Unveiling Melanoma: A Deep Dive into Disparities at a Latin-American Cancer Institute.

INTRODUCTION: The worldwide incidence of melanoma has increased in the last 40 years. Our aim was to describe the clinic-pathological characteristics and outcomes of three cohorts of patients diagnosed with melanoma in a Latin-American cancer institute during the last 20 years. METHODS: We evaluated three retrospective patient cohorts diagnosed with melanoma at Instituto Nacional de Enfermedades Neoplasicas (INEN), a public hospital in Lima, Peru, for the years 2005-2006, 2010-2011, and 2017-2018. Survival rate differences were assessed using the Log-rank test. RESULTS: Overall, 584 patients were included (only trunk and extremities); 51% were male, the mean age was 61 (3-97) years, and 48% of patients resided in rural areas. The mean time to diagnosis was 22.6 months, and the mean Breslow thickness was 7.4 mm (T4). Lower extremity was the most common location (72%). A majority of the patients (55%) had metastases at the time of presentation, with 36% in stage III and 19% in stage IV. Cohorts were distributed as 2005-2006 (n = 171), 2010-2011 (n = 223), and 2017-2018 (n = 190). No immunotherapy was used. Cohort C exhibited the most significant increase in stage IV diagnoses (12.3%, 15.7%, 28.4%, respectively; p < 0.01). The median overall survival rates at the three-year follow-up demonstrated a decline over the years for stages II (97%, 98%, 57%, respectively; p < 0.05) and III (66%, 77%, 37%; p < 0.01). CONCLUSIONS: There has been a worsening in the incidence of late-stage metastatic melanoma in Peru throughout the years, coupled with a significant decline in overall survival rates. This is underscored by the fact that half of the population lives in regions devoid of oncological access.

Microbial communities present in Sargassum spp. leachates from the Mexican Caribbean which are involved in their degradation in the environment, a tool to tackle the problem.

The Sargassum phenomenon is currently affecting the Caribbean in several ways; one of them is the increase of greenhouse gases due to the decomposition process of this macroalgae; these processes also produce large amounts of pollutant leachates, in which several microbial communities are involved. To understand these processes, we conducted a 150-day study on the Sargassum spp environmental degradation under outdoor conditions, during which leachates were collected at 0, 30, 90, and 150 days. Subsequently, a metagenomic study of the microorganisms found in the leachates was carried out, in which changes in the microbial community were observed over time. The results showed that anaerobic bacterial genera such as Thermofilum and Methanopyrus were predominant at the beginning of this study (0 and 30 days), degrading sugars of sulfur polymers such as fucoidan, but throughout the experiment, the microbial communities were changed also, with the genera Fischerella and Dolichospermum being the most predominant at days 90 and 150, respectively. A principal component analysis (PCA) indicated, with 94% variance, that genera were positively correlated at 30 and 90 days, but not with initial populations, indicating changes in community structure due to sargassum degradation were present. Finally, at 150 days, the leachate volume decreased by almost 50% and there was a higher abundance of the genera Desulfobacter and Dolichospemum. This is the first work carried out to understand the degradation of Sargassum spp, which will serve, together with other works, to understand and provide a solution to this serious environmental problem in the Caribbean.

Maternal Risk Factors Associated With Neonatal Outcome in Primiparous, Machala, Ecuador.

