Tribe : A Socio-Political Analysis

In 1974 we authored an essay entitled Tribe and Tribalism which recommended that the term tribe be dropped from scientific usage by anthropologists because of its pejorative connotations associated with non-European peoples and because the term is arbitrarily, rather than systematically applied. Increasing numbers of scholars are putting quotation marks around the word tribe or are using the phrase the so-called tribal societies. Still others are presenting a critical review of the term tribe before abandoning it or using it in the text in modified or altered form. The term primitive has undergone a similar evolution in recent years

American Mercenaries in Rhodesia

In rather well documented literature the United States\u27 Central Intelligence Agency hired significant numbers of American and British nationals, to mention only the most important, to fight against the victorious Popular Movement for the Liberation of Angola. It happens that a similar pattern of recruitment is now underway in Rhodesia although this has not received much attention in the Western press

Guinea-Bissau: 24 September 1973 and Beyond

On 24 September 1973 history was made in Africa. The first sub- Saharan African nation unilaterally declared its sovereignty from European colonialism following a protracted armed struggle. Most African nations gained their independence from colonial powers by negotiation and peaceful transfer of authority. True enough, this transfer was sometimes linked with prolonged periods of demonstrations, strikes, and nationalist propagandizing, but with the exception of Algeria (and perhaps Ethiopia) there were no wars of national liberation which led to a declaration of independence until Guinea-Bissau. The implications of this move are immense

A Genealogical and Historical Study of the Mahas of the Three Towns, Sudan

The Mahas (a Nubian ethnic group) in the central Sudan have made a fundamental contribution to the Islamization and urbanization of this Afro-Arab nation. Their building of the first permanent structures in the Three Towns (Khartoum area) may be claimed as the start of the modern process of Sudanese urbanization. The Mahas leaders who became teachers and advisors to the Funj state were also centrally responsible for the spread of Islam along the Blue and White Niles at their confluence at the Three Towns in communities which have been occupied continuously for about five centuries

A psychological intervention for suicide applied to non-affective psychosis: the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial protocol

From Springer Nature via Jisc Publications RouterHistory: received 2020-04-21, accepted 2020-05-27, registration 2020-05-28, pub-electronic 2020-06-16, online 2020-06-16, collection 2020-12Publication status: PublishedFunder: Efficacy and Mechanism Evaluation Programme; doi: http://dx.doi.org/10.13039/501100001922; Grant(s): 13/161/25Abstract: Background: Suicide is a leading cause of death globally. Suicide deaths are elevated in those experiencing severe mental health problems, including schizophrenia. Psychological talking therapies are a potentially effective means of alleviating suicidal thoughts, plans, and attempts. However, talking therapies need to i) focus on suicidal experiences directly and explicitly, and ii) be based on testable psychological mechanisms. The Cognitive AppRoaches to coMbatting Suicidality (CARMS) project is a Randomised Controlled Trial (RCT) which aims to investigate both the efficacy and the underlying mechanisms of a psychological talking therapy for people who have been recently suicidal and have non-affective psychosis. Methods: The CARMS trial is a two-armed single-blind RCT comparing a psychological talking therapy (Cognitive Behavioural Suicide Prevention for psychosis [CBSPp]) plus Treatment As Usual (TAU) with TAU alone. There are primary and secondary suicidality outcome variables, plus mechanistic, clinical, and health economic outcomes measured over time. The primary outcome is a measure of suicidal ideation at 6 months after baseline. The target sample size is 250, with approximately 125 randomised to each arm of the trial, and an assumption of up to 25% attrition. Hence, the overall recruitment target is up to 333. An intention to treat analysis will be used with primary stratification based on National Health Service (NHS) recruitment site and antidepressant prescription medication. Recruitment will be from NHS mental health services in the North West of England, UK. Participants must be 18 or over; be under the care of mental health services; have mental health problems which meet ICD-10 non-affective psychosis criteria; and have experienced self-reported suicidal thoughts, plans, and/or attempts in the 3 months prior to recruitment. Nested qualitative work will investigate the pathways to suicidality, experiences of the therapy, and identify potential implementation challenges beyond a trial setting as perceived by numerous stake-holders. Discussion: This trial has important implications for countering suicidal experiences for people with psychosis. It will provide definitive evidence about the efficacy of the CBSPp therapy; the psychological mechanisms which lead to suicidal experiences; and provide an understanding of what is required to implement the intervention into services should it be efficacious. Trial registration: ClinicalTrials.gov (NCT03114917), 14th April 2017. ISRCTN (reference ISRCTN17776666 https://doi.org/10.1186/ISRCTN17776666); 5th June 2017). Registration was recorded prior to participant recruitment commencing

