Can the Experience of Participatory Development Help Think Critically about ‘Patient and Public Involvement’ in UK Healthcare?

The expansion of spaces for ‘patient and public involvement’ (PPI) in health systems in the UK is a relatively recent phenomenon, and yet ‘participation’ as a principle for planned interventions in international development is well established as a field of practice and controversy. Development workers and scholars have passed through moments of enchantment and disenchantment with the idea that the true source of innovation, expertise and workable (and sustainable) solutions is to be found not in the professionals but in communities of experience. Making ‘local knowledge’ the basis of interventions has proved unexpectedly problematic. How could incommensurable forms of knowing, across steep gradients of power be bridged? This article describes a decade-long experiment in participatory development in a remote Adivasi (tribal) region of western India in order to suggest the relevance of this experience for the very different context of PPI in healthcare settings. In particular, it highlights some general points about knowledge practices at the interface, and the human tendency to adjust, mirror, mimic, loop and in other ways make the ‘patient-professional’ interface itself hard to navigate. The article suggests that self-reflective insight into these social processes is necessary for effective ‘engagement’ by professional and lay actors alike

Brokering justice: global indigenous rights and struggles over hydropower in Nepal

This article explores the dynamics of brokerage at the intersection between the justice conceptions enshrined in global norms and the notions of justice asserted in specific socio-environmental struggles. Using the case of a small hydropower project in Nepal, we trace the attempts of an indigenous activist to enrol villagers in his campaign against the background of villagers’ everyday negotiations with the hydropower company. The study shows how global norms, such as indigenous peoples’ rights, may fail to gain traction on the ground or even become sources of injustice in particular contexts

A Decolonial Critique of the Racialized “Localwashing” of Extraction in Central Africa

Responding to calls for increased attention to actions and reactions “from above” within the extractive industry, we offer a decolonial critique of the ways in which corporate entities and multinational institutions propagate racialized rhetoric of “local” suffering, “local” consultation, and “local” fault for failure in extractive zones. Such rhetoric functions to legitimize extractive intervention within a set of practices that we call localwashing. Drawing from a decade of research on and along the Chad-Cameroon Oil Pipeline, we show how multi-scalar actors converged to assert knowledge of, responsibility for, and collaborations with “local” people within a racialized politics of scale. These corporate representations of the racialized “local” are coded through long-standing colonial tropes. We identify three interrelated and overlapping flexian elite rhetoric(s) and practices of racialized localwashing: (a) anguishing, (b) arrogating, and (c) admonishing. These elite representations of a racialized “local” reveal diversionary efforts “from above” to manage public opinion, displace blame for project failures, and domesticate dissent in a context of persistent scrutiny and criticism from international and regional advocates and activists

Some aspects of gene association with high sport achievements

Most papers on sport genetics identify differences between genotypes of athletes and a control group. It is obvious that the genetic differences should also be among sportsmen with different qualifications. Additionally, athletes’ performance depends not only on their genotypes, but also on the gene activities, which can be different during the training process in various athletes.The aim of the study was to compare genotypes of athletes with different qualifications and to analyze the change in expression of some genes responsible for the physical performance. Genotypes of 143 elite sportsmen of 18 national teams were analyzed by PCR method. A comparison of the genotypes of Masters of Sports, International Masters of Sports and Honored Masters of Sports showed that the frequencies of favorable gene variants were higher in the genotypes of more qualified athletes; it proves an appropriate genetic potential necessity for high achievements in sports. The analysis of UCP2, HIF1A and MTHFR gene expression changes in response to two-week hypoxiс training was performed on 15 skaters of high qualification. We found that average UCP2 and MTHFR mRNA levels had significantly increased after the training but the expression of the HIF1A gene had reduced. At the same time, individual athlete variability in UCP2, HIF1A and MTHFR gene expression was revealed. Genotype influence on gene expression was shown with the help of the UCP2 gene – its activity was higher in sportsmen with Val/Val than with Val/Ala or Ala/Ala genotypes. Consequently, genotyping and analysis of gene expression is very important for athlete selection and training

Selectivity and functional diversity in arbuscular mycorrhizas of co-occurring fungi and plants from a temperate deciduous woodland