Introduction The resulting neonatal, weight of the newborn (NB) is considered as a health indicator since the nutritional status of the neonate can have repercussions on the growth and development of the child until adulthood. Secondly, preterm delivery is associated with several maternal risk factors, such as the presence of anemia, adolescence, or advanced age. The aim of the study was to determine the maternal risk factors related to neonatal outcomes in primiparous. Methods A descriptive, observational, quantitative, longitudinal, and non-experimental study was conducted. Data were collected from women who gave birth from September 2021 to August 2022, in a Microsoft Excel database and the analysis was performed using SPSS software, version 26. Results The study population consisted of 224 pregnant women, aged 16 to 41 years, with a mean of 21 years (SD ± 4 years), the most predominant age range was under 20 years, with 53.33%, 81.7% were of middle socioeconomic status, 50.4% had basic education, 89.7% self-identified as mestizo race, 86.2% were of Ecuadorian nationality, and 96.0% resided in the urban area. A total of 97.8% were term NB, 69.9% were normal weight, and 96.4% had an Apgar score of 8 to 10 in the first minute after birth. Maternal factors related to Apgar 7 were adolescent and elderly women, with an odds ratio (OR) of 2.180; having maternal comorbidity OR: 2.0612; the factors related to preterm and post-term neonates were the degree of primary and basic education, OR: 2.0, without statistical significance (p>0.05). And in relation to low weight and high weight, we have an academic education OR: 3.0417, without statistical significance (p>0.05); and mothers with a history of previous abortions, OR: 8.6000, with high statistical significance (p<0.05). Conclusions Among the main maternal factors related to neonatal outcome in primiparous pregnant women were educational level, age, number of prenatal checkups, and history of previous abortions.

Cirugía en coxa vara por osteogénesis imperfecta. Reporte de dos casos / Coxa vara surgery for osteogenesis imperfecta. A report of two cases

Introducción. La coxa vara es una disminución del ángulo cervicodiafisiario (<110°) y se puede presentar hasta en el 10% de los pacientes con osteogénesis imperfecta (OI), siendo más frecuente en el tipo III. Sus manifestaciones clínicas son alteración en la marcha, acortamiento de la pierna, genu valgo y dolor.Presentación de los casos. Varones de 13 años y 8 años con OI tipo III, signo positivo de Trendelenburg, movilidad articular adecuada y antecedentes de fracturas recurrentes y cirugías previas por deformidades en los que se realizó cirugía para la corrección de coxa vara. Se realizó una evaluación radiográfica y una funcional (escala de Harris) a los 6 y 68 meses de la cirugía, respectivamente.En el caso 1 se logró una corrección de 46° en el ángulo cervicodiafisiario (ángulo inicial: 84°; ángulo final: 130°) y el puntaje en la escala de Harris fue de 70 puntos. En el caso 2, se logró una corrección de 50° (82° vs. 132°), con un puntaje en la escala de Harris de 68 puntos. Conclusiones. la técnica de corrección mediante osteotomía subtrocantérica y la utilización de clavo endomedular y agujas de Kirschner es una opción efectiva para el tratamiento de coxa vara en pacientes con osteogénesis imperfecta

Introduction. Coxa vara is a deformity characterized by a decrease in the neck-shaft angle (<110°) that can occur in up to 10% of patients with osteogenesis imperfecta (OI), being more frequent in type III OI. Its clinical manifestations are gait disturbance, leg shortening, genu valgum, and pain.Case presentation. Male patients aged 13 and 8 years presenting with type III OI, positive Trende-lenburg sign, adequate joint mobility, and a history of recurrent fractures and previous surgeries for deformities, including surgery for coxa vara correction. Radiographic and functional evaluation (Harris scale) were performed 6 and 68 months after surgery, respectively.In the first case, a correction of 46° was obtained (initial angle: 84°; final angle: 130°), as well as a Harris score was 70. In the second case, a correction of 50° (82° vs. 132°) was achieved, with a Harris score of 68 points. Conclusions. Subtrochanteric osteotomy and intramedullary K-wire nailing are effective options for the treatment of coxa vara in patients with osteogenesis imperfecta

Environmental impact of Sargassum spp. landings: an evaluation of leachate released from natural decomposition at Mexican Caribbean coast.