Enhanced relapse prevention for bipolar disorder – ERP trial. A cluster randomised controlled trial to assess the feasibility of training care coordinators to offer enhanced relapse prevention for bipolar disorder

BACKGROUND: Bipolar Disorder (BD) is a common and severe form of mental illness characterised by repeated relapses of mania or depression. Pharmacotherapy is the main treatment currently offered, but this has only limited effectiveness. A recent Cochrane review has reported that adding psycho-social interventions that train people to recognise and manage the early warning signs of their relapses is effective in increasing time to recurrence, improving social functioning and in reducing hospitalisations. However, the review also highlights the difficulties in offering these interventions within standard mental health services due to the need for highly trained therapists and extensive input of time. There is a need to explore the potential for developing Early Warning Sign (EWS) interventions in ways that will enhance dissemination. METHODS AND DESIGN: This article describes a cluster-randomised trial to assess the feasibility of training care coordinators (CCs) in community mental health teams (CMHTs) to offer Enhanced Relapse Prevention (ERP) to people with Bipolar Disorder. CMHTs in the North West of England are randomised to either receive training in ERP and to offer this to their clients, or to continue to offer treatment as usual (TAU). The main aims of the study are (1) to determine the acceptability of the intervention, training and outcome measures (2) to assess the feasibility of the design as measured by rates of recruitment, retention, attendance and direct feedback from participants (3) to estimate the design effect of clustering for key outcome variables (4) to estimate the effect size of the impact of the intervention on outcome. In this paper we provide a rationale for the study design, briefly outline the ERP intervention, and describe in detail the study protocol. DISCUSSION: This information will be useful to researchers attempting to carry out similar feasibility assessments of clinical effectiveness trials and in particular cluster randomised controlled trials

World Heart Federation Roadmap on Atrial Fibrillation – A 2020 Update

The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world’s population and an increase in cardiovascular risk factors that predispose to AF. The goal of the AF roadmap was to provide guidance on priority interventions that are feasible in multiple countries, and to identify roadblocks and potential strategies to overcome them.Since publication of the AF Roadmap in 2017, there have been many technological advances including devices and artificial intelligence for identification and prediction of unknown AF, better methods to achieve rhythm control, and widespread uptake of smartphones and apps that could facilitate new approaches to healthcare delivery and increasing community AF awareness. In addition, the World Health Organisation added the non-vitamin K antagonist oral anticoagulants (NOACs) to the Essential Medicines List, making it possible to increase advocacy for their widespread adoption as therapy to prevent stroke. These advances motivated the WHF to commission a 2020 AF Roadmap update. Three years after the original Roadmap publication, the identified barriers and solutions were judged still relevant, and progress has been slow.This 2020 Roadmap update reviews the significant changes since 2017 and identifies priority areas for achieving the goals of reducing death and disability related to AF, particularly targeted at low-middle income countries. These include advocacy to increase appreciation of the scope of the problem; plugging gaps in guideline management and prevention through physician education, increasing patient health literacy, and novel ways to increase access to integrated healthcare including mHealth and digital transformations; and greater emphasis on achieving practical solutions to national and regional entrenched barriers. Despite the advances reviewed in this update, the task will not be easy, but the health rewards of implementing solutions that are both innovative and practical will be great

National Integration and Disintegration: The Southern Sudan

The southern Sudan has been torn by internal and external struggles for most of its long history. The area has seldom been unified by its own leaders or by those seeking to impose their rule upon the southerners. One of the greatest experiments in national integration is now underway in that region. Certain progress has been made, but much remains to be done. The struggle for national integration in the huge and underdeveloped Sudan is very difficult, with ethnic and geographical factors weighing heavily. The problem has been complicated by the deep roots of national division planted by British colonialism and nourished by changing governments in Khartoum and b y global powers which have used the southern Sudan for their own ends. Here we will review the past in order to judge the future prospects for national integration