Building the nation's body:The contested role of abortion and family planning in post-war South Sudan

: This paper offers an ethnographic analysis of public health policies and interventions targeting unwanted pregnancy (family planning and abortion) in contemporary South Sudan as part of wider 'nation-building' after war, understood as a process of collective identity formation which projects a meaningful future by redefining existing institutions and customs as national characteristics. The paper shows how the expansion of post-conflict family planning and abortion policy and services are particularly poignant sites for the enactment of reproductive identity negotiation, policing and conflict. In addition to customary norms, these processes are shaped by two powerful institutions - ethnic movements and global humanitarian actors - who tend to take opposing stances on reproductive health. Drawing on document review, observations of the media and policy environment and interviews conducted with 54 key informants between 2013 and 2015, the paper shows that during the civil war, the Sudan People's Liberation Army and Movement mobilised customary pro-natalist ideals for military gain by entreating women to amplify reproduction to replace those lost to war and rejecting family planning and abortion. International donors and the Ministry of Health have re-conceptualised such services as among other modern developments denied by war. The tensions between these competing discourses have given rise to a range of societal responses, including disagreements that erupt in legal battles, heated debate and even violence towards women and health workers. In United Nations camps established recently as parts of South Sudan have returned to war, social groups exert a form of reproductive surveillance, policing reproductive health practices and contributing to intra-communal violence when clandestine use of contraception or abortion is discovered. In a context where modern contraceptives and abortion services are largely unfamiliar, conflict around South Sudan's nation-building project is partially manifest through tensions and violence in the domain of reproduction.<br/

Construção de política para gestão de resíduos na Universidade de São Paulo como modelo para implementação da PNRS em IES

The actual scenario of the University of São Paulo (USP) has, in an isolated form, various environmental initiatives in diverse fronts, according to the reality of its campi. In 2010, USP designated an Environmental Management coordinator attached to the university’s rectory. The following year USP approved the its Environmental Policy, that promotes environmental sustainability in all its campi. In 2012 the Environmental Management Superintendence (SGA) was created as an office responsible for environmental management of the university, with the objective of developing norms for environmental issues in agreement to the proposed environmental policy. This superintendence created in 2012 a Working Group for dealing with issues related to solid residues generated in USP. This group, composed of specialists in this area and coordinated by an member of the SGA, developed, using participative processes, strategies and procedures for the elaboration and implementation of the Solid Residue Management Policy (PGRUSP). This policy following a previous model (PUSP-C, 2010), has as objective adequate the National Solid Residue Policy (PNRS) to the university’s environment. An initial version of the PGRUSP was presented to the academic community in a Forum promoted by the SGA. In this occasion, representatives of all the categories coming from the university’s different campi, apart from members of the external community, analyzed the document and made suggestions on its contents that were later included in the final document. PGRUSP determines the elaboration of Residue Management Plans in all the units that belong to USP. At this moment, the Working Group is elaborating directives for the training of the academic community for the execution of an ample residue diagnosis, with the objective of also mobilizing and publicizing the directives of the PGRUSP. The training and residue management plan construction presupposes learning about the practical issues of residue management. Data production and indicator construction will be the basis for the continuous and efficient implementation of this policy. For the ordering of the data a virtual platform is being developed. With such a platform, USP pretends to control generation, stocking, treatment and destination of Solid Residues produced in its academic units. It pretends with this database, to generate information that will permit the SGA to make decisions that will improve residue management in USP’s campi and, consequently, minimize environmental impacts caused in all levels of its activities. O cenário atual da Universidade de São Paulo (USP) tem, isoladamente, diversas ações ambientais em diferentes frentes, de acordo com a realidade de seus campi. Em 2010, a USP designou um coordenador de Gestão Ambiental junto à Reitoria. No ano seguinte, regulamentou a Política Ambiental da USP, que visa promover a sustentabilidade ambiental nos campi. Em 2012, foi criado um órgão institucional responsável pela gestão ambiental, a Superintendência de Gestão Ambiental (SGA), que tem como premissa ditar normas para questões ambientais em consonância com a política ambiental proposta. Esta superintendência formou, em 2012, um Grupo de Trabalho para cuidar das questões relativas aos resíduos gerados na USP. Tal grupo, composto por especialistas na área, sob a coordenação de um assessor de gabinete da própria SGA, priorizou desenvolver, através de processos participativos, estratégias e procedimentos para elaboração e implantação de uma Política de Gestão de Resíduos (PGRUSP), com base na Política Nacional de Resíduos Sólidos. A PGRUSP prevê a elaboração dos planos de gerenciamento de resíduos em todas as unidades pertencentes à USP e prevê também a capacitação da comunidade acadêmica para a realização de um diagnóstico de resíduos e sistematização dos indicadores numa plataforma virtual unificada de resíduos. Assim, pretende-se controlar tanto os insumos utilizados como a geração, o armazenamento, os tratamentos e os descartes relacionados aos resíduos gerados em nossas Unidades e, consequentemente, minimizar impactos ambientais causados em todos os níveis e atividades