Large volumes of pelagic Sargassum spp. have stranded periodically on the Mexican Caribbean shoreline. The aim of this research was to study the mobility of metals through the leachates released into the environment during the natural decomposition process of Sargassum spp. Fresh Sargassum samples were placed in cone-bed reactors: under laboratory and local environmental conditions. The leachate generated naturally by decomposition in both conditions was recovered periodically and analyses of pH, volume, and metal content were carried out. Sargassum biomass was monitored by electron microscopy, FT-IR, and CHNS analysis. The Sargassum biomass studied presented a C: N ratio of 24.39, making it a potential raw feedstock for biofuels and other value-added products. Calculations performed on leachate production allowed inferring that each ton of fresh Sargassum that decomposes at a controlled temperature of 27 °C can produce 316 L of leachate. This leachate can contain 5.67 g of As and other potentially toxic metals (e.g., B, Al, Cu). At the end of both experiments, the biomass that was incubated for 30 days presented a C: N ratio of 28.86, so it can still be used as raw material for biofuels; however, the Sargassum biomass that remained 180 days in incubation decreased its C:N ratio at 8.45 at this point, it can be considered a waste. The leachate generated during the natural decomposition process of Sargassum on beaches or disposal sites represents a high risk of contamination of the Yucatan Peninsula water system due to the high content of arsenic and the presence of potentially toxic metals.

Cumplimiento de estándares e indicadores de parto y nacimiento humanizado en el centro de salud tipo C Velasco Ibarra, Machala Ecuador / Compliance with standards and indicators of humanized labor and birth in the type C health center Velasco Ibarra, Machala Ecuador

El parto constituye un acontecimiento extraordinario en la vida de la mujer, dado precisamente, por ser la culminación del embarazo humano y al unísono, el inicio de una nueva vida, razón por la que se le atribuye especial interés a nivel universal. Objetivo: Analizar el cumplimiento de estándares e indicadores de parto y nacimiento humanizado en el Centro de Salud Tipo C. Materiales y Métodos: Estudio observacional, descriptivo, prospectivo, de corte transversal. Con una población total de pacientes atendidas en el Servicio de Centro Obstétrico del Instituto "Velasco Ibarra", en Machala Ecuador, de enero a diciembre del 2020. Resultados: 743 pacientes tuvieron control prenatal con más de 5 sesiones, el 100% de los partos fue espontaneo, con ruptura anteparto, sin inducción, en su mayoría con las semanas completas. En cuanto a la presentación del parto 996 casos fueron de presentación cefálica. 862 pacientes no tuvieron acompañantes, sino, el grupo sanitario, médicos y enfermeras y solo a 125 se le permitió tener a su pareja. En cuanto a la posición del parto, 908 estuvieron en posición de litotomía (ginecológica), en cuanto a la analgesia, solo 267 y ninguna requirió anestesia, así como tampoco requirieron sangre, sulfato, hierro ni anticonceptivos postparto. Conclusiones: Se precisa la inclusión del componente humanizador e integral para la concepción del parto como un proceso natural y fisiológico, con la combinación científico-humanista en el logro de una atención con calidad y calidez, donde la mujer ecuatoriana protagonice su proceso de parto como un sujeto de cuidado y no como objeto del mismo(AU)

Childbirth is an extraordinary event in a woman's life, given precisely because it is the culmination of human pregnancy and at the same time the beginning of a new life, which is why special interest is attributed to it at a universal level. Objective: To analyze compliance with humanized childbirth and delivery standards and indicators in the Type C Health Center. Materials and Methods: Observational, descriptive, prospective, cross-sectional study. With a total population of patients treated at the Obstetric Center Service of the "Velasco Ibarra" Institute, in Machala Ecuador from January to December 2020. Results: 743 patients had prenatal control with more than 5 sessions, 100% of deliveries were spontaneous with antepartum rupture, without induction and almost all with complete weeks. And in 3, regarding the presentation of delivery, 996 cases were of cephalic presentation. 862 patients did not have companions, but the health group, doctors and nurses and only 125 were allowed to have their partner. As for the position of delivery, 908 were in the lithotomy (gynecological) position, as for analgesia only 267 and none required anesthesia, nor did they require blood, sulfate, iron, or postpartum contraceptives. Conclusions: the inclusion of the humanizing and integral component is required for the conception of childbirth as a natural and physiological process, with the scientific-humanistic combination in achieving care with quality and warmth, where the Ecuadorian woman is the protagonist of her birth process as a a subject of care and not as its object(AU)

