19,125 research outputs found

    Community engagement in Cutaneous Leishmaniasis research in Brazil, Ethiopia, and Sri Lanka: A decolonial approach for global health.

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    Cutaneous leishmaniasis (CL) is a parasitic skin disease endemic in at least 88 countries where it presents an urgent, albeit often "neglected" public health problem. In this paper, we discuss our model of decolonial community engagement in the ECLIPSE global health research program, which aims to improve physical and mental health outcomes for people with CL. The ECLIPSE program has four interlinked phases and underpinning each of these phases is sustained and robust community engagement and involvement that guides and informs all activities in ECLIPSE. Our decolonial approach implies that the model for community engagement will be different in Brazil, Ethiopia and Sri Lanka. Indeed, we adopt a critical anthropological approach to engaging with community members and it is precisely this approach we evaluate in this paper. The data and material we draw on were collected through qualitative research methods during community engagement activities. We established 13 Community Advisory Groups (CAGs): in Brazil ( = 4), Ethiopia ( = 6), and Sri Lanka ( = 3). We identified four overarching themes during a thematic analysis of the data set: (1) Establishing community advisory groups, (2) CAG membership and community representation, (3) Culturally appropriate and context-bespoke engagement, and (4) Relationships between researchers and community members. During our first period of ECLIPSE community engagement, we have debunked myths (for instance about communities being "disempowered"), critiqued our own practices (changing approaches in bringing together CAG members) and celebrated successes (notably fruitful online engagement during a challenging COVID-19 pandemic context). Our evaluation revealed a gap between the exemplary community engagement frameworks available in the literature and the messy, everyday reality of working in communities. In the ECLIPSE program, we have translated ideal(istic) principles espoused by such community engagement guidance into the practical realities of "doing engagement" in low-resourced communities. Our community engagement was underpinned by such ideal principles, but adapted to local sociocultural contexts, working within certain funding and regulatory constraints imposed on researchers. We conclude with a set of lessons learned and recommendations for the conduct of decolonial community engagement in global health research. [Abstract copyright: Copyright © 2022 Polidano, Parton, Agampodi, Agampodi, Haileselassie, Lalani, Mota, Price, Rodrigues, Tafere, Trad, Zerihun and Dikomitis.

    Victims' Access to Justice in Trinidad and Tobago: An exploratory study of experiences and challenges of accessing criminal justice in a post-colonial society

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    This thesis investigates victims' access to justice in Trinidad and Tobago, using their own narratives. It seeks to capture how their experiences affected their identities as victims and citizens, alongside their perceptions of legitimacy regarding the criminal justice system. While there have been some reforms in the administration of criminal justice in Trinidad and Tobago, such reforms have not focused on victims' accessibility to the justice system. Using grounded theory methodology, qualitative data was collected through 31 in-depth interviews with victims and victim advocates. The analysis found that victims experienced interpersonal, structural, and systemic barriers at varying levels throughout the criminal justice system, which manifested as institutionalized secondary victimization, silencing and inequality. This thesis argues that such experiences not only served to appropriate conflict but demonstrates that access is often given in a very narrow sense. Furthermore, it shows a failure to encompass access to justice as appropriated conflicts are left to stagnate in the system as there is often very little resolution. Adopting a postcolonial lens to analyse victims' experiences, the analysis identified othering practices that served to institutionalize the vulnerability and powerlessness associated with victim identities. Here, it is argued that these othering practices also affected the rights consciousness of victims, delegitimating their identities as citizens. Moreover, as a result of their experiences, victims had mixed perceptions of the justice system. It is argued that while the system is a legitimate authority victims' endorsement of the system is questionable, therefore victims' experiences suggest that there is a reinforcement of the system's legal hegemony. The findings suggest that within the legal system of Trinidad and Tobago, legacies of colonialism shape the postcolonial present as the psychology and inequalities of the past are present in the interactions and processes of justice. These findings are relevant for policymakers in Trinidad and Tobago and other regions. From this study it is recognized that, to improve access to justice for victims, there needs to be a move towards victim empowerment that promotes resilience and enhances social capital. Going forward it is noted that there is a need for further research

