The Measure of a Man: Young Male, Interpersonal Violence and Construction of Masculinities An Ethnographic Study from Lima, Peru

Men are the main perpetrators and victims of violence worldwide. Previous studies show that violent behaviour is related –to ideas of masculinity. However research on “gender-based violence” typically focuses on violence between men and women, paying less attention to acts of violence between men. To address this research gap I conducted a cross-sectional, ethnographic study in an urban-deprived area of Lima, Peru. The study aims to understand the interrelationships between interpersonal violence and the construction of masculinities among young men living in a context of structural and symbolic violence, stigma and exclusion. I examine the interaction of structural and individual-level factors in the reproduction of violence by placing the “construction of masculinities” approach at the centre of the analysis. In this thesis I propose that violence between men is a form of gender-based violence that offers young men a short cut to achieving masculinity mandates prevalent in their milieu, in a context that limits their potential to “become men” in non-violent ways. The relationship between men’s violence and masculinity is not a direct one. Violence does not equal masculinity, instead it allows these young men to gain status within the community, to earn a living, to protect their alliances and women, to demonstrate power and exert control over others: all characteristics associated with masculinity. Men in this setting choose violence, and violence is one of the strategies that they use to perpetuate masculine hegemony. This study highlights the importance of the social setting in which masculinities are performed, the homosocial nature of these performances and the relevance of the male body in the enactment of the social practices through which masculinities are constructed. In the final part of the thesis, I provide recommendations for interventions in the field of young men’s violence, and make suggestions for future research

Is transactional sex exploitative? A social norms perspective, with implications for interventions with adolescent girls and young women in Tanzania

Although transactional sex is common in many sexual relationships, there has been little research into the degree to which the practice is considered exploitative in the settings in which it is practiced. We describe the social norms that influence transactional sex in two sites in Mwanza, Tanzania, and explore local understandings of whether and under what conditions it is considered exploitative. We then compare these "emic" understandings of exploitation to international definitions and norms around sexual exploitation. This study employed a qualitative research design involving 18 focus group discussions and 43 in-depth interviews with young people aged 14-24 years and parents with children aged 14-24 years in a rural area and an urban center within Mwanza, Tanzania. Thematic analysis was conducted with the aid of NVivo 10. The social norms influencing the practice of transactional sex included: reciprocity as a core cultural value that permeates the way exchange in sexual relationships is judged; gendered expectations that men should provide for women's material needs in sexual relationships and that women should reciprocate by means of sex; and peer pressure to be perceived as "fashionable". Adolescent girls and young women (AGYW) are under strong peer pressure to conform to a "modern lifestyle" as reflected in stylish clothing and other items of modernity such as cellphones. The emic conceptualization of exploitation is defined by circumstances surrounding the relationship or a sexual encounter. Important factors that characterize local notions of when transactional relationships are considered exploitative include: when the encounter or relationship involves an imbalance of power (based on age, male economic power and social status); when a man fails to reciprocate; and when sex is coerced. According to community perspectives, young women's behavior should be considered exploitative of men when they take gifts or money yet refuse sex or when they demand large sums of money. Interventions aimed at reducing AGYW's exploitation through transactional sex need to be cognizant of the variations in the understanding of what constitutes sexual exploitation as well as the social and gender norms influencing the practice of transactional sex. Interventions need to involve communities and families in critical thinking that helps them identify positive alternatives to current gendered social norms that shape the involvement of AGYW and men in transactional sex

'I trap her with a CD, then tomorrow find her with a big old man who bought her a smart phone'. Constructions of masculinities and transactional sex: a qualitative study from North-Western Tanzania

Men’s role in transactional sex is relatively unexplored, limiting initiatives to prevent exploitative transactional sex and its negative health implications for girls and women. We addressed this literature gap by conducting eight focus group discussions and twenty in-depth-interviews with boys and men aged 14 − 49 years in 2015 in Tanzania. We employed a novel combination of theoretical perspectives – gender and masculinities, and social norms – to understand how transactional sex participation contributes to perpetuating gendered hierarchies, and how reference groups influence men’s behaviour. Findings signal two gender norms that men display within transactional sex: the expectation of men’s provision in sexual relationships, and the expectation that men should exhibit heightened sexuality and sexual prowess. Adherence to these expectations in transactional sex relationships varied between older and younger men and created hierarchies among men and between men and women and girls. We found that approval of transactional sex was contested. Although young men were likely to object to transactional sex, they occupied a structurally weaker position than older men. Findings suggest that interventions should employ gender synchronised and gender transformative approaches and should prioritise the promotion of alternative positive norms over preventing the exchange of gifts or money in relationships

Community perspectives on the extent to which transactional sex is viewed as sexual exploitation in Central Uganda.