Efectividad del tratamiento con acupuntura en la urgencia hipertensiva / Effectiveness of acupuncture treatment in hypertensive emergency

Introducción: La hipertensión arterial constituye un problema de salud, tanto a nivel mundial como en Cuba, por las complicaciones e implicaciones que tiene en la morbilidad de la población mayor de 15 años. Una mayor y mejor asistencia sanitaria no consiste tan solo en la práctica de costosos tratamientos, sino ante todo en educar, sanitariamente, a la población en la utilización de los recursos de la naturaleza, así como en el empleo de técnicas y la búsqueda de terapias menos invasivas y sin efectos secundarios. Objetivo: Evaluar la efectividad del tratamiento acupuntural en la urgencia hipertensiva. Métodos: Se realizó un estudio cuasi-experimental en el Policlínico Fray Benito, municipio Rafael Freyre, en el período comprendido enero de 2019 y mayo de 2020. El universo lo conformaron todos los pacientes que acudieron al cuerpo de guardia de dicho policlínico, remitidos del consultorio médico de familia con diagnóstico de urgencia hipertensiva. La muestra de estudio se escogió de forma aleatoria y quedó constituida por aquellos pacientes con diagnóstico de urgencia hipertensiva, que cumplieron con los criterios de inclusión y los criterios de exclusión. Las principales variables utilizadas fueron edad, sexo, resultados del tratamiento, presencia de reacciones adversas o no. Conclusiones: Se demostró la efectividad del tratamiento acupuntural en la urgencia hipertensiva en el Policlínico Fray Benito(AU)

Introduction: Hypertension constitutes a health problem, both worldwide and in Cuba, due to the complications and implications it has on the morbidity of the population over 15 years of age. More and better health care does not consist only in the practice of expensive treatments, but above all in educating the population in health, in the use of natural resources, as well as in the use of techniques and the search for less invasive therapies and without side effects. Objectives: To evaluate the effectiveness of acupuncture treatment in hypertensive emergency. Methods: A quasi-experimental study was carried out at Fray Benito Community Clinic, Rafael Freyre municipality, from January 2019 to May 2020. The universe was made up of all the patients who attended the emergency room of said polyclinic, referred from their family doctor's office with emergency hypertensive diagnosis. The study sample was chosen randomly with those patients with a hypertensive emergency diagnosis, who met the inclusion and exclusion criteria. The main variables used were age, sex, treatment results, presence of adverse reactions or not. Conclusions: The effectiveness of acupuncture treatment in hypertensive emergencies was demonstrated at Fray Benito Community Clinic(AU)

Cooperation in the face of thresholds, risk, and uncertainty: Experimental evidence in fisher communities from Colombia.

Cooperation is thought to be a necessary condition to solve collective action dilemmas such as climate change or the sustainable use of common pool resources. Yet, it is poorly understood how situations pervaded by thresholds shape the behaviour of people facing collective dilemmas. Here we provide empirical evidence that resource users facing thresholds maintain on average cooperative behaviours in the sense of maximising their individual earnings while ensuring future group opportunities. A framed field experiment in the form of a dynamic game with 256 Colombian fishers helped us investigate individual behavioural responses to the existence of thresholds, risk and uncertainty. Thresholds made fishers extract less fish compared to situation without thresholds, but risk had a stronger effect on reducing individual fishing effort. Contrary to previous expectations, cooperation did not break down. If cooperation can be maintained in the face of thresholds, then communicating uncertainty is more policy-relevant than estimating precisely where tipping points lay in social-ecological systems.

