Engaging stakeholders across a socio-environmentally diverse network of water research sites in North and South America

Maintaining and restoring freshwater ecosystem services in the face of local and global change requires adaptive research that effectively engages stakeholders. However, there is a lack of understanding and consensus in the research community regarding where, when, and which stakeholders should be engaged and what kind of researcher should do the engaging (e.g., physical, ecological, or social scientists). This paper explores stakeholder engagement across a developing network of aquatic research sites in North and South America with wide ranging cultural norms, social values, resource management paradigms, and eco-physical conditions. With seven sites in six countries, we found different degrees of engagement were explained by differences in the interests of the stakeholders given the history and perceived urgency of water resource problems as well as differences in the capacities of the site teams to effectively engage given their expertise and resources. We categorized engagement activities and applied Hurlbert and Gupta's split ladder of participation to better understand site differences and distill lessons learned for planning comparative socio-hydrological research and systematic evaluations of the effectiveness of stakeholder engagement approaches. We recommend research networks practice deliberate engagement of stakeholders that adaptively accounts for variations and changes in local socio-hydrologic conditions. This, in turn, requires further efforts to foster the development of well-integrated research teams that attract and retain researchers from multiple social science disciplines and enable training on effective engagement strategies for diverse conditions

Engaging stakeholders across a socio-environmentally diverse network of water research sites in North and South America

Maintaining and restoring freshwater ecosystem services in the face of local and global change requires adaptive research that effectively engages stakeholders. However, there is a lack of understanding and consensus in the research community regarding where, when, and which stakeholders should be engaged and what kind of researcher should do the engaging (e.g., physical, ecological, or social scientists). This paper explores stakeholder engagement across a developing network of aquatic research sites in North and South America with wide ranging cultural norms, social values, resource management paradigms, and eco-physical conditions. With seven sites in six countries, we found different degrees of engagement were explained by differences in the interests of the stakeholders given the history and perceived urgency of water resource problems as well as differences in the capacities of the site teams to effectively engage given their expertise and resources. We categorized engagement activities and applied Hurlbert and Gupta's split ladder of participation to better understand site differences and distill lessons learned for planning comparative socio-hydrological research and systematic evaluations of the effectiveness of stakeholder engagement approaches. We recommend research networks practice deliberate engagement of stakeholders that adaptively accounts for variations and changes in local socio-hydrologic conditions. This, in turn, requires further efforts to foster the development of well-integrated research teams that attract and retain researchers from multiple social science disciplines and enable training on effective engagement strategies for diverse conditions.Fil: Smyth, Robyn L.. Bard College; Estados UnidosFil: Fatima, Uroosa. Bard College; Estados UnidosFil: Segarra, Monique. Bard College; Estados UnidosFil: Borre, Lisa. Cary Institute of Ecosystem Studies; Estados UnidosFil: Zilio, Mariana Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Económicas y Sociales del Sur. Universidad Nacional del Sur. Departamento de Economía. Instituto de Investigaciones Económicas y Sociales del Sur; ArgentinaFil: Reid, Brian. Universidad Austral de Chile; ChileFil: Pincetl, Stephanie. Institute of the Environment and Sustainability; Estados UnidosFil: Astorga, Anna. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Económicas y Sociales del Sur. Universidad Nacional del Sur. Departamento de Economía. Instituto de Investigaciones Económicas y Sociales del Sur; ArgentinaFil: Huamantinco Cisneros, María Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Geografía y Turismo; ArgentinaFil: Conde, Sergio Daniel. Universidad de la República; UruguayFil: Harmon, Thomas Christopher. University of California Merced; Estados UnidosFil: Hoyos, Natalia. Universidad del Norte; ColombiaFil: Escobar, Jaime. Universidad del Norte; Colombia. Smithsonian Tropical Research Institute; PanamáFil: Lozoya, Juan Pablo. Universidad de la República; UruguayFil: Perillo, Gerardo Miguel E.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto Argentino de Oceanografía. Universidad Nacional del Sur. Instituto Argentino de Oceanografía; Argentina. Universidad Nacional del Sur. Departamento de Geología; ArgentinaFil: Piccolo, Maria Cintia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto Argentino de Oceanografía. Universidad Nacional del Sur. Instituto Argentino de Oceanografía; Argentina. Universidad Nacional del Sur. Departamento de Geografía y Turismo; ArgentinaFil: Rusak, James A.. Dorset Environmental Science Centre; Canadá. Queens University; CanadáFil: Velez, Maria I.. University of Regina; Canad

Malignant melanoma arising from a perianal fistula and harbouring a BRAF gene mutation: a case report

<p>Abstract</p> <p>Background</p> <p>Melanoma of the anal region is a very uncommon disease, accounting for only 0.2-0.3% of all melanoma cases. Mutations of the <it>BRAF </it>gene are usually absent in melanomas occurring in this region as well as in other sun-protected regions. The development of a tumour in a longstanding perianal fistula is also extremely rare. More frequent is the case of a tumour presenting as a fistula, that is, the fistula being a consequence of the cancerous process, although we have found only two cases of fistula-generating melanomas reported in the literature.</p> <p>Case Presentation</p> <p>Here we report the case of a 38-year-old male who presented with a perianal fistula of four years of evolution. Histopathological examination of the fistulous tract confirmed the presence of malignant melanoma. Due to the small size and the central location of the melanoma inside the fistulous tract, we believe the melanoma reported here developed in the epithelium of the fistula once the latter was already formed. Resected sentinel lymph nodes were negative and the patient, after going through a wide local excision, remains disease-free nine years after diagnosis. DNA obtained from melanoma tissue was analysed by automated direct sequencing and the <it>V600E </it>(<it>T1799A</it>) mutation was detected in exon 15 of the <it>BRAF </it>gene.</p> <p>Conclusion</p> <p>Since fistulae experience persistent inflammation, the fact that this melanoma harbours a <it>BRAF </it>mutation strengthens the view that oxidative stress caused by inflammatory processes plays an important role in the genesis of <it>BRAF </it>gene mutations.</p

Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App: Analysis of Real-World, Medium-Term Feasibility Studies

Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support. Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use. Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app ≥30 days was used as the cut-off for higher app use. Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25-P75) 16-36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3-45] days, translated on a median use rate of 15 [3-38]%. Median inhaler adherence assessed through the app was 34 [4-73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6-83]% and 43 [3-73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen. Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.info:eu-repo/semantics/publishedVersio

Theotonio dos Santos (1936-2018), the revolutionary intellectual who pioneered dependency theory

This article analyzes the origins and development of the dependency theory through the life and work of Theotonio Dos Santos. His formative years at the academy and his early political activism in Brazil are examined, particularly, his time at the University of Brasilia with Vania Bambirra, Ruy Mauro Marini and André Gunder Frank ("the quartet"). This is followed by a discussion about their years of exile in Chile where the quartet regrouped at the Center for Socio-Economic Studies (ceso) of the University of Chile, and where they wrote their founding texts on dependency theory. Chile provided fertile ground for the development of this theory due to its intellectual climate, institutionality, and the country's political transformations in the late 1960s and early 1970s. The military overthrow of the Allende government on that fateful September 11th, 1973 forced the quartet once again into exile. The article continues with an analysis of Dos Santos' writings during his exile in Mexico and then back in Brazil. During this period he became involved with world system theory which culminated in the publication of his extensive trilogy on the contemporary crisis of capitalism and social theory