano de biodiesel. Verificou-se que os benefícios do Programa de Biodiesel na Guiné-Bissau poderão envolver as receitas fiscais, geração de emprego e renda para mais de 80.000 pessoas que atuam no setor agrícola, benefícios ambientais e econômicos na diversificação da base produtiva, além de impulsionar a criação das cooperativas agrícolas com notável atuação na cadeia produtiva do biodiesel. A partir desta análise, foi elaborada uma proposta de Quadro Institucional e de implicações de gestão para implantação do PNBGB. A análise da implantação do programa apresentou a necessidade de transferência tecnológica e de financiamentos estrangeiros. Neste contexto, observou-se que o país conta com parceiros sub-regionais e internacionais para financiamento de projetos de desenvolvimento e de transferências de tecnologias agrícolas, elevando o potencial de sucesso na introdução do Programa de Biodiesel na Matriz Energética guineense. / The objective of this study was to examine the alternative of Biodiesel Production in Guinea- Bissau, taking as a basis the implementation of the learning constructed by the Program for the Production and Use of Biodiesel in Brazil - PNPB, examine the reality of PNPB in Brazil, check the perception of viability by the agents of the Guinean government, association of farmers and build a model of the Institutional Framework of the Biodiesel Program in Guinea, as an alternative to promote economic advancement and regional development. The success of the PNPB was evidenced by the benefits provided in the Brazilian economy. Until 2010 Brazil has already failed to spend $2.84 billion with imports of diesel. With the addition of B10, Brazil does not need more importing diesel. To increase the production of biodiesel until 2020, the projected investment of R$ 7.36 billion, which would generate 531,045 direct jobs and 6 million indirect jobs. The Guinea-Bissau faces problem of extreme poverty and economy based on monoculture plantations of cashew nuts. Spending on fossil fuel subsidies in 2015 accounted for 30% of total imports of the country, contributing greatly to the deficit in the trade balance of the country and the weakening of the economy already weakened by poverty. The shortage of energy has boosted the local companies to use generators powered by diesel oil to meet this demand. Despite the evidence of governmental efforts in the provision of energy, the price does not have the same proportion with the economic condition of the country. In this sense, the Biodiesel Program in Guinea Bissau - PNBGB is characterized in a prominent mechanism to leverage the economy of that country, because it is an activity with a link at the agriculture and with potential for generating employment and income in the country and reduction of greenhouse gas emissions - GHG in the atmosphere. To achieve the objectives of the survey was used the methodology of explo ratory research. The data were collected in Bissau, Guinea-Bissau, initially by interviews via Skype and finalized by application of questionnaires by mail. The interviews were attended by the Minister of Economy and Finance and the Ministry of Agriculture and Rural Development of Guinea-Bissau, for a set of technicians and specialists in the area. The results showed that the Guinea-Bissau presents great potential for production of biodiesel from oilseeds in the country as jatropha curcas, palm oil, cotton and castor oil. However, the plant indicated by the Ministry of Agriculture is the jatropha. With this, there was a projection of the demand and supply of biodiesel until 2031, which showed that the scale economically viable for Guinea- Bissau starts with the level of compulsory mixture of 5% - B5, equivalent to the amount of 4,091.14 m³/year of biodiesel. It was found that the benefits of the Biodiesel Program in Guinea Bissau may involve the tax revenue, generation of employment and income for more than 80,000 people working in the agricultural sector, environmental benefits and economic diversification of the productive base, in addition to boost the creation of agricultural cooperatives with remarkable performance in the biodiesel production chain. From this analysis, a proposal was drawn up to the institutional framework and implications for management for deployment of PNBGB. The analysis of the implementation of the program presented the need for technology transfer and foreign financing. In this context , it was noted that the country has partners sub-regional and international financing of development projects and for transfers of agricultural technologies, increasing the potential for success in the introduction of the Biodiesel Program in the energy matrix.