Valoración de independencia funcional en pacientes geriátricos / Functional Independence assessment in geriatrics patients

Habitualmente las personas adultas mayores presentan cambios físicos, psicológicos, y sociales que afectan las funciones básicas debido al envejecimiento fisiológico. El objetivo de este estudio fue valorar el grado de independencia funcional en pacientes geriátricos y su relación con la edad, nivel de educación y tiempo de residencia. Pacientes y Métodos Se realizó un estudio descriptivo, transversal enfocándose en la valoración del grado de independencia funcional bajo el índice de Barthel; efectuado en residentes con rangos de edad entre 65- 90 años, donde se obtuvo una descripción importante del nivel de independencia en personas de la tercera edad. El total de la población (muestra) fue de 110 residentes (57 mujeres y 53 hombres). Resultados Pacientes del sexo masculino tuvieron mayor independencia funcional (43% hombres vs. 32% mujeres), corroborando una apreciación estadística de un censo nacional hecho en el año 2010. Adicionalmente, los resultados han sido analizados con sus correlaciones y las significancias del nivel de funcionalidad de los residentes respecto a su edad, nivel de educación, y tiempo de residencia. Conclusiones El nivel de instrucción mostró una ligera correlación con su nivel de funcionalidad, sin embargo, no se encontró relación entre la funcionalidad con la edad y/o tiempo de permanencia en el hogar. Futuros estudios a mayor escala deberían ser efectuados para un apoyo estadístico de relevancia.

Older adults usually have physical, psychological, and social changes that affect basic functions due to physiological aging. The objective of this study was to assess the degree of functional independence in geriatric patients and their relationship to age, level of education and time of residence. Patients and Methods A descriptive, cross-cutting study focused on the assessment of the degree of functional independence under barthel's index was carried out; made in residents with age ranges between 65-90 years, where an important description of the level of independence in seniors was obtained. The total population (sample) was 110 residents (57 women and 53 men). Results It showed that men have greater independence functionality (43% men vs. 32% women), corroborating this appreciation with a national census statistic performed in 2010. In addition, the results have been analyzed with its correlation and significance of the Residents' Functional Level outcome regarding to their age, education level, and time in the institution. Conclusions The educational level showed a slight correlation with its physical functionality, however, no connection was found between functionality and age, nor institutionalized time. Further studies should be performed on a major scale to support static relevance

Consolidated Bioprocess for Bioethanol Production from Raw Flour of Brosimum alicastrum Seeds Using the Native Strain of Trametes hirsuta Bm-2.

Consolidated bioprocessing (CBP), which integrates biological pretreatment, enzyme production, saccharification, and fermentation, is a promising operational strategy for cost-effective ethanol production from biomass. In this study, the use of a native strain of Trametes hirsuta (Bm-2) was evaluated for bioethanol production from Brosimum alicastrum in a CBP. The raw seed flour obtained from the ramon tree contained 61% of starch, indicating its potential as a raw material for bioethanol production. Quantitative assays revealed that the Bm-2 strain produced the amylase enzyme with activity of 193.85 U/mL. The Bm-2 strain showed high tolerance to ethanol stress and was capable of directly producing ethanol from raw flour at a concentration of 13 g/L, with a production yield of 123.4 mL/kg flour. This study demonstrates the potential of T. hirsuta Bm-2 for starch-based ethanol production in a consolidated bioprocess to be implemented in the biofuel industry. The residual biomass after fermentation showed an average protein content of 22.5%, suggesting that it could also be considered as a valuable biorefinery co-product for animal feeding.

Influence of two polarization potentials on a bioanode microbial community isolated from a hypersaline coastal lagoon of the Yucatan peninsula, in México.

