Polylateralism as diplomatic method : the case of the Kimberley Process, 2000-2002

Examples of state and non-state actors collaborating on issues of global politics abound. Non-state actors are increasingly involved in policy formulation processes, in peace-keeping processes, in human rights and environmental issues by advising governments or inter-governmental organisations. This type of collaboration mostly takes place at the discretion of states. However, non-state actors sometimes appear to initiate diplomatic processes. The Kimberley Process is an example of such a case. States and another non-state actor, namely business, were forced to the negotiating table by NGOs who were effectively raising consumer awareness about the role of diamonds in fuelling conflict and who held the power over launching a possible consumer boycott. Polylateralism is a term that was coined to represent the participation of non-state actors in the conduct of international relations. The study uses the Kimberley Process negotiations from 2000 to 2002 as a case study to analyse the dynamics of polylateral diplomacy by examining the nature and form of interaction between the three sets of actors, namely states, civil society and business in order to understand the role played by each group in both agenda setting and rule making, and the extent to which their interactions conform to the central ideas of polylateralism as advanced by international scholars. In so doing the study examines the evolving mode of interaction between states and non-state actors in the Kimberley Process, the ability of non-state actors to influence diplomatic processes, the extent to which states determined the boundaries of non-state diplomatic involvement and, finally, the limitations of polylateral diplomacy. The study concludes that the apparent increase in collaboration between state and non-state actors in diplomatic processes does not constitute a new method of diplomacy and that this will not change until non-state actors have become recognised polities. It also finds that the involvement of non-state actors in diplomacy, particularly as consumers of diplomatic outcomes is likely to become more-and-more prevalent and that professional diplomats, especially those in developing countries, may have to adapt their working methods in order to benefit from this phenomenon by allowing for a more systematic engagement with non-state actors. Finally, it finds that while the Kimberley Process is a good example of the involvement of non-state actors as producers of diplomatic outcomes, this phenomenon is less likely to reoccur and may well be the exception rather than the rule for the foreseeable future.Dissertation (MDiplomatic Studies)--University of Pretoria, 2011.Political Sciencesunrestricte

Analysis of the complete genome sequence of Cucumber mosaic virus strain K

The complete genome sequence of Cucumber mosaic virus strain K was determined by deep RNA sequencing. The tripartite genome consists of a 3,382-nucleotide (nt) RNA1, a 3,050-nt RNA2, and a 2,218-nt RNA3 segment. Phylogenetic analysis placed RNA1 and RNA2 in subgroup IB. However, RNA3 grouped with subgroup IA isolates, indicating a likely recombination event. © 2018 Moyle et al

A critical evaluation of the Beckman Coulter Access hsTnI: analytical performance, reference interval and concordance

We investigated the analytical performance, outlier rate, carryover and reference interval of the Beckman Coulter Access hsTnI in detail and compared it with historical and other commercial assays.We compared the imprecision, detection capability, analytical sensitivity, outlier rate and carryover against two previous Access AccuTnI assay versions. We established the reference interval with stored samples from a previous study and compared the concordances and variances with the Access AccuTnI+3 as well as with two commercial assays.The Access hsTnI had excellent analytical sensitivity with the calibration slope 5.6 times steeper than the Access AccuTnI+3. The detection capability was markedly improved with the SD of the blank 0.18-0.20 ng/L, LoB 0.29-0.33 ng/L and LoD 0.58-0.69 ng/L. All the reference interval samples had a result above the LoB value. At a mean concentration of 2.83 ng/L the SD was 0.28 ng/L (CV 9.8%). Carryover (0.005%) and outlier (0.046%) rates were similar to the Access AccuTnI+3. The combined male and female 99th percentile reference interval was 18.2 ng/L (90% CI 13.2-21.1 ng/L). Concordance amongst the assays was poor with only 16.7%, 19.6% and 15.2% of samples identified by all 4 assays as above the 99th, 97.5th and 95th percentiles. Analytical imprecision was a minor contributor to the observed variances between assays.The Beckman Coulter Access hsTnI assay has excellent analytical sensitivity and precision characteristics close to zero. This allows cTnI measurement in all healthy individuals and the capability to identify numerically small differences between serial samples as statistically significant. Concordance in healthy individuals remains poor amongst assays

Evaluating the Effectiveness of Complex, Multi-component, Dynamic, Community Based Injury Prevention Interventions: A Statistical Framework

