In situ study of soil processes in an oxisol-spodosol sequence of Amazonia (Brazil)

L'étude in situ de l'évolution d'échantillons de vermiculite et de résines à cations échangeables et kelates insérés dans le sol met en évidence les processsus pédogénétiques caractérisant une séquence de sols de la région de Manaus (Brésil

Patients’ perceived needs for medical services for non-specific low back pain: A systematic scoping review

Background: An improved understanding of patients’ perceived needs for medical services for low back pain (LBP) will enable healthcare providers to better align service provision with patient expectations, thus improving patient and health care system outcomes. Thus, we aimed to identify the existing literature regarding patients’ perceived needs for medical services for LBP. Methods: A systematic scoping review was performed of publications identified from MEDLINE, EMBASE, CINAHL and PsycINFO (1990–2016). Descriptive data regarding each study, its design and methodology were extracted and risk of bias assessed. Aggregates of patients’ perceived needs for medical services for LBP were categorised. Results: 50 studies (35 qualitative, 14 quantitative and 1 mixed-methods study) from 1829 were relevant. Four areas of perceived need emerged: (1) Patients with LBP sought healthcare from medical practitioners to obtain a diagnosis, receive management options, sickness certification and legitimation for their LBP. However, there was dissatisfaction with the cursory and superficial approach of care. (2) Patients had concerns about pharmacotherapy, with few studies reporting on patients’ preferences for medications. (3) Of the few studies which examined the patients’ perceived need of invasive therapies, these found that patients avoided injections and surgeries (4) Patients desired spinal imaging for diagnostic purposes and legitimation of symptoms. Conclusions: Across many different patient populations with data obtained from a variety of study designs, common themes emerged which highlighted areas of patient dissatisfaction with the medical management of LBP, in particular, the superficial approach to care perceived by patients and concerns regarding pharmacotherapy. Patients perceive unmet needs from medical services, including the need to obtain a diagnosis, the desire for pain control and the preference for spinal imaging. These issues need to be considered in developing approaches for the management of LBP in order to improve patient outcomes

Understanding the limits to ethnic change: lessons from Uganda's “lost counties”

The historically constructed nature of ethnicity has become a widely accepted paradigm in the social sciences. Scholars have especially have focused on the ways modern states have been able to create and change ethnic identities, with perhaps the strongest case studies coming from colonial Africa, where the gap between strong states and weak societies has been most apparent. I suggest, however, that in order to better understand how and when ethnic change occurs it is important to examine case studies where state-directed ethnic change has failed. To rectify this oversight I examine the case of the “lost counties” of Uganda, which were transferred from the Bunyoro kingdom to the Buganda kingdom at the onset of colonial rule. I show that British attempts to assimilate the Banyoro residents in two of the lost counties were an unmitigated failure, while attempts in the other five counties were successful. I claim that the reason for these differing outcomes lies in the status of the two lost counties as part of the historic Bunyoro homeland, whereas the other five counties were both geographically and symbolically peripheral to Bunyoro. The evidence here thus suggests that varying ethnic attachments to territory can lead to differing outcomes in situations of state-directed assimilation and ethnic change

Genetic Diversity of PCR-Positive, Culture-Negative and Culture-Positive Mycobacterium ulcerans Isolated from Buruli Ulcer Patients in Ghana.

Culture of Mycobacterium ulcerans from Buruli ulcer patients has very low sensitivity. Thus confirmation of M. ulcerans infection is primarily based on PCR directed against IS2404. In this study we compare the genotypes obtained by variable number of tandem repeat analysis of DNA from IS2404-PCR positive cultures with that obtained from IS2404 positive, culture-negative tissue. A significantly greater genetic heterogeneity was found among culture-negative samples compared with that found in cultured strains but a single genotype is over-represented in both sample sets. This study provides evidence that both the focal location of bacteria in a lesion as well as differences in the ability to culture a particular genotype may underlie the low sensitivity of culture. Though preliminary, data from this work also suggests that mycobacteria previously associated with fish disease (M. pseudoshottsii) may be pathogenic for humans