In recent years, halotolerant biofilms have become a subject of interest for its application in Bioelectrochemical systems for wastewater treatment. To determine if the polarization potential affects the microbial community of a halotolerant bioanode, four bioanodes were poised at potentials of +0.34 V/SHE and - 0.16 V/SHE and the 16S rRNA gene was analyzed through a MiSeq (Ilumina) system. Oceanospirillum, Halomonas and Marinobacterium were the most predominant genus; no previous studies have reported the presence of Oceanospirillum in anodic biofilms. The fitness with the dataset for +0.34 V/SHE with a modified Butler Volmer Monod model, gives a value of K1 was 0.0002 (2.64 A m-2 and 38% coulombic efficiency), indicating the fastest electrochemical reaction. Whereas that -0.16 V/SHE case, the high value of K1 (12.2 with 1.82 A m-2 and 10% coulombic efficiency) indicated that the electron transfer was far from being reversible (Nernstian).

Physicochemical characterization of goat milk produced in the Comarca Lagunera, Mexico.

The purpose of this study was to determine goat milk physicochemical parameters during the feed scarcity season. An evaluation was made for 398 milk samples from 80 multiparous goats belonging to three different production systems: (S1) mechanized milking grazing pasture and harvested residue (alfalfa) and grain supplemented; (S2) system grazing native pasture; and (S3) system grazing native pasture and grain supplemented. The general averages were: fat (FT) 4.0 ± 0.20%, protein (PR) 3.3 ± 0.05%, lactose (LC) 4.9 ± 0.09%, nonfat solids (NFS) 8.9 ± 0.13%, total solids (TS) 14.5 ± 0.20%, temperature (TM) 24.6 ± 1.06°C, and acidity (pH) 6.7 ± 0.049. Most of the physicochemical components of milk were affected (p < 0.0001) by the production system × month interaction and production system × group × month interaction. The FT content was higher (p < 0.05) in S2 (4.56 ± 0.18) than in S1 (3.64 ± 0.20) and S3 (3.50 ± 0.20). LC differed (p < 0.05) in S2 (5.07 ± 0.08) than in S1 (4.77 ± 0.09) and S3 (4.70 ± 0.09). No differences were observed for the rest of the variables (p < 0.05) among the production systems. The study unveiled a higher content of FT, LC, NFS, PR, and TS for S2 than for S1 and S3. This higher content may be explained because S2 only grazed on herbs and shrubs, in contrast to S1 and S3 which were additionally supplemented with grain concentrates.

Corn industrial wastewater (nejayote): a promising substrate in Mexico for methane production in a coupled system (APCR-UASB).

In Mexico, the corn tortilla is a food of great economic importance. Corn tortilla production generates about 1500-2000 m3 of wastewater per 600 tons of processed corn. Although this wastewater (also known as nejayote) has a high organic matter content, few studies in Mexico have analyzed its treatment. This study presents fresh data on the potential methane production capacity of nejayote in a two-phase anaerobic digestion system using an Anaerobic-Packed Column Reactor (APCR) to optimize the acidogenic phase and an up-flow anaerobic sludge blanket (UASB) reactor to enhance the methanogenic process. Results indicate that day 8 was ideal to couple the APCR to the UASB reactor. This allowed for a 19-day treatment that yielded 96% COD removal and generated a biogas containing 84% methane. The methane yield was 282 L kg-1 of CODremoved. Thus, two-phase anaerobic digestion is an efficient process to treat nejayote; furthermore, this study demonstrated the possibility of using an industrial application by coupling the APCR to the UASB reactor system, in order to assess its feasibility for biomethane generation as a sustainable bioenergy source.

Entramados humano-naturales como ruta posible hacia la transdisciplinariedad en el campo de la ecología humana y saberes ambientales de la universidad de caldas / Human-natural web as possible route towards transdisciplinarity in the field of human ecology and environmental knowledge at universidad de caldas