Construction of a Residue Management Policy in the University of São Paulo: A model for the implementation of the NSRP in HEI

O cenário atual da Universidade de São Paulo (USP) tem, isoladamente, diversas ações ambientais em diferentes frentes, de acordo com a realidade de seus campi. \ud Em 2010, a USP designou um coordenador de Gestão Ambiental junto à Reitoria. No ano seguinte, regulamentou a Política Ambiental da USP, que visa promover a \ud sustentabilidade ambiental nos campi. Em 2012, foi criado um órgão institucional responsável pela gestão ambiental, a Superintendência de Gestão Ambiental (SGA), \ud que tem como premissa ditar normas para questões ambientais em consonância com a política ambiental proposta. Esta superintendência formou, em 2012, um \ud Grupo de Trabalho para cuidar das questões relativas aos resíduos gerados na USP. Tal grupo, composto por especialistas na área, sob a coordenação de um assessor \ud de gabinete da própria SGA, priorizou desenvolver, através de processos participativos, estratégias e procedimentos para elaboração e implantação de uma Política de \ud Gestão de Resíduos (PGRUSP). Esta Política, aos moldes de um trabalho anterior (PUSP-C, 2010), tem como proposta adequar as especificidades contidas na Política \ud Nacional de Resíduos Sólidos, para o contexto universitário.Uma versão inicial da PGRUSP foi apresentadapara a comunidade acadêmica em um Fórum promovido \ud pela SGA. Nesta ocasião, representantes de todas as categorias advindos dos diversos campi da USP, além de outros da comunidade externa, fizeram considerações \ud sobre o conteúdo desta versão, que foi, então, reformulada. A PGRUSP prevê a elaboração dos planos de gerenciamento de resíduos em todas as unidades pertencentes \ud à USP. Neste momento, o Grupo de Trabalho está elaborando diretrizes para a capacitação da comunidade acadêmica para a realização de um diagnóstico de resíduos, \ud com intuito também de mobilizar e conscientizar sobre os ditames da PGRUSP. A partir da capacitação e da elaboração dos planos de gerenciamento de resíduos, \ud pressupõe-se um aprendizado sobre questões práticas da gestão de resíduos. A geração de dados e de indicadores fornecerá embasamento para uma implementação \ud contínua e eficaz da política. Para sistematização destes dados, está sendo desenvolvida uma plataforma virtual unificada. Assim, pretende-se controlar tanto os \ud insumos utilizados como a geração, o armazenamento, os tratamentos e os descartes relacionados aos resíduos gerados em nossas Unidades. Pretende-se, ainda, com \ud esta sistematização, fornecer informações que permitam à SGA atomar medidas norteadoras para melhora na gestão dos resíduos nos campi, e,consequentemente, \ud minimizar impactos ambientais causados em todos os níveis e atividades

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Plasma citrulline after small bowel transplantation: effect of time from transplantation, acute cellular rejection, and renal failure

Background: Plasma citrulline concentration (CIT) depends on its synthesis by enterocytes and its catabolism by renal tubules. To evaluate CIT applicability as a marker of acute cellular rejection (ACR) after intestinal transplantation (ITx), CIT was investigated according to time from ITx, episodes of ACR, and creatinine clearance (CrCl). Methods: Twenty-four adult ITx recipients were prospectively studied. The results were compared with those of 19 healthy controls (HCs) and of 29 patients with chronic renal failure (CRF). Results: In ITx recipients, CIT was lower than in HCs during the first two postoperative weeks; it then progressively increased and reached the range observed in HCs, approximately between the 31st and the 45th postoperative day. A positive association with postoperative days (R = 0.63; p < 0.0001) and a negative association with CrCl (R = -0.57; p < 0.0001) were observed. CIT was higher in patients with CRF than in HCs (p < 0.0001). CIT sensitivity and specificity in detecting ACR after the 45th postoperative day were 38% and 83%, using CIT threshold observed in HCs, and 69% and 77%, respectively, using CIT threshold adjusted for CRF degree. Conclusions: Adjusting CIT threshold for CRF degree almost doubled the sensitivity of CIT as a non-invasive marker of ACR in ITx recipients. © 2015 John Wile