BACKGROUND: Obstetric fistula (OF) is described as a health and human rights tragedy due to its devastating consequences and debilitating sequelae. In sub-Saharan Africa, the lifetime prevalence of OF symptoms is estimated at 3.0 cases (95% CI 1.3-5.5) per 1000 women of reproductive age. In Guinea, this prevalence is 6·0 (95% CI 3·9–7·4) per 1000 women of reproductive age, a double that of sub-Saharan Africa. As maternal mortality reduction is accelerating in many countries due to better access to cesarean section and more women are benefiting treatment for OF worldwide, women who have a successful fistula repair need more attention to prevent fistula recurrence and adverse maternal and neonatal outcomes.AIM: To analyze the long-term reproductive health outcomes in women who undergo fistula surgery in Guinea and contribute to closing the knowledge gap on the reproductive health of women after fistula surgery.METHODS: The situational analysis of fistula management programs in Guinea included three retrospective cohort studies. Study I analyzed the clinical outcomes of fistula care programs in Guinea. Study II analyzed the trends and factors associated with loss to follow-up after surgical repair of obstetric fistula in Guinea. Study III estimated the overall proportions of surgical failure of fistula closure and incontinence among women undergoing repair for obstetric fistula in Guinea and identified factors associated with these outcomes. To analyze the health and reproductive outcomes in women after female genital fistula surgery in Guinea, two studies (IV and V) were conducted. Study IV critically reviewed the existing literature on pregnancy and childbirth post repair of obstetric fistula and Study V analyzed the incidence of fistula recurrence and pregnancy post repair along with the associated maternal and neonatal outcomes. RESULTS: Routine programmatic repair of OF was found to achieve satisfactory short-term clinical outcomes with 85% of women having their fistula closed and 79% becoming continent after surgery (Study I). However, additional 18% recurrence and 10% residual urinary incontinence were recorded within 28 months median follow-up post-surgery (Study V). Reimbursement of transportation costs and the reduction of geographical barriers to care for women with OF were highly related to reduced loss to follow-up after hospital discharge (Study II). Women who present for surgery with a damaged urethra and those who delivered vaginally during the delivery leading to the fistula were more likely to experience surgical repair failure and residual urinary incontinence (Study III). Women who become pregnant and deliver after fistula repair in sub-Saharan Africa were identified as carrying high risk of adverse maternal and neonatal health outcomes (Study IV). In Guinea, only few women achieved pregnancy (28%) after surgery. Stillbirths (24%) and recurrence of fistula after delivery (14%) were common among women who delivered after fistula repair (Study V). CONCLUSIONS: Improving the performance of fistula management programs in the context of decentralization of services in Guinea needs therefore to integrate long-term perspectives. This should include establishing a “level of care framework” into fistula surgery along with training for health providers, tracing of women after repair, and increased community awareness-raising that include men and target gender inequalities (Studies I to III). Increasing funding and support for fistula care from both local governments and international donors is needed in the current context of decentralization of fistula care to address service gaps for women suffering from fistula (Studies III to V). Achieving a fistula free generation should include interventions to address women’s vulnerability before fistula formation and after fistula repair (Studies IV and V). / Doctorat en Sciences de la santé Publique / info:eu-repo/semantics/nonPublished

INTRODUÇÃO: A relevância do parênquima pulmonar distal na fisiopatologia da asma tem sido intensamente enfatizada. Vários estudos sugerem a inibição da Rho quinase como uma intervenção benéfica e promissora na asma. Entretanto, não há estudos anteriores que avaliaram os efeitos destes inibidores na modulação da mecânica do parênquima pulmonar e suas alterações histopatológicas em um modelo animal de inflamação pulmonar alérgica crônica. OBJETIVO: Avaliar a inibição da Rho quinase (Y-27632) na modulação da responsividade, inflamação, remodelamento da matriz extracelular e ativação do estresse oxidativo no parênquima pulmonar de cobaias com inflamação pulmonar alérgica crônica. MÉTODOS: As cobaias receberam sete inalações de ovalbumina (1-5 mg / ml; grupo OVA) ou salina (grupo SAL) ao longo de quatro semanas. A partir da quinta inalação, os animais do grupo Rho quinase foram submetidos a inalação com Y-27632, 10 minutos antes de cada inalação com OVA ou SAL. Setenta e duas horas após a sétima inalação, os animais foram anestesiados e exanguinados, e das tiras do tecido pulmonar foram realizadas a mecânica oscilatória, sob condições basais e após o desafio de ovalbumina (0,1%). Após a mecânica, as fatias de pulmão foram submetidas a análise histológica por meio da morfometria. RESULTADOS: A inibição de Rho quinase nos animais expostos à ovalbumina atenuou a elastância e a resistência