Improving Breast Cancer Control via the Use of Community Health Workers in South Africa: A Critical Review

Breast cancer is a growing concern in low- and middle-income countries (LMCs). We explore community health worker (CHW) programs and describe their potential use in LMCs. We use South Africa as an example of how CHWs could improve access to breast health care because of its middle-income status, existing cancer centers, and history of CHW programs. CHWs could assume three main roles along the cancer control continuum: health education, screening, and patient navigation. By raising awareness about breast cancer through education, women are more likely to undergo screening. Many more women can be screened resulting in earlier-stage disease if CHWs are trained to perform clinical breast exams. As patient navigators, CHWs can guide women through the screening and treatment process. It is suggested that these roles be combined within existing CHW programs to maximize resources and improve breast cancer outcomes in LMCs

The Chlamydomonas reinhardtii proteins Ccp1 and Ccp2 are required for long-term growth, but are not necessary for efficient photosynthesis, in a low-CO\u3csub\u3e2\u3c/sub\u3e environment

The unicellular green alga Chlamydomonas reinhardtii acclimates to a low-CO2 environment by modifying the expression of a number of messages. Many of the genes that increase in abundance during acclimation to low-CO2 are under the control of the putative transcription factor Cia5. C. reinhardtii mutants null for cia5 do not express several of the known low-CO2 inducible genes and do not grow in a low-CO2 environment. Two of the genes under the control of Cia5, Ccp1 and Ccp2, encode polypeptides that are localized to the chloroplast envelope and have a high degree of similarity to members of the mitochondrial carrier family of proteins. Since their discovery, Ccp1/2 have been candidates for bicarbonate uptake proteins of the chloroplast envelope membrane. In this report, RNA interference was successful in dramatically decreasing the abundance of the mRNAs for Ccp1 and Ccp2. The abundance of the Ccp1 and Ccp2 proteins were also reduced in the RNAi strains. The RNAi strains grew slower than WT in a low-CO2 environment, but did not exhibit a mutant carbon concentrating phenotype as determined by the cells\u27 apparent affinity for dissolved inorganic carbon. Possible explanations of this RNAi phenotype are discussed

Embodied learning: Responding to AIDS in Lesotho's education sector

This is an Author's Accepted Manuscript of an article published in Children's Geographies, 7(1), 2009. Copyright @ 2009 Taylor & Francis, available online at: http://www.tandfonline.com/doi/abs/10.1080/14733280802630981.In contrast to pre-colonial practices, education in Lesotho's formal school system has historically assumed a Cartesian separation of mind and body, the disciplining of students' bodies serving principally to facilitate cognitive learning. Lesotho has among the highest HIV-prevalence rates worldwide, and AIDS has both direct and indirect impacts on the bodies of many children. Thus, students' bodies can no longer be taken for granted but present a challenge for education. Schools are increasingly seen as a key point of intervention to reduce young people's risk of contracting the disease and also to assist them to cope with its consequences: there is growing recognition that such goals require more than cognitive learning. The approaches adopted, however, range from those that posit a linear and causal relationship between knowledge, attitudes and practices (so-called ‘KAP’ approaches, in which the role of schools is principally to inculcate the pre-requisite knowledge) to ‘life skills programmes’ that advocate a more embodied learning practice in schools. Based on interviews with policy-makers and practitioners and a variety of documentary sources, this paper examines a series of school-based AIDS interventions, arguing that they represent a less radical departure from ‘education for the mind’ than might appear to be the case. The paper concludes that most interventions serve to cast on children responsibility for averting a social risk, and to ‘normalise’ aberrant children's bodies to ensure they conform to what the cognitively-oriented education system expects

Beings in their own right? Exploring Children and young people's sibling and twin relationships in the Minority World

This paper examines the contributions that the sociological study of sibship and twinship in the Minority World can make to childhood studies. It argues that, in providing one forum within which to explore children and young people's social relationships, we can add to our understanding of children and young people's interdependence and develop a more nuanced understanding of agency. As emergent subjects, children, young people and adults are in a process of ‘becoming’. However, this does not mean that they can ‘become’ anything they choose to. The notion of negotiated interdependence (Punch 2002) is useful in helping us to grasp the contingent nature of children and young people's agency

Precise Determination of Proton Spin-Precession Angles in the K600 Spectrometer and Beamline

This research was sponsored by the National Science Foundation Grant NSF PHY-931478

Childhood and the politics of scale: Descaling children's geographies?

This is the post-print version of the final published paper that is available from the link below. Copyright @ 2008 SAGE Publications.The past decade has witnessed a resurgence of interest in the geographies of children's lives, and particularly in engaging the voices and activities of young people in geographical research. Much of this growing body of scholarship is characterized by a very parochial locus of interest — the neighbourhood, playground, shopping mall or journey to school. In this paper I explore some of the roots of children's geographies' preoccupation with the micro-scale and argue that it limits the relevance of research, both politically and to other areas of geography. In order to widen the scope of children's geographies, some scholars have engaged with developments in the theorization of scale. I present these arguments but also point to their limitations. As an alternative, I propose that the notion of a flat ontology might help overcome some difficulties around scalar thinking, and provide a useful means of conceptualizing sociospatiality in material and non-hierarchical terms. Bringing together flat ontology and work in children's geographies on embodied subjectivity, I argue that it is important to examine the nature and limits of children's spaces of perception and action. While these spaces are not simply `local', they seldom afford children opportunities to comment on, or intervene in, the events, processes and decisions that shape their own lives. The implications for the substance and method of children's geographies and for geographical work on scale are considered

