BRICS health and tuberculosis control collaborations during an era of global health

In this think piece, I examine the difference introduced by BRICS (Brazil, Russia, India, China, and South Africa) health collaborations in an era of global health. Using tuberculosis control as a grounding example, I show that BRICS collaborations prioritize: state-led solutions, particularly through policies aimed at expanding universal health coverage; scientific and programmatic innovation; experience and technology sharing; clear benchmarks for progress, based on current best practices of control; and flexibility. Unlike international health, BRICS health collaborations are not primarily concerned with preventing the importation of infectious disease across national borders. Nor are they based on global health’s concerns about global biosecurity or humanitarian biomedicine. Rather, BRICS collaborative health efforts fall within the nation-state paradigm, while also aspiring towards the global. They remain flexible in their operation, gesturing towards a neoliberal ethic. This flexibility allows BRICS to work within existing structures, while also establishing their own institutions from which to change traditional assistance relationships

Fatigue after traumatic brain injury: a systematic review.

Health and self-regulatio

Burden of Care Implications and Association of Intracranial Hypertension With Extremely Severe Post-traumatic Amnesia After Traumatic Brain Injury: A 5-Year Retrospective Longitudinal Study

Post-traumatic amnesia (PTA) is characterized by a state of disorientation and confusion following traumatic brain injury (TBI). Few studies have looked at the effect of prolonged PTA on the functional outcomes beyond 1 year post-injury. This study aims to evaluate the burden of care in individuals with extremely severe PTA (esPTA; PTA >28 days) from acute inpatient rehabilitation admission to 5 years post-injury as well as the association between intracranial hypertension (ICH; Intracranial pressure (ICP) ≥20 mmHg) and esPTA status. Three hundred and forty-two individuals with moderate to severe TBI enrolled in the Northern California TBI Model System (TBIMS) of Care were included in this study. The FIM® instrument was chosen as the outcome measurement as it is a widely used functional assessment in the rehabilitation community. Repeated measure ANOVA revealed greater burden of care based on FIM® total scores (p < 0.001) from admission to 5-year follow-up for the esPTA group compared to the non-esPTA group (PTA ≤ 28 days). Unlike the non-esPTA group where FIM® total score plateaued 1 year post-injury, FIM® total score continued to improve up to 2 years post-injury for the esPTA group. The odds of developing esPTA was ~3 times higher for individuals with ICH vs. individuals without ICH (p < 0.001). In conclusion, individuals with esPTA have increased short- and long-term burden of care and the presence of ICH during hospitalization increased the odds of experiencing esPTA. These results may help the rehabilitation team and family in planning care post rehabilitation discharge

Engaging avian influenza: the uncertainties and pragmatics of pandemic preparedness in Hong Kong-SAR

This thesis investigates the avian influenza pandemic preparedness project in Hong Kong Special Administrative Region (SAR). I explore how the state, through its policies, practices, and actors, engages with the uncertainty posed by a future avian influenza pandemic by forming preparedness protocols that seek to mitigate portended misfortunes in pragmatic ways. I contextualize current preparedness practices into a history of infectious disease management in Hong Kong. Media reports and interviews elucidate nuances between state discourse on avian influenza and state healthcare actors‟ personal perceptions and practices. I argue that an engagement with the uncertain is fundamental to the very existence of avian influenza as a powerfully real social entity. While fissures and points of contradiction are evident, the logic underpinning pandemic preparedness remains intact, allowing for the continued existence of avian influenza despite its prolonged low incidence of human infection and continued uncertainty.Ce mémoire porte sur le plan d'action en prévision d'une pandémie de grippe aviaire dans la région administrative spéciale de Hong Kong. J'examine les engagements de l'état face à l'incertitude d'une eventuelle pandémie de grippe aviaire à travers les politiques, les pratiques et les acteurs qui contribuent à des mesures pragmatiques pour mitiger des malheurs potentiels. Ces mesures sont considerées dans le contexte historique de la gestion des maladies infectieuses à Hong Kong. Des entrevues servent à démontrer les nuances entre le discours étatique sur la grippe aviaire et les perceptions et les pratiques individuelles du personnel de santé de l'état. Un engagement avec l'incertitude est au coeur de l'existence de la grippe aviaire comme une entité sociale puissante. Malgré des ruptures et des contradictions, la logique sous-jacente des mésures et des plans contre la pandémie demeure intacte, et elle assure la perénnité de la grippe aviaire malgré son faible incidence d'infection chez les humains et les incertitudes qui l'entoure

Habitat, directional orientation, and entrance diameter preference of northern Michigan parasitoid larvae provisioning.