tecidual, o número de eosinófilos, a expressão de IL-2, IL-4, IL-5, IL-13, TIMP-1, MMP-9, TGF-, IFN-g, NF-kB e iNOS e o conteúdo de 8-iso-PGF2, fibras elásticas, fibras colágenas e actina em comparação com o grupo OVA (P<0,05). CONCLUSÃO: A inibição da Rho quinase contribui para o controle da capacidade de responsividade do parênquima pulmonar, da inflamação eosinofílica, das respostas Th1/Th2, ao controle do remodelamento da matriz extracelular em um modelo animal de inflamação pulmonar alérgica crônica. Podendo ser considerada uma futura ferramenta farmacológica para o tratamento de doenças pulmonares crónicas. / RATIONALE: Previous studies with Rho-kinase inhibitors suggest a beneficial influence of these drugs in asthma. The relevance of distal lung tissue in functional asthmatic impairment has been intensely emphasized. There have not been any previous studies evaluating the effects of these inhibitors on the modulation of distal lung mechanics and histopathological alterations in an animal model of chronic pulmonary inflammation. OBJECTIVE: To evaluate if Rho-kinase inhibition (Y- 27632) modulates distal lung responsiveness, inflammation, extracellular matrix remodeling and oxidative stress activation in guinea pigs with chronic allergic inflammation. METHODS: Guinea pigs received seven inhalations of ovalbumin (1-5 mg/ml; OVA group) or saline (SAL group) over 4 wk. From the 5th inhalation, the Rho-kinase group animals were submitted to Y-27632 inhalation 10 min before each inhalation with OVA or SAL. Seventy-two hours after the seventh inhalation, the animals were anesthetized and exsanguinated, and oscillatory mechanics of the lung tissue strips were performed under the baseline condition and after the ovalbumin challenge (0.1%). Afterwards, the lung slices were submitted to morphometry. RESULTS: The Rho-kinase inhibition in the ovalbumin-exposed animals attenuated the tissue elastance and resistance, eosinophils, the IL-2, IL-4, IL-5, IL-13, TIMP-1, MMP-9, TGF-, IFN-g, NF-kB, iNOS-positive cells and the 8-iso-PGF2, elastic, collagen and actin content compared with the OVA group (P<0.05). CONCLUSION: Rho-kinase inhibition contributes to the control of distal lung responsiveness and the eosinophilic and Th1/Th2 responses to the control of extracellular matrix remodeling in an animal model of chronic allergic inflammation. It may be considered a future pharmacological tool for the treatment of chronic pulmonary diseases.

INTRODUÇÃO: Vários estudos têm mostrado a importância da Rho quinase na modulação da contração do músculo liso, hiperresponsividade das vias aéreas e inflamação. Entretanto, os efeitos do tratamento crônico com um inibidor específico desta via não haviam sido previamente investigados. MÉTODOS: No presente estudo, foram avaliados os efeitos do tratamento crônico com Y-27632, um inibidor altamente seletivo Rho quinase, sobre a hiperresponsividade das vias aéreas, a ativação do estresse oxidativo, o remodelamento da matriz extracelular, a inflamação eosinofílica e a expressão de citocinas em um modelo animal de inflamação crônica das vias aéreas. As cobaias foram submetidas a sete inalações com ovalbumina ou solução salina (duas vezes por semana durante quatro semanas). Inalações com o inibidor da Rho quinase (Y-27632; 1mM) foram realizadas 10 min antes de cada exposição ao antígeno, começando na quinta inalação. Setenta e duas horas após a 7ª inalação, a avaliação da mecânica pulmonar foi realizada e o óxido nítrico exalado foi coletado. Os pulmões foram então removidos e a análise histológica foi realizada utilizando morfometria. RESULTADOS: O tratamento com Y-27632 em animais sensibilizados reduziu o óxido nítrico exalado, as respostas máximas de resistência e elastância do sistema respiratório, o número de eosinófilos, o conteúdo colágeno e fibras elásticas, o número de células positivas para IL-2, IL-4, IL-5, IL-13, iNOS, MMP -9, TIMP-1, TGF-, NFkappa B e IFN-, e o conteúdo de 8-iso-PGF2 em relação ao grupo não tratado (p<0,05). Houve correlação positiva entre as respostas funcionais e os marcadores de inflamação, remodelamento e ativação da via de estresse oxidativo avaliados. CONCLUSÕES: A ativação da vida da Rho quinase contribui para a potencialização da hiperresponsividade, inflamação, processo de remodelamento da matriz extracelular e ativação do estresse oxidativo. Estes resultados sugerem que os inibidores da Rho quinase podem ser uma ferramenta farmacológica em potencial para o controle da asma / INTRODUCTION: Several studies have shown the importance of Rho-kinase in the modulation of smooth muscle contraction, airway hyperresponsiveness and inflammation. However, the effects of chronic treatment with a specific inhibitor of this pathway had not been previously investigated. METHODS: We evaluated the effects of chronic treatment with Y-27632, a highly selective Rho-kinase inhibitor, on airway hyperresponsiveness, oxidative stress activation, extracellular matrix remodeling, eosinophilic inflammation and cytokines expression in an animal model of chronic airway inflammation. Guinea pigs were submitted to seven ovalbumin or saline exposures (twice a week for four weeks). Rho-kinase inhibitor (Y-27632; 1mM) was aerosolized 10 min before each antigen exposure, beginning at the 5th inhalation. Seventy-two hours after the 7th inhalation, pulmonary