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Les méningo-encéphalocèles (MEC) sincipitaux sont des malformations congénitales rares qui se manifestent par une hernie de tissu cérébral ou méningé à travers une ouverture dans l'étage antérieur de la base du crâne. Ces malformations touchent toujours l'os frontal, plus précisément la région glabellaire et l'angle naso-frontal. Une collaboration entre Médecins du Monde et le Children's Surgical Center de Phnom Penh a permis de prendre en charge plus de quatre cents cas sur vingt ans. Les patients n'ont généralement pas eu d'examens radiologiques, les stratégies chirurgicales étant basées sur les observations cliniques et peropératoires. Il existe plusieurs formes cliniques de MEC : naso-frontales, naso-ethmoïdales, et naso-orbitaires. La classification de Suwanwela de 1972 reste la plus pertinente. Les MEC naso-frontales sont souvent associés à une importante expansion cutanée sans déformation osseuse majeure, contrairement aux MEC naso-ethmoïdales, qui entraînent des déformations significatives et sont les plus fréquentes. Les MEC naso-orbitaires, plus rares, provoquent le plus souvent une augmentation du volume orbitaire. La nature du tissu hernié et le volume de la hernie sont déterminants pour la stratégie chirurgicale. La canthopexie, un élément clé de la reconstruction, doit être précise et répond à des règles strictes pour assurer un résultat esthétique. Le remodelage fronto-nasal finalise la réparation. La chirurgie des MEC suit des principes bien codifiés. Le contexte humanitaire influence la prise en charge, avec un accent sur la sécurité chirurgicale et la transmission des compétences. Le traitement repose sur une vision clinique plus que radiologique, même si les avancées en imagerie sont aujourd'hui disponibles au Cambodge. Le suivi à long terme, surtout chez les enfants, reste un défi à documenter pour évaluer les impacts sur la croissance et la stabilité des résultats chirurgicaux. Sincipital meningoencephaloceles (MECs) are rare congenital malformations characterized by the herniation of brain or meningeal tissue through an opening in the anterior floor of the skull base. These malformations always affect the frontal bone, specifically the glabellar region and the naso-frontal angle. A collaboration between Médecins du Monde and the Children's Surgical Center in Phnom Penh has enabled the treatment of over four hundred cases over twenty years. Patients typically have not undergone radiological examinations, with surgical strategies based on clinical and intraoperative observations. There are several clinical forms of MECs: naso-frontal, naso-ethmoidal, and naso-orbital. The 1972 classification by Suwanwela remains the most relevant. Naso-frontal MECs are often associated with significant skin expansion without major bone deformity, unlike naso-ethmoidal MECs, which lead to significant deformities and are the most common. Naso-orbital MECs, being rarer, most frequently result in an increased orbital volume. The nature of the herniated tissue and the volume of the hernia are critical in determining the surgical strategy. Canthopexy, a key element of reconstruction, must be precise and adhere to strict rules to ensure an aesthetic result. The fronto-nasal remodeling completes the repair. The surgery for MECs follows well-codified principles. The humanitarian context influences management, with an emphasis on surgical safety and skill transmission. Treatment relies more on clinical assessment than radiological, although imaging advancements are now available in Cambodia. Long-term follow-up, especially in children, remains a challenge to document in order to evaluate the impacts on growth and the stability of surgical outcomes. [ABSTRACT FROM AUTHOR]

Drawing on 203 quantitative surveys with women workers in Cambodia and a further set of semi-structured interviews with 60 original participants, this paper is one of the very first to present empirically grounded research from garment workers on the financial challenges of navigating the first year of the COVID-19 pandemic. We show how in the making of clothes to be worn by Western consumers, poorly paid garment workers are reducing their eating to repay long-term debts and those newly taken on to cope with wage reductions resulting from factory closures, suspensions, and cuts in working hours. In its examination of this phenomenon, the paper improves understanding of the gendered contingencies of the COVID-19 pandemic and the 'wearing out' of garment workers through their attempts to reproduce life under (pre-existing) conditions of privation. We argue that the debt-hunger nexus is not new but reflects problems within Cambodia's capitalist development, and capitalism itself, as the costs of social reproduction and risk are privatised and financialised in the body politic. The COVID-19 pandemic is consolidating relations with financialised life such that they will outlast its duration and have long-lasting implications for workers and their families globally. [ABSTRACT FROM AUTHOR]