En el presente escrito me aproximo a la transdisciplinariedad y la necesidad que tenemos de abordarla desde la maestría en Ecología Humana y Saberes Ambientales de la Universidad de Caldas. Para ello, me remito a la exposición de dos referentes teóricos críticos de la modernidad que ponen de manifiesto dos cosas: en primer lugar, las tensiones existentes entre ciencias sociales y ciencias naturales (fundamentales en nuestra formación) y la necesidad de superarlas, en segundo lugar y no menos importante, las relaciones de poder y los procesos que han hecho que estas dos vertientes de la producción de conocimientos invisibilicen otros sistemas de prácticas y conocimientos presentes en sujetos no-tan-modernos (Martínez-Dueñas, 2012). Se plantea que observar entramados humano-naturales (Escobar, 2013) y la ontología política de los problemas ecológicos-humanos, sugieren un camino adecuado para avanzar hacia la construcción de agendas transdisciplinarias de investigación en ecología humana y saberes ambientales.

This paper offers an approach to transdisciplinarity and the need to engage it in the Human Ecology and Environmental Knowledge Master's Program at Universidad de Caldas, Colombia. To do this, two critical theoretical perspectives on the modernity are presented which illustrate, first, the tension existing between Social and Natural Sciences (essential in the academic background), and the need to overcome them, and secondly and equally important, the power relationships and the process that have made these two aspects of knowledge production to make invisible other systems of practice of knowledge present in not-so-modern actors (Martínez-Dueñas, 2012). This study proposes that observing human-natural webs (Escobar, 2013) and a political ontology of human-ecological problems suggest the adequate route to advance towards the construction of transdisciplinary research agendas in human ecology and environmental knowledge.

Removal of organic matter and electricity generation of sediments from Progreso, Yucatan, Mexico, in a sediment microbial fuel cell.

Sediment microbial fuel cells (SMFCs) are devices that generate electrical energy through sediments rich in organic matter (OM). The present study assessed the potential of sediments collected at two sites in Yucatan, Mexico, (the swamp of Progreso port and Yucalpetén dock) to be used in these electrochemical devices. Sediments were collected during the rainy and winter seasons and were monitored in the SMFC for 120 days through electrochemical and physicochemical characterization. OM removal in the SMFC ranged from 8.1-18.01%, generating a maximum current density of 232.46 mA/cm2 and power density of 95.85 mW/cm2. SUVA analysis indicated that with a young soil, the ratio E4/E6 presented evidence directly related to the degradation of aromatic and aliphatic compound formation, implying humification and, therefore, sediment enrichment.

Reflections on trauma, symbolization and psychic pain in a case of neurosis and a case of psychosis.

This paper seeks to advance some considerations on trauma, historical reality, its symbolization and the psychic pain generated by the investigation of unconscious processes in psychoanalytic treatment. These themes will be explored by demonstrating the differences arising between traumatic experiences and their expression in phantasy, as they occurred in a case of neurosis and another of psychosis. In each case, the differences in the features of the symbolization and the processes of working through shall also be taken into consideration. Particular attention shall be paid to the specific difficulties encountered by the analyst in the interpretative treatment of the trauma resulting from the amount of psychic pain induced in the patient, which at times proves to be an insurmountable barrier and a destructive distortion of the process.

Exacerbating the Tragedy of the Commons: Private Inefficient Outcomes and Peer Effect in Experimental Games with Fishing Communities.

Economic Experimental Games have shown that individuals make decisions that deviate down from the suboptimal Nash equilibrium. However, few studies have analyzed the case when deviation is above the Nash equilibrium. Extracting from above the Nash equilibrium is inefficient not only socially but also privately and it would exacerbate the tragedy of the commons. That would be the case of a race to the fish when stocks are becoming depleted or driver behavior on a highly congested road. The objective of this study is to analyze private inefficient extraction behavior in experimental games and to associate the type of player and the type of player group with such inefficient outcomes. To do this, we carried out economic experimental games with local coastal fishermen in Colombia, using a setting where the scarcity of the resource allows for an interior Nash equilibrium and inefficient over-extraction is possible. The state of the resource, the type of player and the composition of the group explain, in part, this inefficient behavior.

Valuing blue carbon: carbon sequestration benefits provided by the marine protected areas in Colombia.