mechanics evaluation was performed and exhaled nitric oxide was collected. Lungs were removed and histological analysis was performed using morphometry. RESULTS: Treatment with Y-27632 in sensitized animals reduced exhaled nitric oxide, maximal responses of resistance and elastance of respiratory system, eosinophils, collagen and elastic fibers content, IL-2, IL-4, IL-5, IL-13, iNOS, MMP-9, TIMP-1, TGF-, NFkappa B and IFN- positive cells, and 8-iso-PGF2 content compared to the non-treated group (P<0.05). There were positive correlations among the functional responses and the markers of inflammation, remodeling and oxidative stress pathway activation evaluated. CONCLUSIONS: Rho-kinase pathway activation contributes to the potentiation of the hyperresponsiveness, inflammation, extracellular matrix remodeling process and oxidative stress activation. These results suggest that Rho-kinase inhibitors may be a potential pharmacological tool for controlling asthma

Projeções dos eventos severos/extremos relacionados às mudanças climáticas têm sido cada vez mais socialmente debatidas e servido de subsídio para a intensificação das discussões e compromissos multilaterais no âmbito das Conferências das Partes (COPs). Como desdobramento disso, aumenta o número de países que, ao nível nacional, se dedicam à construção de políticas públicas para lidar preparativamente com os eventos projetados, os quais, em muitos casos, já estão ocorrendo. Inseridos de forma subordinada no âmbito dessas discussões multilaterais estão os países denominados pelas Nações Unidas como \"Menos Avançados\", assim classificados por possuírem limitadas capacidades institucionais para diagnosticar e lidar com essas situações adversas. Tais países têm sido contemplados por meio de diferentes programas com fundos ambientais para auxiliá-los na elaboração e implementação de seus respectivos Planos Nacionais de Adaptação às Mudanças do Clima (PANA/NAPA, este último na sua sigla em inglês). O presente estudo teve como objetivo analisar a dimensão sociopolítica da construção do Plano Nacional de Adaptação às Mudanças do Clima (PANA) da Guiné-Bissau. Através de uma perspectiva sociológica, problematizamos aspectos da lógica operativa, de caráter sociopolítico, através dos quais o Estado guineense se constitui e estabelece sua interlocução, de um lado, na arena multilateral de COPs e, de outro, junto aos seus povos constituintes quando estes vivenciam os desastres ditos \"naturais\". Tendo como base o processo histórico que forjou um Estado nacional socialmente excludente, fez-se uma análise transescalar de três níveis das relações de poder, a saber: o que considera a posição do Estado guineense frente às forças multilaterais de desenvolvimento e do ambiente; o que demarca as características da interação do Estado com as ONGs e demais parceiros que auxiliam na consecução das políticas socioambientais; e, por fim, o nível local, onde as comunidades sofrem os reflexos e as injunções dos níveis superiores por meio de embates e alianças. Para a realização da pesquisa, adotamos três procedimentos qualitativos básicos, a saber: um levantamento bibliográfico, um levantamento documental e a pesquisa de campo. / Prognostics of severe and extreme events related to climate change have been increasingly socially debated and supported the multilateral discussions and commitments in UNFCCC Conferences of the Parties (COPs). Subsequently, it has increased the number of countries that, on national level, dedicate themselves to the task of building public policies to cope with the predicted events, which are often considered to be already in course. In the multilateral discussions, inserted, but in a subordinate way, are the \"Least Developed Countries\", as denominated by the United Nations, so classified for having limited institutional capacity to diagnose and manage adverse conditions. Such countries have been granted with environmental support from different programs to assist in the preparation and implementation of the National Adaptation Programmes of Action (NAPA). This study has the objective of analysing the socio-political dimension of the construction of the National Adaptation Programme of Action of Guinea-Bissau. From a sociological perspective, it is discussed aspects of the operative logic, of socio-political character, which the Guinean state is built on and establishes its interactions, in one side, with the multilateral arena of COPs, and, on the other, with its own peoples when they experience the so-called \"natural\" disasters. From the foundations of the historical process that led to a socially excluding national state, this study makes a cross-scale analysis of three levels of power relations, namely: (a) one that considers the position of Guinea-Bissau when facing multilateral forces of economic and environmental development; (b) one that delimits the characteristic of the interaction between the national state and the NGOs and additional partners which assist in the planning/implementation of socioenvironmental policies; (c) the one in the local level, where the communities suffer the consequences and impositions from superior levels, by means of conflicts and alliances. This research has adopted three qualitative research methods: bibliographic research, documentary research, and field research.