BACKGROUND: Definitions of child sexual exploitation vary. Sexual exploitation violates children's rights and exposes them to mental and physical harm. There exist differences in views of behaviour that is considered exploitative, including transactional sex. This paper explores community perspectives on the extent to which transactional sex is considered exploitative. METHODS: In 2014, we conducted 19 focus group discussions and 44 in-depth interviews with young people and adults in two communities in Uganda. Participants were presented with vignettes describing sexual encounters between adolescent girls and young women and men to explore under what conditions participants considered the scenario to be exploitative and why. Interviews were conducted in Luganda using a semi-structured tool, audio recorded and transcribed verbatim. Analysis was thematic and complemented by constant comparison and deviant case analysis techniques. RESULTS: Definitions by multilateral, bilateral, and non-governmental organisations of the sexual exploitation of children shared similarities with community conceptualisations of wrong or unfair sex. Although in community conceptualisations there was no consensus on what constituted sexual exploitation, transactional sex was condemned to the extent to which it involved sex with a minor or misled a naïve or immature girl; involved lack of consent, particularly in relationships characterised by power differentials; or worsened the pre-existing status of the girl. Also relevant was the extent to which a man's intentions were considered inappropriate; the adolescent girl or young woman was considered vulnerable; and the adolescent girl or young woman was considered responsible for 'her situation'. CONCLUSIONS: Existing social norms that condemn sex with a minor or sex that involves deception, sexual coercion or misleading an immature girl, present opportunities to mobilise communities to protect adolescent girls and young women at risk. Any intervention must, however, be designed with full cognisance of the social and structural drivers that underlie transactional sex and limit adolescent girls' and young women's opportunities to provide for themselves without recourse to sexual relationships with men. Interventions must also be designed to recognise that girls in transactional sex relationships may not consider themselves as exploited, thus requiring engagement with them based on their own concerns, aspirations, and expectations

‘I Believe What I’m Saying More Than the Test’: The Complicated Place of Rapid, Point-of-Care Tests in Veterinary Diagnostic Practice

This is the final version. Available on open access from MDPI via the DOI in this recordData Availability Statement: Data in this study are not readily available due to ethical restrictions. Given the personal nature of participatory event discussion material, participants consented to material derived being used only for scientific and research purposes/outputs coordinated by the research team. As such, datasets generated are deposited in a UKRI depository at termination of contract research. Requests to access the datasets should be directed to www.dialamr.com.Antimicrobial resistance (AMR) is a global health and development threat, with calls for the optimisation of antimicrobial use (AMU) in the treatment of both humans and animals prevalent across national and international policy. Rapid, low-cost and readily available diagnostics that specifically identify pathogens and their antimicrobial susceptibility profiles have been identified as essential parts of this optimisation process, yet questions over the assumed utility of novel rapid technology as a cornerstone of tackling agricultural AMU still exist. To understand whether this technology may support the optimisation of AMU in the treatment of animal disease, this study qualitatively examines the discourse between veterinarians, laboratory representatives, veterinary researchers and (cattle) farmers within three participatory events concerning diagnostic testing on UK farms, to offer a critical examination of the interaction between veterinary diagnostic practice and agricultural AMU. Veterinarian-led discussion suggested that veterinary rationales for engaging with diagnostic testing are nuanced and complex, where veterinarians (i) were driven by both medical and non-medical motivators; (ii) had a complex professional identity influencing diagnostic-test engagement; and (iii) balanced a multitude of situated contextual factors that informed “gut feelings” on test choice and interpretation. In consequence, it is suggested that data-driven diagnostic technologies may be more palatable for veterinarians to promote to their farm clients in the pursuit of better and more sustainable AMU, whilst also being in synergy with the emerging preventative role of the farm veterinarian.Economic and Social Research Council (ESRC

Diagnostics and the challenge of antimicrobial resistance: a survey of UK livestock veterinarians’ perceptions and practices

This is the author accepted manuscript. The final version is available from BMJ Publishing Group via the DOI in this recordBackground This paper explores the current role and place of diagnostic tests in the treatment of farm animal disease. With the growing focus on reduced reliance on antibiotic medicines in both animal and human patient care, attention is increasingly being focused on the practice, the technology and the function of diagnostic tests and how these can support responsible antimicrobial use. Emerging diagnostic technologies offer the possibility of more rapid testing for bacterial disease, while food chain actors and others are increasingly seeking to make diagnostic tests mandatory before the use of critically important antibiotics. Method This paper reports the findings of a recent large-scale online survey of UK farm animal veterinarians (n=153) which investigated current veterinary diagnostic practice with particular attention to the relationship between diagnostic test use and antibiotic treatment. Results Results revealed a range of factors that influence veterinary diagnostic practice and demonstrate the continuing importance of clinical observation and animal/herd knowledge in the selection of antibiotic treatment. Conclusion The findings identify a considerable ambivalence on the part of farm animal veterinarians regarding the current and future uses of rapid and point-of-care diagnostic tests as a means of improving clinical diagnosis and addressing inappropriate antibiotic medicine use.Economic and Social Research Council (ESRC

