‘Language becomes the only “home” to inhabit when all else is lost’: censorship, exile, and identity in the works of Haifa Zangana

This thesis explores the themes of exile, identity, and censorship in Haifa Zangana’s literary work, the first sustained analysis of her literary oeuvre. This includes a memoir, Dreaming of Baghdad; a novel, Women on a Journey; an Iraqi woman’s account of war and resistance, City of Widows; a chapter she wrote in an edited collection against the Iraq occupation called ‘The Torturer in the Mirror’; and, finally, a collage titled Map of Destruction. A postcolonial theoretical framework is used to scaffold my reading of these texts and is nuanced by the use of Michel Foucault’s theory of biopower. This approach to the context of Zangana’s work has facilitated an exploration of the exertion of systemic power over the people of Iraq. This thesis highlights how Zangana’s literary work offers critique of Saddam Hussein and the US occupation of Iraq, and their role in exile, identity, and censorship, which in turn produces collective memory and mourning. This thesis concludes that Zangana’s writing amplifies the collective voice, which has been suppressed due to the weaponization of the Iraqi identity; her work helps us understand how ordinary lives have been uprooted in the fight for freedom

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk–outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk-outcome associations. METHODS: We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Stanaway JD, Afshin A, Gakidou E, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1923-1994.Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk outcome pairs, and new data on risk exposure levels and risk outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017,34.1 million (95% uncertainty interval [UI] 33.3-35.0) deaths and 121 billion (144-1.28) DALYs were attributable to GBD risk factors. Globally, 61.0% (59.6-62.4) of deaths and 48.3% (46.3-50.2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10.4 million (9.39-11.5) deaths and 218 million (198-237) DALYs, followed by smoking (7.10 million [6.83-7.37] deaths and 182 million [173-193] DALYs), high fasting plasma glucose (6.53 million [5.23-8.23] deaths and 171 million [144-201] DALYs), high body-mass index (BMI; 4.72 million [2.99-6.70] deaths and 148 million [98.6-202] DALYs), and short gestation for birthweight (1.43 million [1.36-1.51] deaths and 139 million [131-147] DALYs). In total, risk-attributable DALYs declined by 4.9% (3.3-6.5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23.5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18.6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd

Women and activism : Indian Muslim women's responses to apartheid South Africa

Bibliography: leaves 125-128

Sex and the legal subject: woman and legal capacity in Hanafi law

This study of ahliyya (legal capacity), illustrates how femaleness features as a category of law and further how sex difference determines the legal capacities of women. It originates in concerns for equality in South African debates on state recognition of Muslim marriage. Theoretically and methodologically, it is located in the interdisciplinary space of feminist studies and Islamic law, draws on feminist theories of sex difference and employs feminist methods of reading texts to theorise the differential treatment of women in classical and contemporary legal theory (uṣūl al-fiqh) and positive law (furū‘ al-fiqh). Reading classical legal theory texts taught in a Ḥanafī madrasas and contemporary adaptations of classical law I make apparent the ‘imaginary configurations', ‘metaphoric networks' and points of tension through which the texts convey ideas about the woman of Islamic law.In the complex formulation of the female legal subject I find that classical Ḥanafī legal theory does not explicitly distinguish female legal capacity from male legal capacity; femaleness does not feature amongst the nineteen impediments to legal capacity. Nonetheless classical legal theory and positive law both distinguish between male and female legal subjects. The challenge in studying legal capacity and sex difference is to ponder the intersection of these two paradigms, the theoretical non-distinction of women's legal capacity from other forms of legal capacity and the distinctions between men and women in positive law generally. I find that the normative legal subject of the historical law is a free, adult, male yet, unlike the enslaved male and the infant or minor male, the female legal subject is not similarly distinguished by virtue of a differentiated category of legal capacity; gender is not a distinguishing legal category of the theoretical legal subject. Implicitly, however, in the classical legal text social norms come to work as natural conditions that attach to ideas of femaleness. Accordingly, it is incorrect to assume the absence of a distinctive category results in the absence of distinctive legal subjectivity for women. Rather distinctive legal capacity does not necessarily arise from a distinct category of legal incapacity. Instead, the law locates bodies in a matrix of other social categories, viz. reason, age, social class, life experience and marital status, so as to disrupt the symmetry of biology and sex differentiated legal capacity. It relies instead on a discursive construction of femaleness that formulates uneven legal capacities for women. The social facts that attach to women's bodies inform us of the ideological system that produces the female subject of the legal text. Contemporary legal theory, contrary to its classical precursor, either imposes severe restrictions upon women as legal subjects or pretends to the absence of distinction between female and male legal subjects. The pretense denies the differential treatment of women in the law while the restrictions result in a category of ‘imperfect legal capacity' for women. Further, comparing classical and contemporary approaches, the former frames a distinct but discursive female legal subject, multiply and situationally constituted. However, both historical and modern approaches occlude the obvious impediment to legal capacity that marriage effects on female legal subjects, notably limitations on a wife's legal capacities within the marriage and the marital authority of husbands to manage the sociality, mobility, and spirituality of wives, ownership of the marital bond being a uniquely male legal capacity. Finally, contemporary legal theory frames inflexible determinates of female legal subjectivity and eventually produces essentialist and existential understandings of women. This illustrates the modern representation of women's legal capacity as not merely a modern manifestation of historical legal thought, but indeed modern in its origin and formation.Cette étude découle du souci d'équité dans les débats sud-africains quant à la reconnaissance étatique du mariage musulman. D'un point de vue théorique et méthodologique, le projet se situe dans le champ interdisciplinaire des études féministes et du droit islamique. Il puise dans les théories féministes sur les différences entre les sexes et emploie des méthodes féministes de lecture des textes pour théoriser le traitement différentiel des femmes dans les théories classique et contemporaine des sources du droit (uṣūl al-fiqh) et le droit positif (furū‘ al-fiqh). Une lecture des textes classiques faisant partie du curriculum d'une madrasa ḥanafite ainsi que des adaptations contemporaines du droit classique nous a permis de dégager les configurations imaginaires, les réseaux métaphoriques et les points de tension que portent ces textes au sujet de la femme dans le droit islamique. Avec le traitement d'al-ahliyya (la capacité juridique) comme point focal, nous avons exploré comment la féminité est considérée comme une catégorie du droit et comment la différence de sexe détermine la capacité juridique de la femme. Rendant compte de la complexité de la femme en tant que personnalité juridique, nous constatons que la théorie classique des sources du droit n'établit pas une distinction explicite entre la capacité juridique de l'homme et celle de la femme. En effet, la féminité ne figure pas parmi les dix-neuf empêchements à la capacité juridique. Toutefois, autant la théorie classique des sources du droit ('usûl al-fiqh) que le droit positif (furû` al-fiqh) distinguent entre les sujets de droit mâle et femelle. L'étude de la capacité juridique et des différences entre les sexes pose l'enjeu d'une réflexion sur la croisée de ces deux paradigmes, à savoir l'absence de distinction théorique entre la capacité juridique de la femme et les autres catégories de capacité juridique et la différenciation entre l'homme et la femme dans le droit positif islamique en général. Nous remarquons que le sujet de droit normatif du droit islamique classique est un mâle adulte libre. Cependant, contrairement à l'esclave mâle ou encore à l'enfant mâle mineur, le sujet de droit femelle n'est pas l'objet d'un traitement spécifique en termes de formes différentielles de sa capacité juridique. Selon les usages provenant des normes linguistiques et des pratiques juridiques, le genre n'est pas considéré comme une caractéristique juridique distincte du sujet de droit. Néanmoins, dans le texte juridique les normes sociales fonctionnent comme des conditions naturelles liées à des idées concernant la féminité. Ainsi, il serait erroné de présumer que l'absence d'une catégorie distincte donne lieu inévitablement à l'absence d'une subjectivité juridique distincte. Certes, le droit traite essentiellement du corps, mais il le situe au sein d'une matrice d'autres catégories sociales, à savoir : la raison, l'âge, la classe sociale, l'expérience de vie et la situation matrimoniale troublant ainsi la symétrie entre la biologie et la capacité juridique différenciée selon le sexe. Il repose sur une construction discursive de la féminité qui établit des capacités juridiques différentes pour la femme. Les faits sociaux reliés au corps de la femme nous éclaircissent quant au système idéologique qui donne lieu au sujet féminin du texte juridique. La théorie contemporaine des sources du droit, contrairement à son précurseur classique, impose de sérieuses restrictions aux femmes en tant que sujets de droit ou prétend l'absence de distinction entre les femmes et les hommes en tant que sujets légaux. Les restrictions se basent sur des idées concernant la féminité, associées au corps de la femme, et définissent une catégorie pour les femmes dite de «capacité juridique imparfaite». L'allégation nie le traitement différentiel des femmes dans le droit