Marine protected areas are aimed to protect and conserve key ecosystems for the provision of a number of ecosystem services that are the basis for numerous economic activities. Among the several services that these areas provide, the capacity of sequestering (capturing and storing) organic carbon is a regulating service, provided mainly by mangroves and seagrasses, that gains importance as alternatives for mitigating global warming become a priority in the international agenda. The objective of this study is to value the services associated with the capture and storage of oceanic carbon, known as Blue Carbon, provided by a new network of marine protected areas in Colombia. We approach the monetary value associated to these services through the simulation of a hypothetical market for oceanic carbon. To do that, we construct a benefit function that considers the capacity of mangroves and seagrasses for capturing and storing blue carbon, and simulate scenarios for the variation of key variables such as the market carbon price, the discount rate, the natural rate of loss of the ecosystems, and the expectations about the post-Kyoto negotiations. The results indicate that the expected benefits associated to carbon capture and storage provided by these ecosystems are substantial but highly dependent on the expectations in terms of the negotiations surrounding the extension of the Kyoto Protocol and the dynamics of the carbon credit's demand and supply. We also find that the natural loss rate of these ecosystems does not seem to have a significant effect on the annual value of the benefits. This approach constitutes one of the first attempts to value blue carbon as one of the services provided by conservation.

Considerações sobre a realidade externa no enactment / Considerations on the external reality in the enactment

Estabelecem-se diferenças conceituais entre os termos enactment e acting out. Mediante o enactment se tenta modificar a realidade do outro, sua alteridade. A partir de um material clínico de um paciente acometido de uma significativa patologia narcisista, se estuda o medo ao breakdown nos termos de Winnicott e como este medo tinha sido inicialmente experimentado pelo analista e só ulteriormente pelo paciente. Mostra-se a evolução do enactment mediante o processo de elaboração e a substituição do enactment pela representação da fantasia que este contém. Considera-se que o processo de elaboração inconsciente consiste, essencialmente, em uma passagem desde a equação simbólica ao símbolo e isto implica uma transformação no sistema representacional. Trata-se da importância da inclusão da realidade não-eu nas intervenções do analista, ademais das interpretações da realidade interior. Estuda-se o caráter traumático das identificações projetivas recebidas pelo sujeito...

Conceptual differences are established between the terms enactment and acting out. Through the enactment, an attempt is made to modify the other’s reality and alterity. Starting from the clinical material of a patient suffering from a significant narcissistic pathology, the fear of breakdown, in Winnicott’s terms, is studied, and how this fear had been initially experienced by the analyst and only later by the patient. The work aims at showing the evolution of the enactment through the elaboration process and the replacement of the enactment by the representation of the fantasy it contains. It is considered that the process of unconscious elaboration consists essentially in a passage from the symbolic equation to the symbol, implying a transformation in the representational system. Furthermore, the article discusses the importance of including the not-me reality in the analyst’s interventions, apart from the interpretations of the inner reality. The traumatic character of projective identifications received by the subject is also under study...

Se establecen diferencias conceptuales entre los términos enactment y acting out. Mediante el enactment se intenta modificar la realidad del otro, su alteridad. A partir de un material clínico de un paciente afectado de una significativa patología narcisista, se estudia el miedo al breakdown en términos de Winnicott y de cómo este miedo había sido inicialmente experimentado por el analista y sólo ulteriormente por el paciente. Se muestra la evolución del enactment mediante el proceso de elaboración y la sustitución del enactment por la representación de la fantasía que éste contiene. Se considera que el proceso de elaboración inconciente consiste esencialmente en un pasaje desde la ecuación simbólica hacia el símbolo, y esto implica una transformación en el sistema representacional. Se trata de la importancia de la inclusión de la realidad no-yo en las intervenciones del analista, además de las interpretaciones de la realidad interior. Se estudia el carácter traumático de las identificaciones proyectivas recibidas por el sujeto...