Transforming matters: sustaining gold lifeways in artisanal and small-scale mining

Growth strategies in mining regions promote gold extraction basedonindustrial mining, associating Artisanal and Small-scale Gold Mining (ASGM) with persistent informality. Against this background, we consider how to approach transformations to sustainability in ASGM. Acknowledging how problematic this topic is for sustainability debates,given howASGM is associated with a host of environmental and social problems,we argue that a justice lens demands we confront such challenges within the global politics of sustainability. This leads us to review advances inthe study of ASGM, linked to debates on extractivism, resource materialities, and informality. We use the notion of gold lifeways to capture how the matter of mining shapes different worlds of extraction. We argue that consideration of the potential for transformations to sustainability needs to be grounded within the realities of ASGM. This necessitates giving value to miners’ knowledge(s), perspectives and interests, while recognising the plurality of mining futures. Nevertheless, we conclude that between the immediacy of precarious work and the structural barriers to change in ASGM, the challenges for transformation cannot be underestimated.NWOGlobal Challenges (FSW

Radiofrequency catheter ablation of supraventricular tachycardia in children and adolescents: Feasibility and cost-effectiveness in a low-income country

The objective of this study is to provide results and costs of catheter ablation in children and adolescents in a low-income country. Reports from first-world countries have demonstrated the cost-effectiveness of radiofrequency catheter ablation (RFCA) compared to medical treatment of supraventricular tachycardia (SVT). The study included 28 patients younger than 18 years of age with SVT in a pediatric cardiology unit in Guatemala. All patients underwent RFCA. Clinical outcome and cost-effectiveness of RFCA compared to continued medical treatment were the end points. Twenty-four patients had successful ablation (85.7%). Mean age at RFCA was 11.42 \ub1 3.49 years. Three patients underwent a second ablation, increasing the success rate to 96.4%. One remaining patient is awaiting a second procedure. At a mean follow-up of 13.69 \ub1 7.16 months, all 27 patients who had a successful ablation remained in sinus rhythm. Mean cost per procedure was 4.9 times higher than that of medical treatment. However, the estimated cost of catheter ablation equal that of medical therapy after 5.1 years and is 3.4 times less after 20 years. Radiofrequency catheter ablation of SVT in children and adolescents is safe and cost-effective compared to medical therapy. Resources must be judiciously allocated, especially in low-income countries, to treat the largest number of pediatric patients. \ua9 Springer Science+Business Media, Inc. 2006