Il est clairement établi que les forêts à caractère sacré ne sont pas que des créations socioculturelles émanant de sociétés traditionnelles comme cadre privilégié d'accomplissement de diverses cérémonies rituelles, mais représentent aussi des formes locales de conservation de la biodiversité. C'est ce dernier rôle qui attire toute l'attention des institutions internationales, des états et des scientifiques. Bien que de telles forêts aient été largement étudiées en Asie et dans d'autres parties de l'Afrique, notre compréhension des forêts sacrées de la Guinée reste pauvre. En effet, ces forêts sont placées, en raison de leur statut sacré, sous l'entière responsabilité des communautés locales et non l'état. Dans ce travail de thèse, quatre cas représentatifs ont été retenus en Haute Guinée, dans les localités proches de Kankan. C'est l'une des régions dont les écosystèmes sont les plus anthropisés par l'agriculture et les activités minières. Les villages de Diankana, Tintioulenkoro et Dossori font partie des rares où des forêts à caractère sacré sont encore maintenues. L'objectif de cette thèse est de diagnostiquer les valeurs socioculturelles et écologiques de ces forêts, dans un contexte local fort d'anthropisation, en vue de leur documentation et de l'élaboration des stratégies d'une gestion durable. Plusieurs approches méthodologiques ont été utilisées : enquêtes sociologiques et ethnobiologiques, inventaires écologiques et botaniques. L'étude révèle un mode de gestion des forêts sacrées qui connaît une évolution chez les Malinkés, reposant à la fois sur des ''codes mythiques'' et des lois définies par la législation traditionnelle. La rigueur dans la gestion et le rôle des forêts pour les populations sont des atouts. Toutefois, les mutations sociales relativement récentes, l'agriculture et l'urbanisation fragilisent le système et pénalisent la conservation. L'analyse diachronique démontre qu'au cours de ces trois dernières décennies, le couvert forestier de l'ensemble des sites sacrés étudiés a connu un recul moyen d'environ 40 % de leur superficie initiale par l'agriculture et l'urbanisation. [...] / It has been widely reported that sacred forests are not just socio-cultural creations emanating from traditional societies as a privileged setting for ritual ceremonies, but that they also represent important local forms of biodiversity conservation. In recent decades, it is this latter role that has attracted the attention of international institutions, states and scientists. Although such forests have been widely studied in Asia and other parts of Africa, our understanding of Guinea's sacred forests remains poor because local communities, not the state, manage them. In effect, because of the sacred status of these forests, the state favours local management strategies by individual communities. In this thesis, four representative case studies of the sacred forests of Upper Guinea, located near Kankan, are studied. The region's ecosystems have been profoundly affected by human impacts, notably agriculture and mining. The villages of Diankana, Tintioulenkoro and Dossori, where these forests are amongst the few areas to conserve sacred forests. The aim of this thesis is to probe the socio-cultural and ecological values of the forests, in a local context of strong human pressures, with a view to their documentation and the elaboration of sustainable management strategies. Several methodological approaches have been used: sociological and ethno biological surveys, ecological and botanical inventories. The study elucidates a mode of management of these sacred forests by an ethnic group, the Malinkés, which is based on both "mythical codes" and laws defined by traditional legislation. The rigor of this management system, and the socio-cultural importance of these forests for local populations, favours their conservation in the wider context of profound human pressures on the environment. However, social changes in recent years appear, agriculture and urbanisation to have weakened this management system and exposed the area's sacred forests to factors that preclude their effective conservation. The diachronic analysis shows that over the last three decades, the forest cover of all sacred sites studied has decreased by just over 40% of their initial area by agriculture and urbanization. [...]

