Perceptual change through transnational experience : American exchange students and HIV/AIDS

Includes bibliographical references (p. 83-97).Includes abstract.This thesis considers the power of United States popular media to construct both conceptions of "Africa" and knowledge of HN / AIDS among exchange students in Cape Town, South Africa. Arguing that the reification of myths about Africa influenced respondents' arrival stories and initial experiences, I exhibit how being in South Africa produced very different associations, particularly with regard to intimate relationships. Drawing on theoretical work that looks at the tendency to imagine disease as a product of "foreign" or "other" people, and building on respondents' imaginary Africa, the conceptual linking of Africa to AIDS is highlighted in their discussions of expectations. The linking of HN / AIDS to Africa affects respondents decision to study in South Africa, as well as their initial interactions; highlighting the tendency of respondents to describe their motivation for studying in South Africa a result of a sense of "responsibility" they feel to "save" Africans from AIDS. Respondents' urge to "save" is in tension with their initial tendency to distance themselves from HIV / AIDS in Africa through an imaginary matrix of immunity exhibited through rhetorics of difference. Evolving from respondents' motivation to "save," a discussion of "moral tourism" and ''voluntouring'' is explored. The thesis argues that the combination of voluntary services and living in Cape Town has the ability to change perceptions that were previously used as explanation for high levels of contraction rates of HIV / AIDS on the African continent and particularly in sub-Saharan Africa

One of a Kind-The Pan African Clinical Trials Registry, a regional registry for Africa

The 2004 Ministerial Summit on Health Research called on the World Health Organization to to establish a registry network with the intention of providing a single access point to identify trials. In 2007 the International Committee of Medical Journal Editors amended their support of this initiative stating that only trials registered prospectively on a member registry of the WHO's Network of Primary Registers would be published. The Pan African Clinical Trials Registry (www.pactr.org), was established in early 2007 as the AIDS, TB and Malaria (ATM) Clinical Trials Registry with the aim of piloting the concept of a registry that would cater to the specific needs of African trialists. In 2009 the ATM Registry expanded its remit to include all diseases for all regions of Africa; The Pan African Clinical Trials Registry became the first and is presently the only African member of the World Health Organization's Network of Primary Registers

Exploring Science Communication Effectiveness in the U.S. Federal Government Research Process: A Case Study with the U.S. Livestock Producers’ Antimicrobial Use Research

Several U.S. federal government agencies collect and disseminate scientific data on a national scale to provide insights for agricultural trade, research, consumer health, and policy. Occasionally, such data have potential to provide insights to advance conversations and actions around critical and controversial issues in the broad agricultural system. Such government studies provide evidence for others to discuss, further interpret, and act upon, but to do so, they must be communicated well. When the research intersects with contentious socio-political issues, successful communication not only depends on tactics, but as this study illuminates, it also depends on relationship quality between research producers, study participants, and end-users. USDA’s Animal and Plant Health Inspection Service (APHIS) conducted first-of-its kind national studies on cattle and swine producers’ use of antimicrobials. The use of antimicrobials in animal agriculture is considered a critical and controversial issue pertaining to antimicrobial resistance. In recognition of the anticipated wide-ranging interests in these studies, APHIS sought to understand stakeholders’ perceptions and experiences of the federal government research process and products with aim of improving their science communication and relations. This study reports on findings from in-depth interviews with 14 stakeholders involved in the antimicrobial use studies to make recommendations for improving communication and relations between the agency and its stakeholders. From this research, we draw implications that are transferrable to numerous types of government science communication efforts within agricultural sectors

Wellbeing on the Edge: The dynamics of Musundian edge- dwelling on the boundaries of protected natural areas in Limpopo, South Africa