Dynamic violence and injury prevention interventions located within community settings raise evaluation challenges by virtue of their complex structure, focus, and aims. They try to address many risk factors simulta neously, are often overlapped in their implementation, and their imple mentation may be phased over time. This article proposes a statistical and analytic framework for evaluating the effectiveness of multilevel, multi system, multi-component, community-driven, dynamic interventions. The proposed framework builds on meta regression methodology and recently proposed approaches for pooling results from multi-component interven tion studies. The methodology is applied to the evaluation of the effec tiveness of South African community-centered injury prevention and safety promotion interventions. The proposed framework allows for complex interventions to be disaggregated into their constituent parts in order to extract their specific effects. The potential utility of the framework is suc cessfully illustrated using contact crime data from select police stations in Johannesburg. The proposed framework and statistical guidelines proved to be useful to study the effectiveness of complex, dynamic, community-based interventions as a whole and of their components. The framework may help researchers and policy makers to adopt and study a specific methodology for evaluating the effectiveness of complex intervention programs.Institute for Social and Health Studies (ISHS

Critical care admission of South African (SA) surgical patients: Results of the SA Surgical Outcomes Study

Background. Appropriate critical care admissions are an important component of surgical care. However, there are few data describing postoperative critical care admission in resource-limited low- and middle-income countries.Objective. To describe the demographics, organ failures, organ support and outcomes of non-cardiac surgical patients admitted to critical care units in South Africa (SA).Methods. The SA Surgical Outcomes Study (SASOS) was a 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient non-cardiac surgery between 19 and 26 May 2014 at 50 government-funded hospitals. All patients admitted to critical care units during this study were included for analysis.Results. Of the 3 927 SASOS patients, 255 (6.5%) were admitted to critical care units; of these admissions, 144 (56.5%) were planned, and 111 (43.5%) unplanned. The incidence of confirmed or strongly suspected infection at the time of admission was 35.4%, with a significantly higher incidence in unplanned admissions (49.1 v. 24.8%, p<0.001). Unplanned admission cases were more frequently hypovolaemic, had septic shock, and required significantly more inotropic, ventilatory and renal support in the first 48 hours after admission. Overall mortality was 22.4%, with unplanned admissions having a significantly longer critical care length of stay and overall mortality (33.3 v. 13.9%, p<0.001).Conclusion. The outcome of patients admitted to public sector critical care units in SA is strongly associated with unplanned admissions. Adequate ‘high care-dependency units’ for postoperative care of elective surgical patients could potentially decrease the burden on critical care resources in SA by 23%. This study was registered on ClinicalTrials.gov (NCT02141867)

Foreign nursing students: Their profile and perceptions of nursing care in Namibia

A survey was conducted using open and close-ended questions to determine how visiting nursing students in Namibia could be assisted during their visits (cultural encounters). Many students decide to complete their clinical exposure in a foreign country, either for personal reasons or in order to meet the course requirements for transcultural nursing. Since 1998, Namibia has received a number of these students. In discussion and from passing remarks from the students themselves, the question has arisen as to how an optimum placement for each student might be achieved. Aspects of the Campina–Bacote model and The Process of Cultural Competence in the Delivery of Health Care Services were used to answer this question. It was decided to gather both biographical (profile) information and information on perceptions of nursing care in Namibia from such foreign nursing students. The biographical (profile) information collected indicates a prevalence of certain shared biographical characteristics among international students. Such students tend to be adventurous, caring and sensitive to human rights issues. This finding correlates with the constructs of cultural desire and cultural awareness as described in the model of Campina–Bacote. Based on this finding, specific recommendations were made for clinical allocations. From the data gathered from the open-ended questions, three themes emerged: firstly, nursing in Namibia has identifiable characteristics; secondly, there is a paternalistic and one-sided communication style among nursing caregivers in Namibia; and finally, nursing care delivery in this country is often characterised by a detached attitude. It was concluded that these themes correlated with a cultural awareness and cultural knowledge among the nursing students. The discovery of these themes was useful for making recommendations for clinical guidelines to help these students adapt, as well as for providing a foundation and substantiation for clinical placement. Opsomming ’n Opname bestaande uit oop en geslote vrae is uitgevoer om te bepaal hoe besoekende verpleegstudente aan Namibië ondersteun kan word (kulturele ervarings). Baie studente besluit om hulle kliniese praktika in die buiteland te voltooi, óf om persoonlike redes óf om aan kursusvereistes in transkulturele verpleging te voldoen. Sedert 1998 het Namibië ’n aantal van hierdie studente ontvang. Uit gesprekke met sowel as spontane kommentaar deur hierdie studente het die vraag ontstaan hoe hulle optimum plasing verseker kan word. Aspekte van die model van Campina–Bacote, naamlik The process of cultural competence in the delivery of health care services , is benut om hierdie vraag te beantwoord. Daarom is besluit om biografiese inligting sowel as inligting oor die studente se persepsies van verpleging in Namibië in te samel. Die biografiese inligting (profiel) het die voorkoms van sekere biografiese kenmerke onder die internasionale studente getoon: Hulle neig daartoe om avontuurlik, deernisvol en sensitief vir menseregte te wees. Dié bevinding korreleer met die konstrukte van kulturele begeertes en kulturele bewustheid soos beskryf in die model van Campina–Bacote. Op grond van hierdie bevindinge is bepaalde aanbevelings aangaande hulle kliniese plasings gemaak. Die data deur die oop vrae verkry het drie temas gegenereer, naamlik dat verpleging in Namibië bepaalde identifiseerbare kenmerke openbaar, dat ’n paternalistiese en eensydige kommunikasiestyl onder verpleegkundiges in Namibië voorkom en dat verpleegsorg deur ’n onbetrokke houding gekenmerk word. Die gevolgtrekking was dat hierdie temas met ’n kulturele bewustheid en kulturele kennis onder die verpleegstudente korreleer. Die identifisering van hierdie temas was bruikbaar as basis vir die motivering van kliniese plasings en in die maak van aanbevelings ten opsigte van kliniese riglyne om die studente te help om aan te pas