    The temporality of rhetoric: the spatialization of time in modern criticism

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    Every conception of criticism conceals a notion of time which informs the manner in which the critic conceives of history, representation and criticism itself. This thesis reveals the philosophies of time inherent in certain key modern critical concepts: allegory, irony and the sublime. Each concept opens a breach in time, a disruption of chronology. In each case this gap or aporia is emphatically closed, elided or denied. Taking the philosophy of time elaborated by Giorgio Agamben as an introductory proposition, my argument turns in Chapter One to the allegorical temporality which Walter Benjamin sees as the time of photography. The second chapter examines the aesthetics of the sublime as melancholic or mournful untimeliness. In Chapter Three, Paul de Man's conception of irony provides an exemplary instance of the denial of this troubling temporal predicament. In opposition to the foreclosure of the disturbing temporalities of criticism, history and representation, the thesis proposes a fundamental rethinking of the philosophy of time as it relates to these categories of reflection. In a reading of an inaugural meditation on the nature of time, and in examining certain key contemporary philosophical and critical texts, I argue for a critical attendance to that which eludes those modes of thought that attempt to map time as a recognizable and essentially spatial field. The Confessions of Augustine provide, in the fourth chapter, a model for thinking through the problems set up earlier: Augustine affords us, precisely, a means of conceiving of the gap or the interim. In the final chapter, this concept is developed with reference to the criticism of Arnold and Eliot, the fiction of Virginia Woolf and the philosophy of cinema derived from Deleuze and Lyotard. In conclusion, the philosophical implications of the thesis are placed in relation to a conception of the untimeliness of death

    Exploring environmental concerns on digital platforms through big data: the effect of online consumers’ environmental discourse on online review ratings

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    By deploying big data analytical techniques to retrieve and analyze a large volume of more than 2.7 million reviews, this work sheds light on how environmental concerns expressed by tourists on digital platforms, in the guise of online reviews, influence their satisfaction with tourism and hospitality services. More specifically, we conduct a multi-platform study of Tripadvisor.com and Booking.com online reviews (ORs) pertaining to hotel services across eight leading tourism destination cities in America and Europe over the period 2017–2018. By adopting multivariate regression analyses, we show that OR ratings are positively influenced by both the presence and depth of environmental discourse on these platforms. Theoretical and managerial contributions, and implications for digital platforms, big data analytics (BDA), electronic word-of-mouth (eWOM) and environmental research within the tourism and hospitality domain are examined, with a view to capturing, empirically, the effect of environmental discourse presence and depth on customer satisfaction proxied through online ratings

    Women’s Experiences of Accessing Breastfeeding and Perinatal Health Support in the Context of Intimate Partner Violence: An Interpretive Description Study

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    Background: Women experiencing intimate partner violence are at a heightened risk of negative perinatal and breastfeeding outcomes. This study explored the experiences of accessing breastfeeding support for women who endorse a history of intimate partner violence. A study of five in-depth semi-structured interviews were completed at 12-weeks postpartum with breastfeeding mothers with a history of intimate partner violence. Findings: Women expressed difficulties in accessing a healthcare provider who had specialized skill in breastfeeding support. Trust in their healthcare provider, built through displays of compassion and competence, was important to mitigate obstacles experienced during care access for this population. Trauma-and-violence-informed care principles were beneficial to the development of the therapeutic relationship in perinatal care. Women placed value on breastfeeding support received from both healthcare providers and social supports, which impacted mothers’ perceived breastfeeding support and self-efficacy. Further, mothers described increased levels of breastfeeding self-efficacy after engaging in a trauma-and-violence-informed care program aimed at supporting breastfeeding. Conclusions: Trauma-informed care may aid in the development of trust in the therapeutic relationship, which in turn impacts access to breastfeeding support and breastfeeding self-efficacy. The inclusion of trauma-and-violence informed principles in perinatal care may be effective at mitigating barriers to access for women who endorse a history of intimate partner violence. health care on how to employ trauma-informed breastfeeding care to may lead to better support for this population

    Exploring the effects of spinal cord stimulation for freezing of gait in parkinsonian patients

