Bottom-up driven community empowerment: the case of African Communities in Australia

The idea of community empowerment has emerged as a possible response to the failure of welfare policies. However, there are arguments in the literature that there is a disconnection between empowerment theory and practice and that it is difficult to implement ‘empowerment’ approaches. In this thesis, a conceptual and analytical framework has been developed by integrating empowerment theorisation and institutional analysis to guide the conduct of research. Ethnographic case studies of African communities were conducted in South Australia, Tasmania and Victoria. For over a year, the researcher participated in community activities as a participant observer, conducted 50 interviews, attended more than 40 events, and collected relevant documents. The study suggests that the empowerment of migrant communities should be theorised in a new way – in relation to migration and settlement, community formation, and interactions among communities, governments and NGOs. The study demonstrated that contexts such as migration and settlement experiences affect the empowerment of African communities. Community formation is identified as the primary mechanism communities used to attain empowerment. The internal dynamics of communities, social conditions such as community partnerships, leadership and social incidents, cultural and financial resources, and existing rules and policies were found to influence the empowerment of African communities. Social incidents facilitated empowerment by creating political and social context for communities to gain support from governments and NGOs. The study identified governments and NGOs as the key external actors in the empowerment of African communities. These actors developed the resources and structures necessary for empowerment and their interactions with African communities shaped empowerment outcomes. These findings demonstrate that empowerment is attained through the creation of social, political, cultural and institutional space where power is shared with and not exercised over others – where it is relational and not necessarily confrontational. The study suggests that policies and programs that take into account the contexts and dynamics of communities are likely to succeed in achieving better empowerment outcomes for communities. The study contributes to knowledge both by providing an understanding of bottom-up driven community empowerment and by developing a conceptual and analytical framework that can guide empowerment studies. However, the generalisability of this study should be considered with caution due to its focus on African communities. Further studies that examine the perspectives of other communities and the roles of governments, NGOs and the private sector in the empowerment of disadvantaged communities in Australia are required

End-of-life experiences and expectations of Africans in Australia: cultural implications for palliative and hospice care

Author version made available in accordance with the publisher's policy.The ageing and frail migrants who are at the end of life are an increasing share of migrants living in Australia. However, within such populations, information about end-of-life experiences is limited, particularly among Africans. This article provides some insights into the sociocultural end-of-life experiences of Africans in Australia and their interaction with the health services in general and end-of-life care in particular. It provides points for discussion to consider ethical framework that include Afro-communitarian ethical principles to enhance the capacity of current health services to provide culturally appropriate and ethical care. This article contributes to our knowledge regarding the provision of culturally appropriate and ethical care to African patients and their families by enabling the learning of health service providers to improve the competence of palliative care systems and professionals in Australia. Additionally, it initi- ates the discussion to highlight the importance of paying sufficient attention to diverse range of factors including the migration history when providing palliative and hospice care for patients from African migrant populations

A phase 1 randomized, open label, rectal safety, acceptability, pharmacokinetic, and pharmacodynamic study of three formulations of tenofovir 1% Gel (the CHARM-01 study)

Objectives: The CHARM-01 study characterized the safety, acceptability, pharmacokinetics (PK), and pharmacodynamics (PD) of three tenofovir (TFV) gels for rectal application. The vaginal formulation (VF) gel was previously used in the CAPRISA 004 and VOICE vaginal microbicide Phase 2B trials and the RMP-02/MTN-006 Phase 1 rectal safety study. The reduced glycerin VF (RGVF) gel was used in the MTN-007 Phase 1 rectal microbicide trial and is currently being evaluated in the MTN-017 Phase 2 rectal microbicide trial. A third rectal specific formulation (RF) gel was also evaluated in the CHARM-01 study. Methods: Participants received 4 mL of the three TFV gels in a blinded, crossover design: seven daily doses of RGVF, seven daily doses of RF, and six daily doses of placebo followed by one dose of VF, in a randomized sequence. Safety, acceptability, compartmental PK, and explant PD were monitored throughout the trial. Results: All three gels were found to be safe and acceptable. RF and RGVF PK were not significantly different. Median mucosal mononuclear cell (MMC) TFV-DP trended toward higher values for RF compared to RGVF (1136 and 320 fmol/106 cells respectively). Use of each gel in vivo was associated with significant inhibition of ex vivo colorectal tissue HIV infection. There was also a significant negative correlation between the tissue levels of TFV, tissue TFV-DP, MMC TFV-DP, rectal fluid TFV, and explant HIV-1 infection. Conclusions: All three formulations were found to be safe and acceptable. However, the safety profile of the VF gel was only based on exposure to one dose whereas participants received seven doses of the RGVF and RF gels. There was a trend towards higher tissue MMC levels of TFV-DP associated with use of the RF gel. Use of all gels was associated with significant inhibition of ex vivo tissue HIV infection. Trial Registration: ClinicalTrials.gov NCT01575405

Metagenomic water quality monitoring with a portable laboratory

We describe the technical feasibility of metagenomic water quality analysis using only portable equipment, for example mini-vacuum pumps and filtration units, mini-centrifuges, mini-PCR machines and the memory-stick sized MinION of Oxford Nanopore Technologies, for the library preparation and sequencing of 16S rRNA gene amplicons. Using this portable toolbox on site, we successfully characterized the microbiome of water samples collected from Birtley Sewage Treatment Plant, UK, and its environs. We also demonstrated the applicability of the portable metagenomics toolbox in a low-income country by surveying water samples from the Akaki River around Addis Ababa, Ethiopia. The 16S rRNA gene sequencing workflow, including DNA extraction, PCR amplification, sequencing library preparation, and sequencing was accomplished within one working day. The metagenomic data became available within 24e72 h, depending on internet speed. Metagenomic analysis clearly distinguished the microbiome of pristine samples from sewage influenced water samples. Metagenomic analysis identified the potential role of two bacterial genera not conventionally monitored, Arcobacter and Aeromonas, as predominant faecal pollution indicators/waterborne hazards. Subsequent quantitative PCR analysis validated the high Arcobacter butzleri abundances observed in the urban influenced Akaki River water samples by portable next generation sequencing with the MinION device. Overall, our field deployable metagenomics toolbox advances the capability of scientists to comprehensively monitor microbiomes anywhere in the world, including in the water, food and drinks industries, the health services, agriculture and beyond

Use of indigenous informed epistemologies can inform intervention models to fight covid-19 in africa

The coronavirus disease 2019 (COVID-19) has put the world in unprecedented health and economic crisis threatening human existence and livelihoods. The pandemic has brought the world to a standstill and, has infected over 15 million and killed over 620 thousand people globally1 . The socioeconomic impact of the pandemic is also expected to be higher. Reports indicate that in the USA alone, over 38 million people have lost their jobs due to the pandemic. Reports from Europe and other parts of the world also depict a grim picture. The pandemic has affected other regions such as Australasia where significant loss of jobs and livelihoods, and changes in societal resilience manifesting in increased mental health problems and domestic violence were reported