The madness of the Black man on his own: an analysis of the silences of history, in search of herstory

The primary purpose of this thesis is to examine the autobiographical works of three Black South African women -- Mamphela Ramphele, Bessie Head, and Ellen Kuzwayo -- to see if and how they were impacted by the masculine discourse of the Black Consciousness Movement (BCM), which was articulated in terms of "the Black man" and his struggle. One of the first points I make and use as a premise throughout the thesis is that the term "man" is neither inclusive nor universal; it, instead, refers specifically to men and cannot refer to both men and women. What could have motivated the use of this masculinist language, particularly in light of the fact that the Nguni and Sotho languages of South Africa do not have a gender differentiation system for the third person pronoun? This question led me to an examination of the English language since English was the language chosen by the activists to conduct the business of the Movement. But, there was yet another factor to consider besides the language. The Black Consciousness Movement took place through the 1960s and into the late 1970s, during the latter part of an era of many other Black nationalist struggles around the world (Negritude, the U.S. Black Power Movements, liberation struggles of many of the other African countries). So, I look specifically at men's writings ' from Negritude and the Black Power Movements and compare them to a sample of writings from male writers in the Black Consciousness Movement, showing that all of these writers articulate employ this masculinist language. The significance of the timing of Black Consciousness (BC) is that it emerged into an international context with a readymade nationalist discourse of the liberation of Black people and the struggle of Black men. That discourse, however, might not have emerged if the usage of the masculine as universal were not already an acceptable practice the English language. Thus, the first chapter is an examination of the masculinity of the English language, primarily through feminist, postructuralist, psychoanalytic, and Marxist theories/theorists. The analysis begins from the premise that masculinity is a system of domination that requires femininity, a small, enclosed space designated for women. Key to the existence of masculinity and femininity is the facade that they are natural7 i.e., inherent to the male and female bodies, respectively. Thus the chapter is largely a deconstruction of that assumption, and the 18th century European assumption of a direct link between hysteria and femininity. I argue that at the base of female hysteria is a much more pervasive and normalised male hysteria, driven by the either/or binary logic of Western philosophy that shows itself in the English language. Indeed, it is masculinity, not femininity, that is irrational, illogical, and mad in its obsession for understanding and control. I move from that assertion into an analysis of how capitalism works to create femininity through Marx's structure of the non-producer, the labourer (to whom Marx consistently refers as he), and the product to examine the relationship between men and women, the masculine and the feminine. After establishing the madness of masculinity and its place in the English language, I move into how this examination of a Western context correlates to the Black Consciousness Movement. I argue that when the male BC activists entered into the English language, they simultaneously entered into its legacy of masculinity, and they adopted that masculinity. Thus their absenting of women was driven by the very same madness of masculinity. In the midst of this oppressive madness called masculinity, how, then did Black women conceive of themselves as agents? Of the three women, only one, Mamphela Ramphele, was an activist in the BCM. She is the onlywoman activist from the BCM who has written her autobiography, or who has written a sizeable body of material on her experience in the Movement. She is also the only of the three who never engages in the masculinist discourse of the Movement. I also look at Ellen Kuzwayo's autobiography, Call Me Woman7 which is dedicated to documenting the contributions of other Black women to the liberation of South Africa, despite which there are curious moments in the text when she slips into masculinist discourse in talking about the BCM and the importance of the Black man's struggle. The third is Bessie Head and her novel, A Question of Power7 which I use as an autobiographical text on the basis of her own admission that it is largely grounded in her own life experiences. Hers is an important text for the framework of madness it provides. I conclude that, true to my previous analyses, she is driven into madness by the hysteria of masculinity

Impacts of COVID-19 on the Coping Behaviours of Canadian Women Experiencing Intimate Partner Violence