Stakeholders’ perceptions of the delivery and quality of sexually transmitted infection treatment by private practitioners in Windhoek, Namibia

The primary objective of this study was to explore the perceptions of the community and other stakeholders regarding the delivery and quality of sexually transmitted infection (STI) treatment and care provided by private general practitioners (PGPs) in Windhoek, Namibia. The study provided a situational and contextual analysis employing qualitative methodologies using different methods of data collection. The methodology used included (1) a review of available country policy documents on STI management and surveillance, as well as the policy with regard to private primary care providers, (2) eight in-depth interviews conducted with key informants and (3)three focus-group discussions held with community members attending PGP practices in Windhoek. The perceptions of the care received from PGPs differed from one person to the next. It emerged that some participants had good experiences and some had negative experiences of the care given.The participants believed that going to a PGP for treatment is a matter of affordability that goes hand in hand with the expectations of receiving care, whilst maintaining confidentiality. The study established that there is no real difference between the care provided to patients with medical aid or those without medical aid. It is recommended that interactions between the public and private sector at various levels be initiated to ensure that curable STIs are appropriately managed and that national guidelines for STI management are adhered to. Health workers should also be sensitised about their approach towards patients. It is further recommended that awareness creation amongst PGPs with regard to the public health importance of STIs needs to be raised to encourage them to participate in the STI-control programme. Opsomming Die hoofdoel van die studie was om ondersoek in te stel na die persepsies van die gemeenskap en ander belanghebbendes oor die lewering en kwaliteit van die behandeling en sorg ten opsigte van seksueel oordraagbare infeksies (SOIs) deur privaat algemene praktisyns in Windhoek. Die studie het ’n situasionele en kontekstuele analise behels, waarin gebruik gemaak is van kwalitatiewe metodologieë en verskillende metodes van data-insameling. Die metodologie het ingesluit (1) die bestudering van beskikbare nasionale beleidsdokumente oor die behandeling en monitering van SOIs sowel as die beleid op privaat primêresorgvoorsieners, (2) agt diepteonderhoude met sleutelinformante en (3) drie fokusgroepgesprekke met lede van die gemeenskap wat die praktyke van privaat algemene praktisyns in Windhoek besoek. Die persepsies van die sorg wat van algemene praktisyns ontvang is, verskil van deelnemer tot deelnemer. Dit het aan die lig gekom dat sommige deelnemers die gelewerde sorg positief ervaar het terwyl ander dit negatief ervaar het. Die deelnemers het geglo dat om ’n algemene praktisyn vir behandeling te besoek ’n kwessie van bekostigbaarheid is wat gepaard gaan met ’n verwagting van sorglewering terwyl vertroulikheid behou word. Die studie het bevind dat daar geen verskil is in die sorg wat gelewer word aan pasiënte met ’n mediese fonds teenoor dié daarsonder nie. Daar word aanbeveel dat interaksie op verskillende vlakke tussen die openbare en privaat sektor aangemoedig moet word om te verseker dat behandelbare SOIs voldoende bestuur word en dat die nasionale riglyne ten opsigte daarvan nagekom word. Gesondheidswerkers behoort gesensitiseer te word ten opsigte van hul benadering tot hul kliënte. Daar word verder aanbeveel dat die bewusmaking van die openbaregesondheidsbelang van SOIs onder privaat praktisyns opgeskerp moet word sodat hulle aan die SOI-beheerprogram sal deelneem