Paradise lost?: Understanding social embeddedness through crisis and violence in the Neapolitan “Land of Fires”

This is the author accepted manuscript. The final version is available from IGI Global via the DOI in this recordSince the mid-90s three million people living in the metropolitan area of Naples (Italy) have been facing one of the most dramatic socio-ecological crisis witnessed in Western Europe. This is a crisis orchestrated by Mafia-like organizations (e.g. the Neapolitan Mafia also known as Camorra) and their interest in the illegal management of waste disposal and incineration in the shadow of a weak state, a phenomenon often referred to as the ‘Land of Fires’. Using evidence from this prolonged socio-ecological crisis, in this chapter, we attempt to inductively mobilise the Polanyian notion of embeddedness, to understand the establishment and expansion of a waste economy in diffused violent social and economic relations. We particularly attempt to extend the notion of ‘embedded economy’, building on the work of Karl Polanyi (1944). We argue that the process of social embeddedness through illegal and violent practices are particularly intense in contexts of socio-ecological crises, where the expropriation of land and destruction of nature is coupled with the disarticulation of the role of the state by criminal organizations.ECOREME

Disease recurrence in paediatric renal transplantation

Renal transplantation (Tx) is the treatment of choice for end-stage renal disease. The incidence of acute rejection after renal Tx has decreased because of improving early immunosuppression, but the risk of disease recurrence (DR) is becoming relatively high, with a greater prevalence in children than in adults, thereby increasing patient morbidity, graft loss (GL) and, sometimes, mortality rate. The current overall graft loss to DR is 7–8%, mainly due to primary glomerulonephritis (70–80%) and inherited metabolic diseases. The more typical presentation is a recurrence of the full disease, either with a high risk of GL (focal and segmental glomerulosclerosis 14–50% DR, 40–60% GL; atypical haemolytic uraemic syndrome 20–80% DR, 10–83% GL; membranoproliferative glomerulonephritis 30–100% DR, 17–61% GL; membranous nephropathy ∼30% DR, ∼50% GL; lipoprotein glomerulopathy ∼100% DR and GL; primary hyperoxaluria type 1 80–100% DR and GL) or with a low risk of GL [immunoglobulin (Ig)A nephropathy 36–60% DR, 7–10% GL; systemic lupus erythematosus 0–30% DR, 0–5% GL; anti-neutrophilic cytoplasmic antibody (ANCA)-associated glomerulonephritis]. Recurrence may also occur with a delayed risk of GL, such as insulin-dependent diabetes mellitus, sickle cell disease, endemic nephropathy, and sarcoidosis. In other primary diseases, the post-Tx course may be complicated by specific events that are different from overt recurrence: proteinuria or cancer in some genetic forms of nephrotic syndrome, anti-glomerular basement membrane antibodies-associated glomerulonephritis (Alport syndrome, Goodpasture syndrome), and graft involvement as a consequence of lower urinary tract abnormality or human immunodeficiency virus (HIV) nephropathy. Some other post-Tx conditions may mimic recurrence, such as de novo membranous glomerulonephritis, IgA nephropathy, microangiopathy, or isolated specific deposits (cystinosis, Fabry disease). Adequate strategies should therefore be added to kidney Tx, such as donor selection, associated liver Tx, plasmatherapy, specific immunosuppression protocols. In such conditions, very few patients may be excluded from kidney Tx only because of a major risk of DR and repeated GL. In the near future the issue of DR after kidney Tx may benefit from alternatives to organ Tx, such as recombinant proteins, specific monoclonal antibodies, cell/gene therapy, and chaperone molecules