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This article analyzes the ways in which oncologists practice medicine in Cambodia. It focuses on everyday practices and describes the processes of biomedical adaptation and appropriation, in other words, to describe how physicians adapt their knowledge and skill, by appropriating the tools and resources at their disposal, in order to treat their patients. I illustrate how Cambodian physicians rely on “evidence-based medicine” (medicine based on randomized clinical trials) to legitimize the validity of their practices. They refer to science—to a “scientific truth” understood as positivist knowledge—by mobilizing statistics from Western medical studies when they must convince patients and their families to undergo treatment. However, these doctors face a certain number of local constraints that lead them to adapt standard treatments. They adjust on a case-by-case basis to “not kill the patient” as they say. Of course, they are confronted with uncertainties related to the deleterious effects of medications and the evolution of the disease. But they must also consider the financial resources of patients. Doctors and users are thus confronted with therapeutic dilemmas that encourage the former to be flexible in their practices. Medicine is based here on a transformation of knowledge resulting from the complex forms of accommodation of medical practice, it is produced by health professionals confronted with empirical realities that are out of step with formal and theoretical knowledge.

Plus de quarante ans après la fin du régime Khmer rouge, le poids du génocide pèse encore sur la diaspora franco-cambodgienne. Confronté au silence des aînés qui refusent de parler du passé génocidaire, Jean-Baptiste Phou recourt au théâtre parlé khmer pour donner la parole à quatre femmes cambodgiennes et mettre en scène leur parcours. Dans cet essai nous proposons de lire Cambodge, me voici à la lumière de la post-mémoire de Marianne Hirsch. Le croisement des axes de désir des protagonistes et la création d’un espace familial, féminin et maternel nous permettront d'analyser la formation de la mémoire diasporique des femmes et les modalités de sa transmission intra- et intergénérationnelle à travers deux couples, sororal et mère-fille. Nous postulons que le choix du casting et la mise en scène des deux versions française et khmère de la pièce transforment l’espace scénique en un lieu de partage mémoriel dans lequel se révèle le rôle de réparatrice et de passeuse culturelle attribué aux femmes.

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This paper advances existing research on both the geographies of fashion and the geographies of waste, utilising their shared interests in commodity biography. Empirically, it documents the use of textile waste from export-oriented garment factories in the peri-urban areas of Phnom Penh, Cambodia as fuel for nearby brick-kilns supplying the city's booming construction sector. Interviews and documentary photography present the forms of living, labour and harm at both the brick-kilns and the garment dump from which the textile waste is sourced. Substantively, the paper argues for the consideration of preconsumer garment waste to complement the dominant preoccupation with postconsumer waste and reuse. Conceptually, the paper argues for geographical biographies of commodity culture that are attentive to things' material dynamics of becoming, unbecoming and transformation across spaces, sectors and material forms: that is, to their 'patch geographies'. [ABSTRACT FROM AUTHOR]

This article offers a case study in Battambang province that examines agrarian and land dynamics in an irrigated command area. Building on the "powers of exclusion" framework developed by Hall, Hirsch and Li, we show how irrigation reshapes socio-spatial configurations locally and reinforces the dynamics of social differentiation between smallholder farmers. We argue that the uneven geography of water and the transformation of land ownership structures to which the irrigation project in question contributes run in the opposite direction of a pathway that would support the development of inclusive pro-smallholder irrigation. [ABSTRACT FROM AUTHOR]