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    Dopaminergic replacement therapies (e.g. levodopa) provide limited to no response for axial motor symptoms including gait dysfunction and freezing of gait (FOG) in Parkinson’s disease (PD) and Richardson’s syndrome progressive supranuclear palsy (PSP-RS) patients. Dopaminergic-resistant FOG may be a sensorimotor processing issue that does not involve basal ganglia (nigrostriatal) impairment. Recent studies suggest that spinal cord stimulation (SCS) has positive yet variable effects for dopaminergic-resistant gait and FOG in parkinsonian patients. Further studies investigating the mechanism of SCS, optimal stimulation parameters, and longevity of effects for alleviating FOG are warranted. The hypothesis of the research described in this thesis is that mid-thoracic, dorsal SCS effectively reduces FOG by modulating the sensory processing system in gait and may have a dopaminergic effect in individuals with FOG. The primary objective was to understand the relationship between FOG reduction, improvements in upper limb visual-motor performance, modulation of cortical activity and striatal dopaminergic innervation in 7 PD participants. FOG reduction was associated with changes in upper limb reaction time, speed and accuracy measured using robotic target reaching choice tasks. Modulation of resting-state, sensorimotor cortical activity, recorded using electroencephalography, was significantly associated with FOG reduction while participants were OFF-levodopa. Thus, SCS may alleviate FOG by modulating cortical activity associated with motor planning and sensory perception. Changes to striatal dopaminergic innervation, measured using a dopamine transporter marker, were associated with visual-motor performance improvements. Axial and appendicular motor features may be mediated by non-dopaminergic and dopaminergic pathways, respectively. The secondary objective was to demonstrate the short- and long-term effects of SCS for alleviating dopaminergic-resistant FOG and gait dysfunction in 5 PD and 3 PSP-RS participants without back/leg pain. SCS programming was individualized based on which setting best improved gait and/or FOG responses per participant using objective gait analysis. Significant improvements in stride velocity, step length and reduced FOG frequency were observed in all PD participants with up to 3-years of SCS. Similar gait and FOG improvements were observed in all PSP-RS participants up to 6-months. SCS is a promising therapeutic option for parkinsonian patients with FOG by possibly influencing cortical and subcortical structures involved in locomotion physiology

    NOMA Transmission Systems: Overview of SIC Design and New Findings

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    Non-Orthogonal Multiple Access (NOMA) has been recently proposed as a good alternative to meet 5G and beyond requirements in terms of high spectral efficiency, massive connectivity, and low latency. It has been demonstrated that the use of NOMA in downlink has superior performance in terms of throughput, whereas the use in uplink outperforms OMA techniques in terms of fairness. A distinctive feature of NOMA is the presence of excessive multiple-access interference due to the case of usage of power domain to multiplex signals, thus the functional implementation of NOMA implies Successive Interference Cancelation (SIC) to combat this interference. Therefore, SIC design becomes the main point in the effectiveness of NOMA systems. On the other hand, hybrid schemes, NOMA/OMA, have been recently proposed to reduce the drawbacks of pure NOMA systems. However, in these schemes, it becomes necessary to distinguish NOMA and OMA users. Cognitive Radio techniques turn to be a good option to effectively separate NOMA/OMA users as well as to distinguish NOMA users. In this chapter, a brief overview of NOMA techniques related to Cognitive Radio technology (CR-NOMA) and SIC design reported in the literature is presented. Also, new findings about NOMA/OMA users’ recognition are described

    Unraveling the effect of sex on human genetic architecture

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    Sex is arguably the most important differentiating characteristic in most mammalian species, separating populations into different groups, with varying behaviors, morphologies, and physiologies based on their complement of sex chromosomes, amongst other factors. In humans, despite males and females sharing nearly identical genomes, there are differences between the sexes in complex traits and in the risk of a wide array of diseases. Sex provides the genome with a distinct hormonal milieu, differential gene expression, and environmental pressures arising from gender societal roles. This thus poses the possibility of observing gene by sex (GxS) interactions between the sexes that may contribute to some of the phenotypic differences observed. In recent years, there has been growing evidence of GxS, with common genetic variation presenting different effects on males and females. These studies have however been limited in regards to the number of traits studied and/or statistical power. Understanding sex differences in genetic architecture is of great importance as this could lead to improved understanding of potential differences in underlying biological pathways and disease etiology between the sexes and in turn help inform personalised treatments and precision medicine. In this thesis we provide insights into both the scope and mechanism of GxS across the genome of circa 450,000 individuals of European ancestry and 530 complex traits in the UK Biobank. We found small yet widespread differences in genetic architecture across traits through the calculation of sex-specific heritability, genetic correlations, and sex-stratified genome-wide association studies (GWAS). We further investigated whether sex-agnostic (non-stratified) efforts could potentially be missing information of interest, including sex-specific trait-relevant loci and increased phenotype prediction accuracies. Finally, we studied the potential functional role of sex differences in genetic architecture through sex biased expression quantitative trait loci (eQTL) and gene-level analyses. Overall, this study marks a broad examination of the genetics of sex differences. Our findings parallel previous reports, suggesting the presence of sexual genetic heterogeneity across complex traits of generally modest magnitude. Furthermore, our results suggest the need to consider sex-stratified analyses in future studies in order to shed light into possible sex-specific molecular mechanisms
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