Background: Strict public health measures central to slowing the spread of COVID-19 have, unintentionally, exacerbated risks for women experiencing intimate partner violence (IPV) while impeding their usual coping strategies. The goal of this study was to understand how coping was influenced by COVID-19 for women who have experienced IPV and identify changes in coping strategies and gaps that need to be addressed to support coping. Methods: A qualitatively driven, sequential, cross-sectional design, where quantitative data informed and was embedded within qualitative data collection, was used to explore the experiences of IPV (CAS-R-SF scale) and coping (Brief-COPE scale) specific to IPV of 95 Canadian women. A subset of 19 women was invited to complete an interview exploring coping strategies identified within the survey to contextualize and validate these findings. Results: Survey data subjected to quantitative content analysis identified ten themes, all of which were explored in semi-structured interviews. Thematic interview findings included (1) influence of COVID-19 on coping, (2) coping during COVID-19, and (3) needed coping strategies. Conclusion: COVID-19 had important impacts on the experiences and coping strategies of women who experience IPV. To better support this population in pandemic circumstances, in-person services should be prioritized with an emphasis on accessible and empathetic care. Public health measures in response to COVID-19, and the eventuality of future pandemics, should aim to be gender- and violence-informed

An international study exploring the experience of survivors of critical illness as volunteers within ICU recovery services

Objectives: Many clinicians have implemented follow-up and aftercare to support patients following ICU. Some of this care is supported and facilitated by peer volunteers. There is limited contemporary work that has explicitly explored volunteer roles within ICU recovery services or the experience of volunteers undertaking these roles. We sought to explore the experience of survivors of critical illness, as volunteers, involved in ICU recovery services and understand their motivation for undertaking these roles. Design: Qualitative exploration using in-depth semistructured interviews. The study design used an inductive content analysis process. We also documented the roles that were adopted by volunteers in each site involved in the study. Setting: Patients and caregivers were sampled from seven sites across three continents. Patients and Subjects: Patients and caregivers who had adopted peer-volunteering roles were undertaken. Interventions: None. Measurements and Main Results: Twelve patient and caregiver peer volunteers were interviewed. Four key themes were identified. These themes related to the experience of volunteers within ICU recovery services and their motivation for undertaking these roles: 1) self-belief and acceptance, 2) developing peer support, 3) social roles and a sense of purpose, and 4) giving back. Overwhelmingly, participants were positive about the role of the volunteer in the critical care setting. Conclusions: Peer volunteers undertake a variety of roles in ICU recovery services and during recovery more generally. These roles appear to be of direct benefit to those in these roles. Future research is needed to develop these roles and fully understand the potential impact on the service, including the impact on other patients

Key mechanisms by which post-ICU activities can improve in-ICU care: results of the international THRIVE collaboratives

Objective: To identify the key mechanisms that clinicians perceive improve care in the intensive care unit (ICU), as a result of their involvement in post-ICU programs. Methods: Qualitative inquiry via focus groups and interviews with members of the Society of Critical Care Medicine’s THRIVE collaborative sites (follow-up clinics and peer support). Framework analysis was used to synthesize and interpret the data. Results: Five key mechanisms were identified as drivers of improvement back into the ICU: (1) identifying otherwise unseen targets for ICU quality improvement or education programs—new ideas for quality improvement were generated and greater attention paid to detail in clinical care. (2) Creating a new role for survivors in the ICU—former patients and family members adopted an advocacy or peer volunteer role. (3) Inviting critical care providers to the post-ICU program to educate, sensitize, and motivate them—clinician peers and trainees were invited to attend as a helpful learning strategy to gain insights into post-ICU care requirements. (4) Changing clinician’s own understanding of patient experience—there appeared to be a direct individual benefit from working in post-ICU programs. (5) Improving morale and meaningfulness of ICU work—this was achieved by closing the feedback loop to ICU clinicians regarding patient and family outcomes. Conclusions: The follow-up of patients and families in post-ICU care settings is perceived to improve care within the ICU via five key mechanisms. Further research is required in this novel area

Enablers and Barriers to Implementing ICU Follow-Up Clinics and Peer Support Groups Following Critical Illness: The Thrive Collaboratives

