Transnational corporations, violence and suffering: the environmental, public health and social impacts from comparative case studies in Zimbabwe and Uganda

The present effects of transnational corporations (TNCs) on social, health, and environmental aspects of local societies have a long history. The preconditions for the insertion of the types of economic initiatives now seen in the Global South, and driven by TNCs, were set through histories of colonialism and development schemes. These initiatives disrupted local economies and modified environments, delivering profound effects on livelihoods. These effects were experienced as structural violence, and have produced social suffering through the decades.In this paper, we compare two African cases across time; the conjunction of development initiatives and structural adjustment in the Zambezi Valley, Zimbabwe in the early 1990s and industrial plantation forestry in present-day Uganda. Each case presents a specific constellation of political and economic forces that has produced prejudicial effects on local populations in their time period of application and are, essentially, different versions of structural violence that produce social suffering. While each case depicts a specific type of violent encounter manifest at a particular historical moment, these are comparable in the domains of environmental impacts, disruptions to societies, co-opting of local economies, disordering of systems of meaning and social reproduction, and nefarious effects on well-being. We analyze the conjunction of these effects through a theoretical lens of structural violence and social suffering. Our analysis draws particular attention to the role of TNCs in driving this structural violence and its effects

Adherence with ethinylestradiol 20 µg/drospirenone 3 mg in a flexible extended regimen supported by the use of a digital tablet dispenser with or without acoustic alarm: an open-label, randomized, multicenter study

Inka Wiegratz,1,2 Jörg Elliesen,3 Anna Maria Paoletti,4 Anja Walzer,3 Bodo Kirsch3 1Kinderwunschpraxis am Goetheplatz, Frankfurt, Germany; 2MVZ Kinderwunschzentrum Wiesbaden GmbH, Wiesbaden, Germany; 3Bayer HealthCare Pharmaceuticals, Berlin, Germany; 4Clinica Ostetrica e Ginecologica, University of Cagliari, Cagliari, ItalyObjective: To evaluate the effect of a digital dispenser's acoustic alarm function on adherence to ethinylestradiol (EE) 20 µg/drospirenone 3 mg in a flexible extended regimen (EE/drospirenoneFlex) among women in five European countries (France, Germany, Italy, Spain, UK) seeking oral contraception.Study design: Randomized, parallel-group open-label study.Methods: Women aged 18–35 years received EE/drospirenoneFlex administered in a regimen with cycle lengths of their choice with the aid of a digital pill dispenser over 1 year. In group A (N=250), the dispenser's acoustic alarm was activated (ie, acoustic alarm + visual reminder). In group B (N=249), the acoustic alarm was deactivated (ie, visual reminder only). In addition, the women recorded pill intake daily in diary cards. The primary efficacy variable was the mean delay of daily pill release after the dispenser reminded the woman to take a pill (reference time). Secondary efficacy variables included number of missed pills, contraceptive efficacy, bleeding pattern, tolerability, and user satisfaction.Results: Dispenser data showed a mean (standard deviation [SD]) daily delay in pill release of 88 (126) minutes in group A vs 178 (140) minutes in group B (P<0.0001). Median (lower quartile, Q1; upper quartile, Q3) number of missed pills was 0 (0; 1) in group A vs 4 (1; 9) in group B (P<0.0001). Diary card results revealed similar trends; however, underreporting of missed pills was evident in both groups. No pregnancies were reported during 424 women-years of exposure. Across the two groups, the mean (SD) EE/drospirenoneFlex cycle length was 51.0 (31.8) days with strong regional differences, and the mean (SD) number of bleeding/spotting days was 50.4 (33.0) days. EE/drospirenoneFlex was well tolerated, and 80% of women were satisfied with treatment.Conclusion: The dispenser's activated acoustic alarm improved adherence with daily tablet intake of EE/drospirenoneFlex, reducing missed pills. EE/drospirenoneFlex provided effective contraception and a good tolerability profile. Keywords: contraception, efficacy, pill dispenser, tolerability, drospirenone, complianc

Genexpression und Morphologie der Follikel nach konventionellem Einfrieren und Vitrifikation von humanem Ovarialgewebe [Gene-expression and morphology of follicles after conventional freezing and vitrification of human ovarian tissue]

Purpose: Cryopreservation, the most important stage of the cryobanking of ovarian tissue, can be carried out using one of two methods: conventional ("slow") freezing, and vitrification (direct and immediate immersion into liquid nitrogen). For human oocytes and embryos vitrification is more effective compared to conventional freezing. However, these comparative data are limited for human ovarian tissue. The aim of this study was to compare conventional freezing of ovarian tissue with vitrification. Material and Methods: Ovarian tissue from 5 patients was transported to the laboratory within 20 min at 32 to 34 °C, divided into smaller pieces (1 × 1 to 1,5 × 0,7 to 1 mm) and randomly distributed into three groups: Group 1: control (fresh tissue), group 2: pieces after vitrification/warming, Group 3: pieces after conventional freezing/thawing. All pieces were cultured in vitro for 12 days. The viability of the tissue was evaluated by the development of the follicles and GAPDH gene expression after in vitro culture. Results: 93, 74 and 78 % of the follicles of groups 1, 2 or 3 were morphologically normal. Molecular analysis showed that the intensity of GAPDH gene expression in the tissue after conventional freezing was greatly increased compared to after vitrification. Conclusion: It was concluded that for the cryopreservation of human ovarian tissue conventional freezing is more suitable than vitrification