The discursive construction of childhood and youth in AIDS interventions in Lesotho's education sector: Beyond global-local dichotomies

This is the post-print version of this article. The definitive, peer-reviewed and edited version of this article is published in Environment and Planning D,Society and Space 28(5) 791 – 810, 2010, available from the link below. Copyright @ 2010 Pion.In southern Africa interventions to halt the spread of AIDS and address its social impacts are commonly targeted at young people, in many cases through the education sector. In Lesotho, education-sector responses to AIDS are the product of negotiation between a range of ‘local’ and ‘global’ actors. Although many interventions are put forward as government policy and implemented by teachers in schools, funding is often provided by bilateral and multilateral donors, and the international ‘AIDS industry’—in the form of UN agencies and international NGOs—sets agendas and makes prescriptions. This paper analyses interviews conducted with policy makers and practitioners in Lesotho and a variety of documents, critically examining the discourses of childhood and youth that are mobilised in producing changes in education policy and practice to address AIDS. Focusing on bursary schemes, life-skills education, and rights-based approaches, the paper concludes that, although dominant ‘global’ discourses are readily identified, they are not simply imported wholesale from the West, but rather are transformed through the organisations and personnel involved in designing and implementing interventions. Nonetheless, the connections through which these discourses are made, and children are subjectified, are central to the power dynamics of neoliberal globalisation. Although the representations of childhood and youth produced through the interventions are hybrid products of local and global discourses, the power relations underlying them are such that they, often unintentionally, serve a neoliberal agenda by depicting young people as individuals in need of saving, of developing personal autonomy, or of exercising individual rights.RGS-IB

Gender Differences in Experiences and Expectations of Hemodialysis in a Frail and Seriously Unwell Patient Population.

Surprisingly few studies have explored the experiences of seriously unwell people with kidney disease on hemodialysis therapy: we conducted a mixed-methods study to investigate gender differences in illness experience, symptom burden, treatment considerations or expectations in this cohort. Seriously unwell people on hemodialysis (1-year mortality risk of >20%) at 3 hospital-based units were invited to take part in a structured interview or to complete the same questions independently via a questionnaire. A total of 54 people took part (36 males, 18 females); data analysis was undertaken using a thematic approach. "Desire to keep living" is the most important and basic thought process when starting dialysis. Fear also predominates influencing risk assessment and decision-making. Once fear is managed, there are physical, social, practical and emotional issues to rationalize, but choice only seems possible if shared decision-making is part of the consultation.Gender differences were seen in perceived hopes and expectations of treatment. Males were more likely to prioritize achievement of physical goals, with females prioritizing a wish to feel well. Both genders reported significantly higher symptom scores than their health care provider perceived, however this difference was more marked in females. Dialysis regret existed in >50% of participants and 6 out of 54 (11%) stated that they would have chosen no dialysis at all. Females were more likely to report feeling depressed (  = 0.001). Different genders approach treatment decisions and prioritize treatment expectations differently. Recognizing this will allow personalized care plans to be developed and improve the experiences of seriously unwell people with kidney disease. [Abstract copyright: © 2022 International Society of Nephrology. Published by Elsevier Inc.

Gender differences in experiences and expectations of haemodialysis in a frail and seriously unwell patient population

Introduction Surprisingly few studies have explored the experiences of seriously unwell people with kidney disease on haemodialysis therapy: we conducted a mixed-methods study to investigate gender differences in illness experience, symptom burden, treatment considerations or expectations in this cohort. Methods Seriously unwell people on haemodialysis (1-year mortality risk of >20%) at three hospital-based units were invited to take part in a structured interview or to complete the same questions independently via a questionnaire. 54 people took part (36 males, 18 females); data analysis was undertaken using a thematic approach. Results ‘Desire to keep living’ is the most important and basic thought process when starting dialysis. Fear also predominates influencing risk assessment and decision-making. Once fear is managed, there are physical, social, practical and emotional issues to rationalise, but choice only seems possible if shared decision-making is part of the consultation. Gender differences were seen in perceived hopes and expectations of treatment. Males were more likely to prioritise achievement of physical goals, with females prioritising a wish to feel well. Both genders reported significantly higher symptom scores than their healthcare provider perceived, however this difference was more marked in females. Dialysis regret existed in >50% of participants and 6/54 (11%) stated that they would have chosen no dialysis at all. Females were more likely to report feeling depressed (P=0.001). Conclusion Different genders approach treatment decisions and prioritise treatment expectations differently. Recognising this will allow personalised care plans to be developed and improve the experiences of seriously unwell people with kidney disease

Understanding children’s constructions of meanings about other children: implications for inclusiveeducation

This paper explores the factors that influence the way children construct meanings about other children, and especially those who seem to experience marginalisation, within school contexts. The research involved an ethnographic study in a primary school in Cyprus over a period of 5 months. Qualitative methods were used, particularly participant observations and interviews with children. Interpretation of the data suggests that children's perceptions about other children, and especially those who come to experience marginalisation, are influenced by the following factors: other children and the interactions between them; adults’ way of behaving in the school; the existing structures within the school; and the cultures of the school and the wider educational context. Even though the most powerful factor was viewed to be the adults’ influence, it was rather the interweaving between different factors that seemed to lead to the creation of particular meanings for other children. In the end, it is argued that children's voices should be seen as an essential element within the process of developing inclusive practices.<br/