Environmental aspects of internal migration in Tanzania

In recent years, the issue of the nexus of climate change and human migration has attracted a growing amount of interest among scholars and policy makers. Using individual-level data from the Tanzania National Panel Survey conducted in 2008\u20132009, we examine the roles played by droughts or floods, crop diseases, and severe water shortages in inter-district migration in Tanzania. Findings reveal that droughts or floods and crop diseases are associated with an overall decrease in the likelihood of inter-district mobility, providing support for the \u201cenvironmental scarcity\u201d hypothesis. Yet migration becomes a likely response to droughts and floods among individuals with no education suggesting mobility is a key livelihood strategy among those most disadvantaged. Future examination of domestic migration-environment processes at the individual-level is critical for informed policy and programs

Análise do desempenho de crianças em risco ambiental na WPPSI-R

[Resumo] Regista-se, actualmente, um interesse crescente em relação ao risco ambiental, isto é, em relacção crianças em cuja história pessoal e familiar se encontram ambientes familiares alterados ou problemas sociais graves. Neste ambito, no presente trabalho procede-se él caracterização do desempenho na WPPSI-R de um grupo de crianças de idade pré-escolar em risco ambiental tomando como comparação um grupo de crianças provenientes de famílias com estatuto socio-económico identico. Analisam-se, ainda, as implicaçoes decorrentes dos resultados obtidos ao nível dos processos de despistagem ou identificação precoce.[Abstract] There is, nowadays, an increasing interest on environmental risk, that is, in children who have experienced disrupted familial environments or serious social problems. This paper compares WPPSI-R results of two matched groups: a) a group of preschool children at environmental risk; b) a low-risk group, similar in age, gender and socioeconomic status. .Implications of the findings for screening and early identification of children at risk are discussed

The Compound Muscle Action Potential as Neurophysiological Marker for Amyotrophic Lateral Sclerosis.

Objectives: To definite the peripheral nervous involvement in ALS through the repeated use of the compound motor action potential (CMAP) to test the progression of disease, to determine different change of phrenic CMAP and forced vital capacity (FVC) in spinal and bulbar onset, and to establish clinical and neurophysiological features of patients with poor prognosis. Material & Methods: CMAP from phrenic, ulnar, and medial plantar nerves, Medical Research Council (MRC) score, revised ALS functional rating scale (ALSFRS-R) and FVC were evaluated in 117 ALS patients every three months in one year-period. Results: Bulbar onset patients had lower FVC but similar amplitude of phrenic CMAP at baseline compared to spinal onset patients. The patients with poor prognosis had lower phrenic CMAP and FVC at baseline. CMAP values, when compared to the rate found in the previous visit, reduced significantly in both poor and good prognosis groups during the entire follow-up period, while the FVC reduced significantly only in the first three months. Conclusions: CMAP is a reproducible sensitive marker for motor neurons loss and collateral reinnervation in ALS also in a short period of time. The changes in CMAP, MRC, FVC and ALSFRS-R score resulted correlated, but CMAP is the only parameter with the advantage to demonstrate objectively the progression of disease in both patients with poor and good prognosis for the entire period of follow-up. It should be used as clinical outcome of ALS in clinical trials, taking advantage of its objectivity and selectivity for peripheral nervous system study

Role of ozone therapy in the treatment of osteonecrosis of the jaws in multiple myeloma patients.

Current treatments for bisphosphonate-associated osteonecrosis of the jaw (ONJ) in multiple myeloma patients have limited efficacy. The biological effects of ozone indicate it may be therapeutic for ONJ. We, here, report the efficacy of a 15-day course of antibiotics, surgery and ozone therapy in 12 MM patients with ONJ

A criança com deficiência mental ligeira

A presente dissertação visa contribuir para o conhecimento das crianças portuguesas identificadas como deficientes mentais ligeiras. Na primeira parte, procurou-se recensear, ponderar e analisar criticamente o que demais relevante se conhece sobre o tópico em estudo, quer este dissesse respeito à caracterização, epidemiologia e etiologia da deficiência mental ligeira (capítulo 1), à interligação da deficiência mental ligeira com os problemas de comportamento (capítulo 2), ou aos determinantes das perceções e reações parentais face a uma criança com deficiência mental ligeira (capítulo 3). Por seu turno, na segunda parte, apresentam-se dois estudos de campo distintos, mas complementares, estando o primeiro direcionado para a avaliação e comparação dos comportamentos das crianças com e sem deficiência mental ligeira nos contextos familiar e escolar (capítulo 4) e o segundo para a análise da importância do carácter adequado ou inadequado desses mesmos comportamentos nos subsistemas diádicos (capítulo 5). Na terceira e última parte, enunciam-se algumas conclusões gerais, estabelecidas a partir do confronto dos resultados obtidos com os derivados de outros estudos. É também neste âmbito, que se salientam contributos de índole reabilitativa, e se sugerem caminhos a percorrer num futuro próximo.info:eu-repo/semantics/publishedVersio