1 The arbuscular mycorrhizal (AM) fungi colonizing plants at a woodland site in North Yorkshire (UK) have been characterized from the roots of five plant species (Rubus fruticosus agg. L., Epilobium angustifolium L., Acer pseudoplatanus L., Ajuga reptans L. and Glechoma hederacea L.), and identified using small-subunit rRNA (SSUrRNA) gene amplification and sequencing. 2 Interactions between five plant species from the site and four co-occurring glomalean fungi were investigated in artificial one-to-one AM symbioses. Three of the fungi were isolated from the site; the fourth was a culture genetically similar to a taxon found at the site. Phosphorus uptake and growth responses were compared with non-mycorrhizal controls. 3 Individual fungi colonized each plant with different spatial distribution and intensity. Some did not colonize at all, indicating incompatibility under the conditions used in the experiments. 4 Glomus hoi consistently occupied a large proportion of root systems and outperformed the other fungi, improving P uptake and enhancing the growth of four out of the five plant species. Only G. hoi colonized and increased P uptake in Acer pseudoplatanus, the host plant with which it associates almost exclusively under field conditions. Colonization of all plant species by Scutellospora dipurpurescens was sparse, and beneficial to only one of the host plants (Teucrium scorodonia). Archaeospora trappei and Glomus sp. UY1225 had variable effects on the host plants, conferring a range of P uptake and growth benefits on Lysimachia nummularia and T. scorodonia, increasing P uptake whilst not affecting biomass in Ajuga reptans and Glechoma hederacea, and failing to form mycorrhizas with A. pseudoplatanus. 5 These experimental mycorrhizas show that root colonization, symbiont compatibility and plant performance vary with each fungus-plant combination, even when the plants and fungi naturally co-exist. 6 We provide evidence of physical and functional selectivity in AM. The small number of described AM fungal species (154) has been ascribed to their supposed lack of host specificity, but if the selectivity we have observed is the general rule, then we may predict that many more, probably hard-to-culture glomalean species await discovery, or that members of species as currently perceived may be physiologically or functionally distinct

The need to promote behaviour change at the cultural level: one factor explaining the limited impact of the MEMA kwa Vijana adolescent sexual health intervention in rural Tanzania. A process evaluation

Background - Few of the many behavioral sexual health interventions in Africa have been rigorously evaluated. Where biological outcomes have been measured, improvements have rarely been found. One of the most rigorous trials was of the multi-component MEMA kwa Vijana adolescent sexual health programme, which showed improvements in knowledge and reported attitudes and behaviour, but none in biological outcomes. This paper attempts to explain these outcomes by reviewing the process evaluation findings, particularly in terms of contextual factors. Methods - A large-scale, primarily qualitative process evaluation based mainly on participant observation identified the principal contextual barriers and facilitators of behavioural change. Results - The contextual barriers involved four interrelated socio-structural factors: culture (i.e. shared practices and systems of belief), economic circumstances, social status, and gender. At an individual level they appeared to operate through the constructs of the theories underlying MEMA kwa Vijana - Social Cognitive Theory and the Theory of Reasoned Action – but the intervention was unable to substantially modify these individual-level constructs, apart from knowledge. Conclusion - The process evaluation suggests that one important reason for this failure is that the intervention did not operate sufficiently at a structural level, particularly in regard to culture. Recently most structural interventions have focused on gender or/and economics. Complementing these with a cultural approach could address the belief systems that justify and perpetuate gender and economic inequalities, as well as other barriers to behaviour change

Genomic Profiling of Childhood Tumor Patient-Derived Xenograft Models to Enable Rational Clinical Trial Design.

Accelerating cures for children with cancer remains an immediate challenge as a result of extensive oncogenic heterogeneity between and within histologies, distinct molecular mechanisms evolving between diagnosis and relapsed disease, and limited therapeutic options. To systematically prioritize and rationally test novel agents in preclinical murine models, researchers within the Pediatric Preclinical Testing Consortium are continuously developing patient-derived xenografts (PDXs)-many of which are refractory to current standard-of-care treatments-from high-risk childhood cancers. Here, we genomically characterize 261 PDX models from 37 unique pediatric cancers; demonstrate faithful recapitulation of histologies and subtypes; and refine our understanding of relapsed disease. In addition, we use expression signatures to classify tumors for TP53 and NF1 pathway inactivation. We anticipate that these data will serve as a resource for pediatric oncology drug development and will guide rational clinical trial design for children with cancer

Correlations, Causes and the Logic of Obscuration: Donor Shaping of Dominant Narratives in Indonesia's Irrigation Development

This article analyses policy trends in Indonesian irrigation, particularly during the last five decades, from the perspective of dominant narratives, as authored, suggested and pushed by international donors. It argues that international donors' adherence to ‘deferred maintenance’ as the core element of irrigation policy problem framing does not match with farmers' and the irrigation agency staff perceptions and practices. The logic of obscuration and the discursive manoeuvers that maintain it are analysed. The article concludes that there is space for more profound conceptual contestation and for alternative actions pathways even within the ‘dominant paradigm’ to address management problems more effectively