OBJECTIVES: Data are lacking regarding implementation of novel strategies such as follow-up clinics and peer support groups, to reduce the burden of postintensive care syndrome. We sought to discover enablers that helped hospital-based clinicians establish post-ICU clinics and peer support programs, and identify barriers that challenged them. DESIGN: Qualitative inquiry. The Consolidated Framework for Implementation Research was used to organize and analyze data. SETTING: Two learning collaboratives (ICU follow-up clinics and peer support groups), representing 21 sites, across three continents. SUBJECTS: Clinicians from 21 sites. MEASUREMENT AND MAIN RESULTS: Ten enablers and nine barriers to implementation of "ICU follow-up clinics" were described. A key enabler to generate support for clinics was providing insight into the human experience of survivorship, to obtain interest from hospital administrators. Significant barriers included patient and family lack of access to clinics and clinic funding. Nine enablers and five barriers to the implementation of "peer support groups" were identified. Key enablers included developing infrastructure to support successful operationalization of this complex intervention, flexibility about when peer support should be offered, belonging to the international learning collaborative. Significant barriers related to limited attendance by patients and families due to challenges in creating awareness, and uncertainty about who might be appropriate to attend and target in advertising. CONCLUSIONS: Several enablers and barriers to implementing ICU follow-up clinics and peer support groups should be taken into account and leveraged to improve ICU recovery. Among the most important enablers are motivated clinician leaders who persist to find a path forward despite obstacles

Genetic variation in complement regulators and susceptibility to age-related macular degeneration.

Age-related macular degeneration (AMD) is the commonest cause of blindness in Western populations. Risk is influenced by age, genetic and environmental factors. Complement activation appears to be important in the pathogenesis and associations have been found between AMD and genetic variations in complement regulators such as complement factor H. We therefore investigated other complement regulators for association with AMD

Rapid characterisation of vegetation structure to predict refugia and climate change impacts across a global biodiversity hotspot

Identification of refugia is an increasingly important adaptation strategy in conservation planning under rapid anthropogenic climate change. Granite outcrops (GOs) provide extraordinary diversity, including a wide range of taxa, vegetation types and habitats in the Southwest Australian Floristic Region (SWAFR). However, poor characterization of GOs limits the capacity of conservation planning for refugia under climate change. A novel means for the rapid identification of potential refugia is presented, based on the assessment of local-scale environment and vegetation structure in a wider region. This approach was tested on GOs across the SWAFR. Airborne discrete return Light Detection And Ranging (LiDAR) data and Red Green and Blue (RGB) imagery were acquired. Vertical vegetation profiles were used to derive 54 structural classes. Structural vegetation types were described in three areas for supervised classification of a further 13 GOs across the region.Habitat descriptions based on 494 vegetation plots on and around these GOs were used to quantify relationships between environmental variables, ground cover and canopy height. The vegetation surrounding GOs is strongly related to structural vegetation types (Kappa = 0.8) and to its spatial context. Water gaining sites around GOs are characterized by taller and denser vegetation in all areas. The strong relationship between rainfall, soil-depth, and vegetation structure (R2 of 0.8–0.9) allowed comparisons of vegetation structure between current and future climate. Significant shifts in vegetation structural types were predicted and mapped for future climates. Water gaining areas below granite outcrops were identified as important putative refugia. A reduction in rainfall may be offset by the occurrence of deeper soil elsewhere on the outcrop. However, climate change interactions with fire and water table declines may render our conclusions conservative. The LiDAR-based mapping approach presented enables the integration of site-based biotic assessment with structural vegetation types for the rapid delineation and prioritization of key refugia

The novel homozygous KCNJ10 c.986T>C (p.(Leu329Pro)) variant is pathogenic for the SeSAME/EAST homologue in Malinois dogs.

SeSAME/EAST syndrome is a multisystemic disorder in humans, characterised by seizures, sensorineural deafness, ataxia, developmental delay and electrolyte imbalance. It is exclusively caused by homozygous or compound heterozygous variations in the KCNJ10 gene. Here we describe a similar syndrome in two families belonging to the Malinois dog breed, based on clinical, neurological, electrodiagnostic and histopathological examination. Genetic analysis detected a novel pathogenic KCNJ10 c.986T>C (p.(Leu329Pro)) variant that is inherited in an autosomal recessive way. This variant has an allele frequency of 2.9% in the Belgian Malinois population, but is not found in closely related dog breeds or in dog breeds where similar symptoms have been already described. The canine phenotype is remarkably similar to humans, including ataxia and seizures. In addition, in half of the dogs clinical and electrophysiological signs of neuromyotonia were observed. Because there is currently no cure and treatment is nonspecific and unsatisfactory, this canine translational model could be used for further elucidating the genotype/phenotype correlation of this monogenic multisystem disorder and as an excellent intermediate step for drug safety testing and efficacy evaluations before initiating human studies