Copyright of Quetes Litteraires is the property of Katolicki Uniwersityt Lubelski Jana Pawla II, Wydzial Nauk Humanistycznych, Institut Filologii Romaj and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Depuis plus de trois décennies, le modèle de gestion participative de l’irrigation promu par gouvernements et bailleurs de fond rencontre de nombreuses difficultés. Partant du constat que la gestion de l’irrigation présente des dimensions tant techniques que sociales, nous mobilisons les champs de la political ecology et des études des sciences et techniques et montrons qu’une politique publique prend de multiples facettes à l’aune des conditions matérielles qu’elle rencontre. Une comparaison de quatre périmètres irrigués au Cambodge illustre le fait que l’émergence d’associations d’usagers de l’eau comme acteurs de la gestion des périmètres irrigués dépend de l’existence de « points d’ancrage », c’est-à-dire d’éléments d’infrastructures de distribution et de partage de l’eau sur lesquels ces associations peuvent exercer leur contrôle et ainsi « s’inscrire » dans le paysage sociotechnique de l’irrigation.

Ces dernières années, la Fédération nationale des syndicats de Chine (FNSC), le seul syndicat autorisé en Chine, n'a eu de cesse d'affirmer sa présence sur la scène internationale. Les amendements successifs apportés à sa constitution imposent non seulement à la FNSC de soutenir l'Initiative Belt and Road aux côtés des autorités chinoises, mais aussi d'imprimer sa marque sur le mouvement syndical international. À travers les témoignages de syndicalistes locaux, cet article examine comment la FNSC s'efforce d'atteindre ces objectifs au Cambodge, pays où le volume des investissements chinois est très important. Il montre comment la Fédération soutient avec constance les acteurs cambodgiens locaux pro-gouvernementaux, habituellement négligés par le mouvement syndical international, en leur fournissant une aide matérielle ainsi que des opportunités de voyage à l'étranger. L'article soutient que l'impact de ces activités ne doit pas être négligé dans la mesure où leur alignement avec l'agenda illibéral des autorités cambodgiennes et les priorités des employeurs pourrait bouleverser le paysage du syndicalisme au Cambodge. [ABSTRACT FROM AUTHOR]

Rapid economic growth, declining fertility and changes in family structures have encouraged the Kingdom of Cambodia to reform its old‐age pension system. The Government of Cambodia reached an important milestone in 2019, when the Law on Social Security was promulgated. The Law includes provisions for a compulsory defined benefit pension scheme, establishing a sound framework for extending compulsory pension coverage beyond the public sector to formal private‐sector workers. As a future step, the compulsory pension scheme should be extended to informal workers. To accompany the reform, the investment policy for the pension scheme's reserve funds, including the supervisory regime and investment strategy, will be essential for the modernization of the Cambodian social security system. In this regard, Cambodia has successfully sought policy advice. However, the country should continue to seek further advice, and to act on this. Otherwise, the necessary and increasingly pressing policy ambitions of Cambodia to develop an adequate and sustainable social protection system may not be fully realized. [ABSTRACT FROM AUTHOR]

The Royal Government of Cambodia recently launched its National Social Protection Policy framework to strengthen and expand social security and assistance. To inform social health protection policy, we examine socio‐economic survey data and administrative coverage data to assess the coverage potential of existing coverage mechanisms and current gaps; and compare equitable contribution rates. Over 53 per cent of the population currently has no social health protection coverage mechanism, and about 16 per cent of the population who do have access to a mechanism are not yet enrolled. Current expansion efforts focus on the formal employee scheme, primarily benefiting individuals from higher income households. In addition, recent coverage expansion to some informal workers leaves significant gaps, particularly among the informal sector. We find out‐of‐pocket health care expenditure to be an excessive share of income among lower wealth quintile individuals and conclude they are financially vulnerable. Finally, we illustrate that an equitable approach to individual, monthly health care contributions among the lower three quintiles has a severely limited potential for revenue generation, and collection costs could exceed the amount collected. Therefore, we recommend that vulnerable groups should be exempted from contribution payments as social health protection is expanded. [ABSTRACT FROM AUTHOR]