Volumetric structural magnetic resonance imaging findings in pediatric posttraumatic stress disorder and obsessive compulsive disorder : a systematic review

Publication of this article was funded by the Stellenbosch University Open Access Fund.The original publication is available at http://www.frontiersin.org/PsychologyObjectives: Structural magnetic resonance imaging (sMRI) studies of anxiety disorders in children and adolescents are limited. Posttraumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD) have been best studied in this regard.We systematically reviewed structural neuroimaging findings in pediatric PTSD and OCD. Methods:The literature was reviewed for all sMRI studies examining volumetric parameters using PubMed, ScienceDirect, and PsychInfo databases, with no limit on the time frame of publication. Nine studies in pediatric PTSD and six in OCD were suitable for inclusion. Results: Volumetric findings were inconsistent in both disorders. In PTSD, findings suggest increased as well as decreased volumes of the prefrontal cortex (PFC) and corpus callosum; whilst in OCD studies indicate volumetric increase of the utamen, with inconsistent findings for the anterior cingulate cortex (ACC) and frontal regions. Conclusions: ethodological differences may account for some of this inconsistency and additional volume-based studies in pediatric anxiety disorders using more uniform approaches are needed.Stellenbosch University Open Access FundPublishers' versio

Effects of HIV and childhood trauma on brain morphometry and neurocognitive function.

A wide spectrum of neurocognitive deficits characterises HIV infection in adults. HIV infection is additionally associated with morphological brain abnormalities affecting neural substrates that subserve neurocognitive function. Early life stress (ELS) also has a direct influence on brain morphology. However, the combined impact of ELS and HIV on brain structure and neurocognitive function has not been examined in an all-female sample with advanced HIV disease. The present study examined the effects of HIV and childhood trauma on brain morphometry and neurocognitive function. Structural data were acquired using a 3T Magnetom MRI scanner, and a battery of neurocognitive tests was administered to 124 women: HIV-positive with ELS (n = 32), HIV-positive without ELS (n = 30), HIV-negative with ELS (n = 31) and HIV-negative without ELS (n = 31). Results revealed significant group volumetric differences for right anterior cingulate cortex (ACC), bilateral hippocampi, corpus callosum, left and right caudate and left and right putamen. Mean regional volumes were lowest in HIV-positive women with ELS compared to all other groups. Although causality cannot be inferred, findings also suggest that alterations in the left frontal lobe, right ACC, left hippocampus, corpus callosum, left and right amygdala and left caudate may be associated with poorer neurocognitive performance in the domains of processing speed, attention/working memory, abstraction/executive functions, motor skills, learning and language/fluency with these effects more pronounced in women living with both HIV and childhood trauma. This study highlights the potential contributory role of childhood trauma to brain alterations and neurocognitive decline in HIV-infected individuals