The politics of ornament Modernity, Identity, and Nationalism in the Decorative Programmes of Selected South African Public and Commercial Buildings 1930 – 1940

Student Number : 8546313 - PhD thesis - School of Arts - Faculty of HumanitesThis thesis interrogates the extent to which the façades of, and decorative programmes in, selected South African public and commercial buildings erected during the decade 1930 – 40 may be understood as important indexes of the various ideological, social and historical concerns underpinning the construction of an imaginary of national belonging during this period. In the context of rapid urbanisation, burgeoning industrialisation, and rampant capitalism that characterise the period, issues of nationalism and political power are brought into sharp relief, with three political agendas competing for dominance: Afrikaner nationalism at one extreme and British imperialism at the other, with, from 1933 to the end of the decade, the insipid ‘South Africa First’ nationalism of the Smuts-Hertzog ‘fusion’ government occupying a highly contested space somewhere between the two. I argue in this thesis that the rhetoric of ‘unity in diversity’ that informs the fusion politics of the 1930s, and particularly its expression in the decorative programmes of public buildings provides for a more nuanced reading of the political and cultural landscape of 1930s South Africa than has been the case to date, where the focus has tended towards deconstructing the cultural nationalism of the 1930s in terms of the rise of Afrikaner nationalism. Moreover, it also serves as a compelling reference point against which to assess contemporary South African attempts to re-narrate notions of nationhood, and the extent to which difficult arguments around ethnicity, autochthony, and the construction of imaginary new ‘publics’ are articulated in post-apartheid public architecture. Chapter 1 is a review of the literature that informs this thesis; both as regards the art historical discourse on South African inter-World War art and architecture, as well as theoretical issues arising from writing on nationalism, national identity, and the role that art and architecture plays in evolving the nation code. In Chapters 2 and 3, I consider the ways in which the notions of identity arising from fusion politics are played out in the decorative programmes of two significant public buildings, South Africa House in London (1933) in Chapter 2 and the Pretoria City Hall (1935) in Chapter 3. I argue that both these buildings are classic examples of the manifestation in architectural terms of the hybrid identity being forged by the centrist ‘South Africa first’ ideologues, in so far as their decorative programmes express an uncomfortable alliance between the entrenched values of British imperialism and a burgeoning Afrikaner nationalism. In Chapter 4, I contrast the decorative programme of the headquarters of the new Afrikaner insurance companies SANTAM and SANLAM (1932) with that of the new corporate headquarters of the Commercial Union Assurance Company (1932), a British owned firm that had had a presence in Cape Town since 1863. The differences in effect of the decorative programmes of these two buildings serve to illuminate the extent of the ideological posturing of volkskapitalisme and its construction of a ‘modern African/Afrikaner’ identity within the imperialist heartland of Cape Town. These debates are brought into sharp relief by the third example discussed in this chapter, the Old Mutual building (1940), the decorative programme of which effectively conflates these concerns with modernity and nationalism in order to construct a hybrid ‘South Africanism’ that neatly elides Boer and Brit imaginings. In conclusion, I show in Chapter 5 how the post-apartheid South African situation presents an interesting case study in terms of constructing an imaginary of national belonging rooted in similar notions of ‘unity in diversity’. Examples here include important national architectural commissions like the legislature buildings for the newly constituted provinces of Mpumalanga (1999) and the Northern Cape (2003), as well as the new Constitutional Court in Johannesburg (2004). In this chapter, I interrogate these debates, and conclude by pointing to parallels with the case studies from the 1930s. The post-1994 examples in question have been widely celebrated as exemplary of a new and appropriate response to the challenges of public building in democratic South Africa. I suggest, however, that the lessons of the 1930s should serve as a reminder that the ostensible dichotomy between ‘good’ (civic) and ‘bad’ (ethnic) nationalism is perhaps not as natural and obvious as it may appear, and that both are equally problematic

A randomized, double-blind, placebo-controlled trial of paracetamol and ketoprofren lysine salt for pain control in children with pharyngotonsillitis cared by family pediatricians