This thesis examines the impacts of a protected natural area (Makuya park) on residents of Musunda village in Limpopo, South Africa. The creation of protected natural areas entails the formation of boundaries to limit access and resource use, often under the assumption that the isolation from human activity will allow 'natural' environments/habitats to re-emerge. When humans are not afforded a place in protected spaces, 'edge-dwellers' emerge. This thesis explores how the resulting changes in land use and access can impact the availability, distribution, and quality of strategically important resources, and thus influence a wide range of ecological, epidemiological, and economic processes that directly and indirectly impinge on an individual's wellbeing. Based on over two years of ethnographic fieldwork in the HaMakuya chieftaincy, this thesis aims to explore the tangible and intangible ways in which Makuya park impacts on Musundian edge-dwellers efforts to achieve wellbeing. Specific research questions include: How do edge-dwellers understand, discuss, and enact wellbeing? How and when are natural resources used toward achieving wellbeing? How and when does land access shape land use in terms of wellbeing and in what ways? Have shifts in practices occurred as a result of the formation of protected areas? I address these questions by engaging with current debates in social, medical and environmental anthropology. Using Cohen's (2013) 'ecologies of wellbeing' as a matrix through which to explore local conceptions of health/wellbeing (mutakalo), this thesis engages with a historical 'political ecology of health' (Harper 2002) and conservation to consider health and wellbeing within 'environmental perspectives' (McElroy and Townsend 2009). In focusing on the everyday practices of Musundians, this thesis foregrounds local notions of health (mutakalo) and local perceptions of natural resource limitations imposed by the park as a way to understand edge-dwellers' local ecologies of wellbeing. This thesis provides TshiVenda speakers' (an under-represented group) perspectives; it shows the negative impacts that the park has on resource access, diet, relationships and local healing practices according to edge-dwellers. Questioning how Musundians maintained ambivalence in these challenging circumstances, I discuss how I came to realize that the park is locally understood to offer the promise of 'good things.' Exploring the ways in which hope and the park intersect, I describe how the park has become incorporated into local ecologies of wellbeing. This thesis explores some wellbeing-related experiences of Musunda's edge-dwellers, while considering the park's influence on those dwelling on the boundary of a protected natural area thereby contributing to social anthropology scholarship at the intersection of environmental and medical anthropology. In doing this, this thesis draws on related disciplines in the social sciences, contributing to literatures in human geography, public health and ecology

Adolescent experiences in a vaccine trial: A pilot study

Little is known about how adolescents experience clinical trials. We assessed the experiences of South African adolescent participants in a clinical trial, employing semi-structured interviews to gather qualitative data on the experiences and effects of trial participation. Despite misunderstanding certain concepts regarding assent and trial processes subsequent to enrolment, participants reported positive experiences overall. Subjects’ motivations for participation included: an ability to help others; receipt of healthcare; and free blood screening. Participants expressed fears associated with trial procedures, such as phlebotomy; however, these apprehensions diminished as the trial progressed. We found that conducting qualitative research within a trial site is feasible, and can provide insight into the uptake and acceptability of interventions

Supporting registration of child-focused clinical trials in Africa: The Child Strategy Project

Editorial abstract not applicabl

The neocortical column

In the middle of the twentieth century, Rafael Lorente de Nó (1902?1990) introduced the fundamental concept of the ?elementary cortical unit of operation,? proposing that the cerebral cortex is formed of small cylinders containing vertical chains of neurons (Lorente de Nó, 1933, 1938). On the basis of this idea, the hypothesis was later developed of the columnar organization of the cerebral cortex, primarily following the physiological and anatomical studies of Vernon Mountcastle, David Hubel, Torsten Wiesel, János Szentágothai, Ted Jones, and Pasko Rakic (for a review of these early studies, see Mountcastle, 1998). The columnar organization hypothesis is currently the most widely adopted to explain the cortical processing of information, making its study of potential interest to any researcher interested in this tissue, both in a healthy and pathological state. However, it is frequently remarked that the nomenclature surrounding this hypothesis often generates problems, as the term ?Column? is used freely and promiscuously to refer to multiple, distinguishable entities, such as cellular or dendritic minicolumns or afferent macrocolumns, with respective diameters of menor que50 and 200?500 ?m. Another problem is the degree to which classical criteria may need to be modified (shared response properties, shared input, and common output) and if so, how. Moreover, similar problems arise when we consider the need to define area-specific and species-specific variations. Finally, and what is more an ultimate goal than a problem, it is still necessary to achieve a better fundamental understanding of what columns are and how they are used in cortical processes. Accordingly, it is now very important to translate recent technical advances and new findings in the neurosciences into practical applications for neuroscientists, clinicians, and for those interested in comparative anatomy and brain evolution

National stakeholders’ perceptions of the processes that inform the development of national clinical practice guidelines for primary healthcare in South Africa