No conclusive evidence exists to determine that epidural steroid injections (ESIs) provide lasting improvements in chronic pain due to herniated discs, in the Workers' Compensation population. Recently, an article by Armon et.al was published by the American Academy of Neurology, which stated that the routine use of ESIs is not recommended and that further studies are needed to elucidate this controversy (Armon, Argoff, Samuels, & Backonja, 2007). In 1998, back pain in the United States was estimated to have incurred total health-care expenditures of $90.7 billion. Medicare part B. claims in 1999 for 40.4 million individuals amounted to $49.9 million for lumbar epidural steroid injections alone. The practice of evidence based medicine will reduce health care costs and discomforts of the procedure. The objective of this study was to determine if ESIs will result in reduction of pain levels and pain medications used, and to determine the cost of treatment. In this retrospective cohort chart review study, where claimants served as their own controls, pain levels and medications used, were retrospectively assessed using documented pain scores based on the numerical pain scale, and medications prescribed, respectively. Further correlations were made with clinical and MRI findings. Costs were derived based on the amount billed by the provider to the insurance company. A randomized list of 600 charts from the insurance company's database was obtained and 120 were selected for study based on criteria. Data abstracted included gender, weight, date of injury, clinical symptoms, MRI findings, pain scores before and after ESIs, medications used before and after ESIs , date of ESIs, total amount billed for the ESIs, surgery, and total cost of the injury to date of data abstraction. The mean pain score before was 6.97 and 7.51 after ESIs The mean number of pain medication groups before was 2.41 and 3.10 after ESIs. The mean morphine equivalent dose before was 10.50mg and 22.07mg after ESIs. There was no significant correlation between amount billed for ESI and pain level. It was concluded that use of ESIs in the treatment chronic radicular pain does not reduce workers' pain levels, amount of pain medications, or narcotic consumed. These measures of discomfort remained the same, or were increased regardless of money spent.

Du XVe au XVII siècle, le Portugal a occupé la première place parmi les Etats les plus avancés de son temps. Et c’est pendant cette époque que les explorateurs de ce pays ont parcouru les océans lors d’expéditions qui les ont amenés en Afrique, en Asie, en Amérique et en Océanie. Or, le contact des peuples et des cultures a toujours été source d’influences réciproques de nature diverse et multiforme. Nous nous proposons d’étudier, dans cette thèse, les empreintes lusitaniennes dans le Golfe de Guinée. La recherche a été menée dans la partie australe de la Côte d’Ivoire, du Ghana, du Togo et du Bénin et elle se fonde sur un corpus composé de quelques centaines d’entrées que nous avons répertoriées à travers une recherche bibliographique et une enquête de huit ans sur le terrain. L’analyse de ces données, se fait selon une méthode qui combine à la fois l’histoire et le structuralisme dans son approche contrastive car, il s’agit, en réalité, de comparer deux systèmes linguistiques : le portugais et des langues Niger-Congo des groupes langues kru et kwa. L’étude se tisse autour de trois parties : la première partie fait un rappel historique des rapports luso-africains puis délimite l’univers géographique cible; la seconde étudie l’emprunt lexical portugais dans les principales langues de la région; enfin, la troisième et dernière partie, aborde la question des emprunts onomastiques portugais dans la région. / From XVth to XVIIth century, Portugal has been ranking first among the most advanced nations of its time. It is during that era that the explorers helped this country to reach out Africa, Asia, America and Oceania. But any contact with peoples and cultures has always been a source of various and multifaceted reciprocal influences. In this thesis, we will study the lusitanian impressions in the Guinea Gulf. The research has been conducted in the southern part of Ivory Coast, Ghana, Togo and Benin and is based on a corpus made up of some hundreds of words that we have listed in a bibliography and an investigation that we have carried out in the field during eight years. The analysis of data is done according to a bipolar method which combines history and structuralism in its contrastive approach because, in reality, we are comparing two linguistic systems: portuguese, kru and kwa languages of the Niger-Congo family. The study includes three parts; the first part deals with the historical background of luso-african relationships then delineates the targeted geographic realms; the second part studies the portuguese lexical borrowings in the main languages of the region; finally, the third and last part touches on the issue of portuguese onomastic borrowings in the region.

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