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The Government of Cambodia is implementing ambitious reform initiatives to improve the country's social health protection system. In January 2018, it was announced that the Health Equity Fund (HEF), which is fully subsidized by a joint government‐donor initiative for the reimbursement of user fees for the poor at public health facilities, is to be expanded to some segments of informal workers belonging to associations, as well as to commune and village chiefs. Since 2017, the National Social Security Fund (NSSF) has provided social health insurance for formal economy workers in enterprises with eight employees or more. In January 2018, it was expanded to civil servants and all employees regardless of the size of the enterprise. However, this article highlights that the new ambitious reforms are not accompanied by careful planning as regards funding, service delivery, human resources and institutional design. This article therefore aims to examine key policy issues and challenges for Cambodia's ambitious reform of its social health protection system in terms of resource generation, population coverage, strategic purchasing and governance. [ABSTRACT FROM AUTHOR]

Copyright of Fruits is the property of International Society for Horticultural Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The discovery of several rare coins inscribed with Lavo pura confirms the existence of a city and province described under the name Lohu (or Lohuk) in Chinese records of the Yuan (Mongol) Dynasty (1260-1368) and in Vietnamese historical records as Lộ Hạc. This city and the province to which it gave its name were evidently the “province of Locach” described in the Travels of Marco Polo, the location of which remained a riddle to the mapmakers and navigators of the Age of Discovery. [ABSTRACT FROM AUTHOR]

Intentional dental modifications are known to have occurred on several continents at different periods and have been used as a diachronic bio-cultural marker to reconstruct the history of human settlement on different geographical scales. Such practices, present since the Neolithic in Southeast Asia, are thought to have originated in China and to co-exist in different forms in archaeological sites. There are many gaps and the proportion of archaeological evidence of these practices varies, making it impossible to trace their history and evolution perfectly. However, in Cambodia, cases of dental ablations are known from the Neolithic, the Metal Age and historical periods, and joint cases of dental abrasions or ablations have been attested since the Metal Age. As cases of dental abrasion were documented right up to the end of the twentieth century, this article aims to provide information on the still living memory of the motivations and techniques used by the mountain populations of Cambodia. As a complement and in comparison, we will present the unpublished cases of the Neolithic burials at the Laang Spean site, which bear witness to similar practices and raise questions about their relationship with those that persist today among certain ethnic groups. [ABSTRACT FROM AUTHOR]

