A critical analysis of South African peacemaking in the conflicts in the Great Lakes region

Includes bibliographical references (leaves 133-150).The Great Lakes region, where conflict resolution and peace operations have been a challenge for 40 years, has been the site of continuous conflicts in the 1960s and 1990s. Despite South Africa's enormous contribution as a peacemaker in the region since 1996, the situation in eastern Democratic Republic of Congo (DRC) remains fragile. How can another potentially deadly conflict in the Great Lakes region be prevented in the future? And how can South Africa improve its performance as a peacemaker? This dissertation analyses South Africa's peace-making efforts in the context of three events in the Great Lakes region: the 1994 Rwandan genocide, the First Congo War in 1996, and the Second Congo War in 1998. The dissertation takes an empirical approach and focuses on eastern DRC, which has the highest concentration of causalities and is crucial to the wars of the DRC. In addition to literature and documents, I have also incorporated key informant interviews and my own personal observations during my assignment as a humanitarian worker from March 2007 to July 2008. These interviews and observations may shed light on the conflict from the perspective of Congolese people. I argue that South Africa has failed as a peacemaker due to four main factors: South Africa's inadequate knowledge of mediation skills; its ambivalent and contradictory foreign policy that stressed the country's interests; its insufficient understanding of major causes, aggravating factors and the nature of this regionalised conflict; and the Southern African Development Community (SADC)'s paradoxical politics. The aim of this dissertation is to explore possible solutions to conflict by strengthening South Africa's peace-making opportunities, which IS the key to implementing successful conflict prevention

Spontaneous otogenic intracerebral pneumocephalus: case report and review of the literature

Pneumocephalus is commonly associated with head and facial trauma, ear infection or surgical interventions. We describe the rare case of a spontaneous pneumocephalus arising from lateral mastoid air cells. A 48-year-old man presented with a 10-day history of sudden, repetitive, ‘hammering-like' acoustic sensations in his left ear that were followed by word-finding difficulties and loss of vision in the right visual field. Imaging revealed a large, left temporal pneumatocele associated with a small acute intracerebral hemorrhage. Left temporal and subtemporal craniotomy and decompression were performed. Further exploration confirmed a dural and osseous defect in the anterolateral surface of the mastoid that was consecutively closed watertight. Although extremely rare, a spontaneous pneumocephalus with mastoidal origin should be considered as a possible diagnosis in patients with suggestive acoustic phenomena and other non-specific neurological symptom

Quebra do paradigma de conformidade contábil fiscal : enfoque histórico

Trabalho de conclusão de curso (graduação)—Universidade de Brasília, Faculdade de Economia, Administração e Contabilidade, Departamento de Ciências Contábeis e Atuariais, 2014.O objetivo deste estudo é a contextualização histórica da Lei nº. 12.973/14, que extingue um período de transição, visando a analisar o impacto desta lei sobre o paradigma da conformidade contábil-fiscal. No passado, buscou-se a quebra desse paradigma por meios meramente formais, ao passo que a literatura aponta para a necessidade de alterações no contexto socioeconômico e cultural do país, possibilitando a introdução da perspectiva Commom law. Nesse sentido, o método utilizado foi a pesquisa bibliográfica sobre os aspectos históricos que construíram o paradigma em tela, bem como a pesquisa documental da legislação para possibilitar a análise do contexto em que a Lei nº. 12.973/14 foi publicada. Chegou-se à conclusão que a escrituração contábil não terá relação de dependência com os critérios tributários estabelecidos pela referida lei, vez que o cenário atual impôs a quebra do paradigma de conformidade contábil-fiscal

Extracranial-intracranial bypass in atherosclerotic cerebrovascular disease: Report of a single centre experience

Despite the failure of the international extracranial-intracranial (EC-IC) bypass study in showing the benefit of bypass procedure for prevention of stroke recurrence, it has been regarded to be beneficial in a subgroup of well-selected patients with haemodynamic impairment. This report includes the EC-IC bypass experience of a single centre over a period of 14 years. All consecutive 72 patients with atherosclerotic occlusive cerebrovascular lesions associated with haemodynamic compromise treated by EC-IC bypass surgery were retrospectively reviewed. Pre-operatively, 61% of patients presented with minor stroke and the remaining 39% with recurrent transient ischemic attacks (TIAs) despite maximal medical therapy. Angiography revealed a unilateral internal carotid artery (ICA) stenosis/occlusion in 79%, bilateral ICA stenosis/occlusion in 15%, MCA stenosis/occlusion in 3% and other multiple vessel stenosis/occlusion in 3% of the cases. H(2)(15)O positron emission tomography (PET) or 99mTc-HMPAO SPECT with acetazolamide challenge was performed for haemodynamic evaluation of the cerebral blood flow (CBF). All the patients had impaired haemodynamics pre-operatively in terms of reduced regional cerebrovascular reserve capacity and rCBF. Standard STA-MCA bypass procedure was performed in all patients. A total of 68 patients with 82 bypasses were reviewed with a mean follow-up period of 34 months. Stroke recurrence took place in 10 patients (15%) resulting in an annual stroke risk of 5%. Improved cerebral haemodynamics was documented in 81% of revascularised hemispheres. Patients with unchanged or worse haemodynamic parameters had significantly more post-operative TIAs or strokes when compared to those with improved perfusion reserves (30% vs.5% of patients, p<0.05). In conclusion, EC-IC bypass procedure in selected patients with occlusive cerebrovascular lesions associated with haemodynamic impairment has revealed to be effective for prevention of further cerebral ischemia, when compared with a stroke risk rate of 15% reported to date in patients only under antiplatelet agents or anticoagulant therapy

Specialized neurocritical care, severity grade, and outcome of patients with aneurysman subarachnoid hemorrhage

Introduction: To evaluate the impact of specialized neurocritical care on the population admitted to a neurovascular center and on the outcome of patients with severe aneurysmal subarachnoid hemorrhage (aSAH). Methods: After exclusion of patients treated with endovascular techniques, between 1999 and 2003, 198 patients with aSAH treated with early aneurysm clipping were analysed. In 1999, a new standardized protocol for intensive care treatment was established in the Department of Neurosurgery, University Hospital Zurich. The results were compared to the earlier time period (1993-1994) immediately after introduction of early aneurysm clipping. Results: Out of 198 patients with aSAH, 90 patients (45.5%) suffered from mild aSAH World Federation of Neurosurgical Societies (WFNS) grade 1 and 2, 41 (27.3%) from aSAH WFNS grade 3, 36 (18.2%) from grade 4, and 57 (28.8%) from grade 5. From 1999 to 2003, significantly more patients with severe aSAH WFNS grade 4 and 5 underwent (further) treatment (93 out of 198 patients; 47.0%) compared to the former time-period after introduction of early surgery (23 out of 150 patients; 15.3%) (p<0.0001). In the early series, 10 out of 23 patients (43.5%) with WFNS 4 recovered with good outcome Glasgow Outcome Score 4 and 5, whereas in the later series 23 out of 36 (63.9%) with WFNS grade 4 survived in a good functional state. Before 1999, all patients with WFNS grade 5 died or survived in a vegetative state. From 1999 to 2003, 20 out of 57 patients (35.1%) with aSAH WFNS grade 5 survived with good outcome. Conclusions: The availability of extended specialized neurocritical care seems to induce a change within the patient population towards a higher severity grade. Patients with high-grade aSAH might benefit most from highly specialized neurocritical care treatmen