Background There is increased international focus on improving the rigour of clinical practice guideline (CPG) development practices. However, few empirical studies on CPG development have been conducted in low- and middle-income countries. This paper explores national stakeholders’ perceptions of processes informing CPG development for primary healthcare in South Africa, focusing on both their aspirations and views of what is actually occurring. Methods A qualitative study design was employed including individual interviews with 37 South African primary care CPG development role-players. Participants represented various disciplines, sectors and provinces. The data were analysed through thematic analysis and an interpretivist conceptual framework. Results Strongly reflecting current international standards, participants identified six ‘aspirational’ processes that they thought should inform South African CPG development, as follows: (1) evidence; (2) stakeholder consultation; (3) transparency; (4) management of interests; (5) communication/co-ordination between CPG development groups; and (6) fit-for-context. While perceptions of a transition towards more robust processes was common, CPG development was seen to face ongoing challenges with regards to all six aspirational processes. Many challenges were attributed to inadequate financial and human resources, which were perceived to hinder capacity to undertake the necessary methodological work, respond to stakeholders’ feedback, and document and share decision-making processes. Challenges were also linked to a complex web of politics, power and interests. The CPG development arena was described as saturated with personal and financial interests, groups competing for authority over specific territories and unequal power dynamics which favour those with the time, resources and authority to make contributions. These were all perceived to affect efforts for transparency, collaboration and inclusivity in CPG development. Conclusion While there is strong commitment amongst national stakeholders to advance CPG development processes, a mix of values, politics, power and capacity constraints pose significant challenges. Contrasting perspectives regarding managing interests and how best to adapt to within-country contexts requires further exploration. Dedicated resources for CPG development, standardised systems for managing conflicting interests, and the development of a political environment that fosters collaboration and more equitable inclusion within and between CPG development groups are needed. These initiatives may enhance CPG quality and acceptability, with associated positive impact on patient care

Tuberculosis treatment intervention trials in Africa: A cross-sectional bibliographic study and spatial analysis

Background Mycobacterium Tuberculosis (TB) poses a substantial burden in sub-Saharan Africa and is the leading cause of death amongst infectious diseases. Randomised controlled trials (RCTs) are regarded as the gold standard for evaluating the effectiveness of interventions. We aimed to describe published TB treatment trials conducted in Africa. Methods This is a cross-sectional study of published TB trials conducted in at least one African country. In November 2019, we searched three databases using the validated Africa search filter and Cochrane’s sensitive trial string. Published RCTs conducted in at least one African country were included for analysis. Records were screened for eligibility. Co-reviewers assisted with duplicate data extraction. Extracted data included: the country where studies were conducted, publication dates, ethics statement, trial registration number, participant’s age range. We used Cochrane’s Risk of Bias criteria to assess methodological quality. Results We identified 10,495 records; 175 trials were eligible for inclusion. RCTs were published between 1952 and 2019. The median sample size was 206 participants (interquartile range: 73–657). Most trials were conducted in South Africa (n = 83) and were drug therapy trials (n = 130). First authors were from 30 countries globally. South Africa had the most first authors (n = 55); followed by the United States of America (USA) (n = 28) and Great Britain (n = 14) with fewer other African countries contributing to the first author tally. Children under 13 years of age eligible to participate in the trials made up 17/175 trials (9.71%). International governments (n = 29) were the most prevalent funders. Ninety-four trials provided CONSORT flow diagrams. Methodological quality such as allocation concealment and blinding were poorly reported or unclear in most trials. Conclusions By mapping African TB trials, we were able to identify potential research gaps. Many of the global north’s researchers were found to be the lead authors in these African trials. Few trials tested behavioural interventions compared to drugs, and far fewer tested interventions on children compared to adults to improve TB outcomes. Lastly, funders and researchers should ensure better methodological quality reporting of trials

Living the life of floods: place-based learning in an Anthropocene harmscape

This article explores how place-based learning and the development of landscape literacies unfold in a place suffused with a complex set of risks resulting from inter-operating and intersecting sociohistorical, political and environmental factors. By analysing assemblages of images and accompanying texts produced through a photovoice process undertaken by co-researchers in an informal settlement in South Africa’s Cape Flats, we show that residents are embedded in an ongoing process of embodied place-connectedness that has extensive pedagogical impact. We suggest that the learning that takes place in this harmscape may enable residents’ survival at the cost of allowing for either hope or the possibility of transformative change