<p>Abstract</p> <p>Background</p> <p>To evaluate the analgesic effect and tolerability of paracetamol syrup compared to placebo and ketoprofen lysine salt in children with pharyngotonsillitis cared by family pediatricians.</p> <p>Methods</p> <p>A double-blind, randomized, placebo-controlled trial of a 12 mg/kg single dose of paracetamol paralleled by open-label ketoprofren lysine salt sachet 40 mg. Six to 12 years old children with diagnosis of pharyngo-tonsillitis and a Children's Sore Throat Pain (CSTP) Thermometer score > 120 mm were enrolled. Primary endpoint was the Sum of Pain Intensity Differences (SPID) of the CSTP Intensity scale by the child.</p> <p>Results</p> <p>97 children were equally randomized to paracetamol, placebo or ketoprofen. Paracetamol was significantly more effective than placebo in the SPID of children and parents (<it>P </it>< 0.05) but not in the SPID reported by investigators, 1 hour after drug administration. Global evaluation of efficacy showed a statistically significant advantage of paracetamol over placebo after 1 hour either for children, parents or investigators. Patients treated in open fashion with ketoprofen lysine salt, showed similar improvement in pain over time. All treatments were well-tolerated.</p> <p>Conclusions</p> <p>A single oral dose of paracetamol or ketoprofen lysine salt are safe and effective analgesic treatments for children with sore throat in daily pediatric ambulatory care.</p

A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study

© 2023Background: The benefit of pharmacogenetic testing before starting drug therapy has been well documented for several single gene–drug combinations. However, the clinical utility of a pre-emptive genotyping strategy using a pharmacogenetic panel has not been rigorously assessed. Methods: We conducted an open-label, multicentre, controlled, cluster-randomised, crossover implementation study of a 12-gene pharmacogenetic panel in 18 hospitals, nine community health centres, and 28 community pharmacies in seven European countries (Austria, Greece, Italy, the Netherlands, Slovenia, Spain, and the UK). Patients aged 18 years or older receiving a first prescription for a drug clinically recommended in the guidelines of the Dutch Pharmacogenetics Working Group (ie, the index drug) as part of routine care were eligible for inclusion. Exclusion criteria included previous genetic testing for a gene relevant to the index drug, a planned duration of treatment of less than 7 consecutive days, and severe renal or liver insufficiency. All patients gave written informed consent before taking part in the study. Participants were genotyped for 50 germline variants in 12 genes, and those with an actionable variant (ie, a drug–gene interaction test result for which the Dutch Pharmacogenetics Working Group [DPWG] recommended a change to standard-of-care drug treatment) were treated according to DPWG recommendations. Patients in the control group received standard treatment. To prepare clinicians for pre-emptive pharmacogenetic testing, local teams were educated during a site-initiation visit and online educational material was made available. The primary outcome was the occurrence of clinically relevant adverse drug reactions within the 12-week follow-up period. Analyses were irrespective of patient adherence to the DPWG guidelines. The primary analysis was done using a gatekeeping analysis, in which outcomes in people with an actionable drug–gene interaction in the study group versus the control group were compared, and only if the difference was statistically significant was an analysis done that included all of the patients in the study. Outcomes were compared between the study and control groups, both for patients with an actionable drug–gene interaction test result (ie, a result for which the DPWG recommended a change to standard-of-care drug treatment) and for all patients who received at least one dose of index drug. The safety analysis included all participants who received at least one dose of a study drug. This study is registered with ClinicalTrials.gov, NCT03093818 and is closed to new participants. Findings: Between March 7, 2017, and June 30, 2020, 41 696 patients were assessed for eligibility and 6944 (51·4 % female, 48·6% male; 97·7% self-reported European, Mediterranean, or Middle Eastern ethnicity) were enrolled and assigned to receive genotype-guided drug treatment (n=3342) or standard care (n=3602). 99 patients (52 [1·6%] of the study group and 47 [1·3%] of the control group) withdrew consent after group assignment. 652 participants (367 [11·0%] in the study group and 285 [7·9%] in the control group) were lost to follow-up. In patients with an actionable test result for the index drug (n=1558), a clinically relevant adverse drug reaction occurred in 152 (21·0%) of 725 patients in the study group and 231 (27·7%) of 833 patients in the control group (odds ratio [OR] 0·70 [95% CI 0·54–0·91]; p=0·0075), whereas for all patients, the incidence was 628 (21·5%) of 2923 patients in the study group and 934 (28·6%) of 3270 patients in the control group (OR 0·70 [95% CI 0·61–0·79]; p <0·0001). Interpretation: Genotype-guided treatment using a 12-gene pharmacogenetic panel significantly reduced the incidence of clinically relevant adverse drug reactions and was feasible across diverse European health-care system organisations and settings. Large-scale implementation could help to make drug therapy increasingly safe. Funding: European Union Horizon 2020