We explored northern Michigan parasitoids by looking at three factors that may afect larvae provisioning: habitat, direction, and provision entrance diameter. We distributed 275 wooden blocks over two habitats, lakeside and woods-edge, and allowed provisioning to occur over approximately 40 days. In fastening blocks to trees, we orientated blocks in three directions: North-South, East-West, and Vertical. Diameter of the prepared hole in blocks where provision occurred was noted upon collection of provisioned. Parasitoids preferred the woods-edge site over the lakeside site for larvae provisioning (Mann-Whitney U, U=10435.5, p=0.004). Parasitoids showed no preference in the orientation of the wooden blocks (Kruskal-Wallis, p>0.05) or for entrance diameter (Chi-Squared, p>0.05) for larval provisioning.http://deepblue.lib.umich.edu/bitstream/2027.42/55010/1/3451.pdfDescription of 3451.pdf : Access restricted to on-site users at the U-M Biological Station

Controlling tuberculosis then and now: Chinese public health policymaking and problematizations in an era of global health

Based on two years of multi-sited, mixed-methods anthropological field research in mainland China, in this dissertation I examine the Chinese state-led project to control tuberculosis. My dissertation is divided into two parts. In Part One, I draw on extensive archival research to investigate two roughly concomitant histories, informed by conversations with public health experts. I first utilize the history of tuberculosis control (1882 to present) as a window to trace the transition from an international health paradigm to global health. I then examine the conceptual linkage between tuberculosis and society in China, as it has developed from the Republican Era to the present. I argue that while global health paradigms move away from a state-based approach to health, in China, a nationalized system for tuberculosis control has only emerged since 2002. In Part Two, I present an ethnographic account of contemporary tuberculosis control in China, drawing on fieldwork conducted mostly in Kunming, Yunnan Province. I begin by examining two demographic groups continually raised by Chinese public health experts as challenges to national control efforts: rural peasants and urban migrants. I posit that under the household registration system, state categories of people, place, and employment become bound together in what I term the “citizenship tripartite.” However, reforms since the late 1970s have introduced neoliberal economic forces and a new sense of time that “misaligns” the citizenship tripartite so that in the eyes of the state peasants are the “people who remain in place yet out of time,” and migrants are those “out of place but in time.” I go on to examine what I term “the price of free,” that is the cost incurred by patients despite the availability of free diagnostic and treatment policies under the national tuberculosis plan (NTP). I argue a focus on individual patient experience and the “unintended expenditures” associated with tuberculosis care should be contextualized within larger epidemiological trends.Cette thèse porte sur le projet de contrôle de la tuberculose du gouvernement chinois. Elle est basée sur deux ans de recherches de terrain multi-site aux méthodologies mixtes. La thèse est divisée en deux parties. La première partie s’appuie sur des recherches d’archives et des entretiens avec des experts en santé publique. En analysant les programmes de contrôle de la tuberculose (de 1882 au moment présent) on peut tracer la transition d’un paradigme de santé internationale vers un de santé mondiale. Ensuite, nous examinerons les liens conceptuels entre la tuberculose et la société chinoise de l’ère républicaine au moment présent. Tandis que les paradigmes de santé mondiale s’éloignent des approches étatiques à la santé, un système national pour le contrôle de la tuberculose en Chine n’existe que depuis l’an 2002.La deuxième partie de la thèse présente un portrait ethnographique d’un programme de contrôle de la tuberculose. Suite à des recherches de terrain menées principalement à Kunming, dans la province du Yunnan, notre regard porte sur deux groupes qui sont souvent identifiés par des experts chinois en santé publique comme posant des défis au programmes nationaux de contrôle de la tuberculose : les paysans ruraux et les migrants urbains. Nous argumentons que le système d’enregistrement des ménages lie les catégories étatiques de personne, lieu et emploi dans une « citoyenneté tripartite ». Par contre, des reformes depuis la fin des années 1970 ont ouvert la porte aux forces économique néolibérales et une nouvelle notion du temps qui désaligne cette citoyenneté tripartite, faisant des paysans des personnes « en lieu mais hors temps » et des migrants des personnes « hors lieu mais dans le temps. » Pas la suite, nous décrirons le « prix du gratuit », c’est à dire le coûts engendrées par les patients malgré les politiques de dépistage et traitement gratuits du plan national de tuberculose (NTP). Nous argumentons que cette attention aux vécus de patients individuels et leurs dépenses imprévues doit être contextualisée dans le cadre de tendances épidémiologiques plus larges