L'Hoabinhien est un faciès sur galet emblématique des régions forestières et tropicales d'Asie du Sud-Est de la fin du Pléistocène supérieur jusqu'au milieu de l'Holocène. Dans une région marquée par l'existence de plusieurs humanités, il apparaît puis disparaît lorsque seuls les humains modernes sont encore présents. Ce phénomène technique se caractérise par la taille préférentiellement unifaciale d'outils lourds et épais sur galet comme des unifaces, des choppers , des chopping tools , des hémi-galets (splits) avec plus rarement des pièces bifaciales ou convergentes. Aucune armature, aucun projectile ou pointe de flèche ne sont représentés dans le lithic tool-kit de ces derniers chasseurs-cueilleurs-foragers paléolithiques des forêts tropicales. Ainsi, en Asie du Sud-Est, il ne semble pas y avoir d'évolution technique des industries lithiques ni aucune trace archéologique d'armatures de pierre pour la chasse entre 40 000 et 4000 BP, ce qui place les galets taillés hoabinhiens comme une réponse partielle à un questionnement plus vaste concernant l'adaptation humaine : le comportement technique, cynégétique, la subsistance en forêt tropicale. Comparé au Paléolithique supérieur contemporain en Occident, ces industries sur galet pourraient apparaître comme une inertie technico-temporelle, un « retard » sans changement majeur voire une régression cognitive. Sans invoquer quelque déterminisme écogéographique, nous sommes en présence d'un choix technique singulier et radical né de/dans/par la forêt qui résulte d'un dialogue entre la technique et l'environnement tropical. Le cas de l'Hoabinhien est un phénomène qui exprime un équilibre entre le minéral et un végétal en particulier, le bambou. L'invisible archéologique dans la matière lithique (armes pointues et armatures) s'est, en toute logique, exprimé dans de la matière végétale parfois siliceuse comme l'est par sa composition, le bambou. L'Hoabinhien porte en lui une complexité et une modernité sans précédent que seul l' Homo sapiens a su inventer. La pérennité de ce phénomène technique en contexte tropical humide associé à des matériaux périssables contraste avec le récit préhistorique habituel porté par le monde occidental. À partir d'exemples pris dans le matériel hoabinhien de fouilles récentes réalisées au Cambodge dans la grotte de Laang Spean par la Mission Préhistorique Franco-Cambodgienne du MEAE, nous illustrerons l'originalité et la diversité des chaînes opératoires lithiques sur galet des Gens de l'Hoabinhien. Nous proposerons également des hypothèses de fonctionnement de ce gros outillage à partir d'une analyse structurelle utilisant la modélisation 3D. The Hoabinhian represents an iconic pebble facies associated with the tropical forest regions of Southeast Asia, dating from the end of the Upper Pleistocene to the middle of the Holocene. In a region distinguished by the existence of multiple human populations, it emerges and then vanishes when only modern humans remain. This technical phenomenon is defined by the crafting of weighty, thick tools from pebbles, including unifaces, choppers, chopping tools, and splits, with bifacial pieces appearing less frequently. Notably absent from this last Paleolithic hunter-gatherer-forager toolkit are armatures, projectiles, or arrowheads. Therefore, in Southeast Asia, there seems to be a lack of technical evolution in lithic industries and no archaeological evidence of hunting projectiles from 40,000 to 4000 BP. This positions the Hoabinhian pebble tools as a part of the broader question concerning human adaptation, specifically technical behavior, forest subsistence, and life in the tropics. Compared to the contemporary Upper Palaeolithic in the West, these pebble industries might seem to exhibit technical-temporal inertia without significant change, or even a cognitive regression. However, without invoking any eco-geographical determinism, we find ourselves examining a unique and radical technical choice that originated in the forest, representing a dialogue between technology and the tropical environment. The Hoabinhian case is a phenomenon that signifies a balance between the mineral world and a specific plant, namely bamboo. The archaeological invisibility of lithic material (like pointed weapons and armatures) is logically offset by plant material, sometimes siliceous like bamboo. The Hoabinhian technique represents a novel complexity and modernity that only modern Homo sapiens has managed to invent. The persistence of this technical phenomenon in a humid tropical context, associated with perishable materials, contrasts sharply with the conventional prehistoric narrative of the Western world. By using examples taken from Hoabinhian material uncovered during recent excavations in the Laang Spean cave in Cambodia by the MEAE's "Mission Préhistorique Franco-Cambodgienne", we aim to illustrate the originality and diversity of lithic reduction sequences on pebbles. We will also propose functional hypotheses for these pebbles using a structural approach based on 3D modeling. [ABSTRACT FROM AUTHOR]

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Objectives: To investigate whether adherence to antiretroviral treatment (ART) can be explained not only by individual factors but also by health care facilities' characteristics, among a sample of people living with HIV (PLWH) treated with PI-based regimens in Cambodia.Methods: The ANRS 12276 2PICAM cross-sectional survey was conducted between February 2013 and April 2014 among PLWH followed up in 13 health care facilities. The 1316 patients in this analysis corresponded to 90% of the total number of adult patients treated with 2nd-line PI-based regimens in Cambodia in the study period. A variable indicating whether patients were non-adherent (=1) or completely adherent (=0) was constructed. Health care facilities and individual characteristics were included in a two-level logistic model to investigate their influence on patients' adherence to ART.Results: A total of 17% of participants did not adhere to ART. Patients in health care facilities outside the capital Phnom Penh were six times more likely to be non-adherent than those treated in health care facilities in the capital (OR: 6.15, 95% CI [1.47, 25.79]). Providing psychosocial care (provided by psychologist counsellors and/or full-time coaches) was found to be a structural facilitator of adherence, as the probability of non-adherence fell by 38.5% per each additional psychological worker present in health care facilities (OR: 0.62, 95% CI [0.43, 0.89]). Financial constraints were the main individual factor preventing adherence.Conclusions: Our results suggest that inefficiencies in health care delivery are detrimental to PLWH health and to the exceptional progress currently being made by Cambodia in response to HIV. Policy makers should focus on increasing the number of psychosocial workers, especially in areas outside the capital. [ABSTRACT FROM AUTHOR]

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Copyright of Autrepart is the property of Presses de Sciences Po and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)