MICA-129 dimorphism and soluble MICA are associated with the progression of multiple myeloma

Natural killer (NK) cells are immune innate effectors playing a pivotal role in the immunosurveillance of multiple myeloma (MM) since they are able to directly recognize and kill MM cells. In this regard, among activating receptors expressed by NK cells, NKG2D represents an important receptor for the recognition of MM cells, being its ligands expressed by tumor cells, and being able to trigger NK cell cytotoxicity. The MHC class I-related molecule A (MICA) is one of the NKG2D ligands; it is encoded by highly polymorphic genes and exists as membrane-bound and soluble isoforms. Soluble MICA (sMICA) is overexpressed in the serum of MM patients, and its levels correlate with tumor progression. Interestingly, a methionine (Met) to valine (Val) substitution at position 129 of the α2 heavy chain domain classifies the MICA alleles into strong (MICA-129Met) and weak (MICA-129Val) binders to NKG2D receptor. We addressed whether the genetic polymorphisms in the MICA-129 alleles could affect MICA release during MM progression. The frequencies of Val/Val, Val/Met, and Met/Met MICA-129 genotypes in a cohort of 137 MM patients were 36, 43, and 22%, respectively. Interestingly, patients characterized by a Val/Val genotype exhibited the highest levels of sMICA in the sera. In addition, analysis of the frequencies of MICA-129 genotypes among different MM disease states revealed that Val/Val patients had a significant higher frequency of relapse. Interestingly, NKG2D was downmodulated in NK cells derived from MICA-129Met/Met MM patients. Results obtained by structural modeling analysis suggested that the Met to Val dimorphism could affect the capacity of MICA to form an optimal template for NKG2D recognition. In conclusion, our findings indicate that the MICA-129Val/Val variant is associated with significantly higher levels of sMICA and the progression of MM, strongly suggesting that the usage of soluble MICA as prognostic marker has to be definitely combined with the patient MICA genotype

Hypofractionation and Concomitant Boost in Ductal Carcinoma In Situ (DCIS): Analysis of a Prospective Case Series with Long-Term Follow-Up

We previously reported on a cohort of breast cancer patients affected with ductal carcinoma in situ (DCIS) that were treated with breast conservative surgery and hypofractionated whole-breast radiotherapy with a concomitant boost to the lumpectomy cavity. We now report on the long-term results of the oncological and toxicity outcomes, at a median follow-up of 11.2 years. We also include an analysis of the predictive factors for local recurrence (LR). Eighty-two patients with long-term observation were considered for this report. All received hypofractionated post-operative radiotherapy with a concomitant boost (45 Gy/20 fractions to the whole breast and 50 Gy/20 fractions to the lumpectomy cavity). We report on LC rates at 5 and 10 years, overall survival (OS), and breast-cancer-specific survival (BCSS), employing the Kaplan-Meier method. Cox proportional regression analysis was used to determine the role of selected clinical parameters on the risk of local recurrence, by the univariate and multivariate models. After a median follow-up of 11.2 years (range 5-15 years), 9 pts (11%) developed LR. The LR rates at 5 years and 10 years were 2.4% and 8.2%, respectively. The 5- and 10-year overall survival rates were 98.8% and 91.6%, respectively. The 5- and 10-year breast-cancer-specific survival rates were 100.0% and 99.0%. Late skin and subcutaneous toxicities were generally mild, and cosmetic results were good-excellent for most patients. For the univariate regression analysis, ER positive status (HR; 95% CI, p = 0.021), PgR positive status (HR; 95% CI, p = 0.012), and the aggregate data of positive hormonal status (HR; 95% CI, p = 0.021) were inversely correlated to LR risk. Conversely, a high tumor grade (G3) was directly correlated with the risk of LR (HR; 95% CI, p = 0.048). For the multivariate regression analysis, a high tumor grade (G3) confirmed its negative impact on LR (HR 0.40; 95% CI 0.19-0.75, p = 0.047). Our long-term data demonstrate hypofractionated whole-breast radiotherapy with a concomitant boost to be feasable, effective, and tolerable. Our experience suggests positive hormonal status to be protective with respect to LR risk. A high tumor grade is a risk factor for LR