Indigenous Peoples, Exclusion and Precarious Work: Design of Strategies to Address Poverty in Indigenous and Peasant Populations in Ecuador through the SWOT-AHP Methodology.

This research analysed the options that, following decent employment and the social economy, can allow the human development of poor, excluded and vulnerable indigenous populations in Ecuador. A set of strategies were developed which can be implemented by public authorities and by community organisations. They were designed from two types of expert consultations: the Delphi method and the analysis of Strengths, Weaknesses, Opportunities and Threats (SWOT) combined with Analytic Hierarchy Process method (AHP) for hierarchizing the criteria collected and obtaining strategies. The proposed strategies are as follows: adopting appropriate legal frameworks, respecting peoples' rights, better distribution of public resources, implementing monitoring systems, developing solidarity markets and recognizing the participation of the poor as a subject of rights. This investigation revealed differences between the state, which identifies the poor with monetary indicators, and the indigenous peoples, who see it as the lack of community links, by conceiving the poor as a beneficiary of official assistance, despite the fact that a strong community and peasant organisation could be used. The value of an economy based on reciprocity and confidence was also recognized, identifying niches of production and consumption to create partnerships and ensure the participation of indigenous peoples in decision-making areas.

The clinical significance of incidental computer tomography finding of gastrointestinal luminal wall thickening as evaluated by endoscopy.

The widespread use of computerized tomography in evaluating patients with various abdominal complaints gave rise to reports of incidental gastrointestinal luminal wall thickening (GILWT), the clinical significance of which remains uncertain. In order to determine the endoscopic significance of GILWT we reviewed 1609 abdominal and/or pelvic CT scans. Ninety-two patients with GILWT were identified. Patients with obvious clinical cause of this abnormality were excluded from the study. The median age of the patients was 58 years, with no significant difference in gender distribution. The GILWTs were distributed along the GI tract as follows: 24 upper (esophageal, gastric, and duodenum), 13 small intestine (jejunum and ileum), 3 combined small and large intestine, and 52 colon. Fifty of these patients underwent endoscopic evaluation. Six patients (12%) had cancer, all of which involved the colon. The endoscopy was unremarkable in 19 (38%) and revealed a nonmalignant finding in the remaining 25 patients (50%). None of the upper GI or small bowel GILWTs were malignant, while 6 of the 34 colonic GILWTs (18%) were malignant. The mean age of the colonic GILWT group was 59. None of the patients younger than 50 had cancer, while 6 of the 24 older patients (25%) had colon cancer. We conclude that as GILWT is not a common finding and could be the initial presentation of malignancy, particularly when involving the colon in patients older than 50, endoscopic evaluation should be strongly recommended in patients who do not have an alternative diagnosis that can satisfactorily explain GILWT.