Clinical-pathological study on β-APP, IL-1β, GFAP, NFL, Spectrin II, 8OHdG, TUNEL, miR-21, miR-16, miR-92 expressions to verify DAI-diagnosis, grade and prognosis

Traumatic brain injury (TBI) is one of the most important death and disability cause, involving substantial costs, also in economic terms, when considering the young age of the involved subject. Aim of this paper is to report a series of patients treated at our institutions, to verify neurological results at six months or survival; in fatal cases we searched for βAPP, GFAP, IL-1β, NFL, Spectrin II, TUNEL and miR-21, miR-16, and miR-92 expressions in brain samples, to verify DAI diagnosis and grade as strong predictor of survival and inflammatory response. Concentrations of 8OHdG as measurement of oxidative stress was performed. Immunoreaction of β-APP, IL-1β, GFAP, NFL, Spectrin II and 8OHdG were significantly increased in the TBI group with respect to control group subjects. Cell apoptosis, measured by TUNEL assay, were significantly higher in the study group than control cases. Results indicated that miR-21, miR-92 and miR-16 have a high predictive power in discriminating trauma brain cases from controls and could represent promising biomarkers as strong predictor of survival, and for the diagnosis of postmortem traumatic brain injury

Excluding pulmonary embolism in primary care using the Wells-rule in combination with a point-of care D-dimer test: a scenario analysis

ABSTRACT: BACKGROUND: In secondary care the Wells clinical decision rule (CDR) combined with a quantitative D-dimer test can exclude pulmonary embolism (PE) safely. The introduction of point-of-care (POC) D-dimer tests facilitates a similar diagnostic strategy in primary care. We estimated failure-rate and efficiency of a diagnostic strategy using the Wells-CDR combined with a POC-D-dimer test for excluding PE in primary care. We considered ruling out PE safe if the failure rate was <2% with a maximum upper confidence limit of 2.7%. METHODS: We performed a scenario-analysis on data of 2701 outpatients suspected of PE. We used test characteristics of two qualitative POC-D-dimer tests, as derived from a meta-analysis and combined these with the Wells-CDR-score. RESULTS: In scenario 1 (SimpliRed-D-dimer sensitivity 85%, specificity 74%) PE was excluded safely in 23.8% of patients but only by lowering the cut-off value of the Wells rule to <2. (failure rate: 1.4%, 95% CI 0.6-2.6%) In scenario 2 (Simplify-D-dimer sensitivity 87%, specificity 62%) PE was excluded safely in 12.4% of patients provided that the Wells-cut-off value was set at 0. (failure rate: 0.9%, 95% CI 0.2-2.6%) CONCLUSION: Theoretically a diagnostic strategy using the Wells-CDR combined with a qualitative POC-D-dimer test can be used safely to exclude PE in primary care albeit with only moderate efficienc

Surviving Mousepox Infection Requires the Complement System

Poxviruses subvert the host immune response by producing immunomodulatory proteins, including a complement regulatory protein. Ectromelia virus provides a mouse model for smallpox where the virus and the host's immune response have co-evolved. Using this model, our study investigated the role of the complement system during a poxvirus infection. By multiple inoculation routes, ectromelia virus caused increased mortality by 7 to 10 days post-infection in C57BL/6 mice that lack C3, the central component of the complement cascade. In C3−/− mice, ectromelia virus disseminated earlier to target organs and generated higher peak titers compared to the congenic controls. Also, increased hepatic inflammation and necrosis correlated with these higher tissue titers and likely contributed to the morbidity in the C3−/− mice. In vitro, the complement system in naïve C57BL/6 mouse sera neutralized ectromelia virus, primarily through the recognition of the virion by natural antibody and activation of the classical and alternative pathways. Sera deficient in classical or alternative pathway components or antibody had reduced ability to neutralize viral particles, which likely contributed to increased viral dissemination and disease severity in vivo. The increased mortality of C4−/− or Factor B−/− mice also indicates that these two pathways of complement activation are required for survival. In summary, the complement system acts in the first few minutes, hours, and days to control this poxviral infection until the adaptive immune response can react, and loss of this system results in lethal infection