How informed is consent in vulnerable populations? Experience using a continuous consent process during the MDP301 vaginal microbicide trial in Mwanza, Tanzania

BACKGROUND: HIV prevention trials conducted among disadvantaged vulnerable at-risk populations in developing countries present unique ethical dilemmas. A key concern in bioethics is the validity of informed consent for trial participation obtained from research subjects in such settings. The purpose of this study was to investigate the effectiveness of a continuous informed consent process adopted during the MDP301 phase III vaginal microbicide trial in Mwanza, Tanzania. METHODS: A total of 1146 women at increased risk of HIV acquisition working as alcohol and food vendors or in bars, restaurants, hotels and guesthouses have been recruited into the MDP301 phase III efficacy and safety trial in Mwanza. During preparations for the trial, participatory community research methods were used to develop a locally-appropriate pictorial flipchart in order to convey key messages about the trial to potential participants. Pre-recorded audio tapes were also developed to facilitate understanding and compliance with gel-use instructions. A comprehension checklist is administered by clinical staff to all participants at screening, enrolment, 12, 24, 40 and 50 week follow-up visits during the trial. To investigate women's perceptions and experiences of the trial, including how well participants internalize and retain key messages provided through a continuous informed consent process, a random sub-sample of 102 women were invited to participate in in-depth interviews (IDIs) conducted immediately after their 4, 24 and 52 week follow-up visits. RESULTS: 99 women completed interviews at 4-weeks, 83 at 24-weeks, and 74 at 52 weeks (a total of 256 interviews). In all interviews there was evidence of good comprehension and retention of key trial messages including that the gel is not currently know to be effective against HIV; that this is the key reason for conducting the trial; and that women should stop using gel in the event of pregnancy. CONCLUSIONS: Providing information to trial participants in a focussed, locally-appropriate manner, using methods developed in consultation with the community, and within a continuous informed-consent framework resulted in high levels of comprehension and message retention in this setting. This approach may represent a model for researchers conducting HIV prevention trials among other vulnerable populations in resource-poor settings. TRIAL REGISTRATION: Current Controlled Trials ISRCTN64716212

New Keywords: Migration and Borders

“New Keywords: Migration and Borders” is a collaborative writing project aimed at developing a nexus of terms and concepts that fill-out the contemporary problematic of migration. It moves beyond traditional and critical migration studies by building on cultural studies and post-colonial analyses, and by drawing on a diverse set of longstanding author engagements with migrant movements. The paper is organized in four parts (i) Introduction, (ii) Migration, Knowledge, Politics, (iii) Bordering, and (iv) Migrant Space/Times. The keywords on which we focus are: Migration/Migration Studies; Militant Investigation; Counter-mapping; Border Spectacle; Border Regime; Politics of Protection; Externalization; Migrant Labour; Differential inclusion/exclusion; Migrant struggles; and Subjectivity

Stability studies with tigecycline in bacterial growth medium and impact of stabilizing agents

Purpose!#!This study aimed to examine the degradation of tigecycline in Mueller Hinton broth (ca-MHB), as knowledge about bacterial susceptibility is key for therapeutic decisions.!##!Methods!#!Antioxidative stabilizers were evaluated on tigecycline stability in a quantitative chromatography assay and tigecycline induced kill against Staphylococcus aureus (ATCC29213) was determined in time kill studies.!##!Results!#!Ascorbic acid caused rapid degradation of tigecycline and resulted in loss of antibacterial activity. Tigecycline was stabilized in aged broth by 2% pyruvate and bacterial growth, and tigecycline killing was similar to fresh broth without supplementation, but independent of age.!##!Conclusion!#!Our results underline the importance of using freshly prepared ca-MHB or the need for stabilizers for tigecycline susceptibility testing while using aged ca-MHB

L’exploitation économique et le rôle des politiques migratoires racistes

Wie hängen die Migrationspolitiken mit der ökonomischen Ausbeutung von Migrant_innen zusammen? Wie kann man die Kämpfe in den verschiedenen Bereichen zusammenbringen? Im Workshop sollen verschiedene Formen von Diskriminierung und Ausbeutung gesammelt, Erfahrungen ausgetauscht und Möglichkeiten für Widerstand diskutiert werden.Comment les politiques migratoires et l‘exploitation économique des migrant-e-s sont-elles liées? Comment peut-on unir les combats dans les différents domaines? Cet atelier souhaite aborder de manière conjointe les différentes formes de discrimination et d‘exploitation, échanger les expériences et discuter des possibilités de résistance