18 research outputs found

    Applying a power and gender lens to understanding health care provider experience and behavior: A multicountry qualitative study

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    A limited but growing body of literature shows that health care providers (HCPs) in reproductive, maternal, and newborn health face challenges that affect how they provide services. Our study investigates provider perspectives and behaviors using 4 interrelated power domains—beliefs and perceptions; practices and participation; access to assets; and structures—to explore how these constructs are differentially experienced based on one’s gender, position, and function within the health system. We conducted a framework-based secondary analysis of qualitative in-depth interview data gathered with different cadres of HCPs across Kenya, Malawi, Madagascar, and Togo (n=123). We find across countries that power dynamics manifest in and are affected by all 4 domains, with some variation by HCP cadre and gender. At the service interface, HCPs’ power derives from the nature and quality of their relationships with clients and the community. Providers’ power within working relationships stems from unequal decision-making autonomy among HCP cadres. Limited and sometimes gendered access to remuneration, development opportunities, material resources, supervision quality, and emotional support affect HCPs’ power to care for clients effectively. Power manifests variably among community and facility-based providers because of differences in prevailing hierarchical norms in routine and acute settings, community linkages, and type of collaboration required in their work. Our findings suggest that applying power—and secondarily, gender lenses—can elucidate consistencies in how providers perceive, internalize, and react to a range of relational and environmental stressors. The findings also have implications on how to improve the design of social behavior change interventions aimed at better supporting HCPs

    Discovery of a glutathione utilization pathway in Francisella that shows functional divergence between environmental and pathogenic species.

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    Glutathione (GSH) is an abundant metabolite within eukaryotic cells that can act as a signal, a nutrient source, or serve in a redox capacity for intracellular bacterial pathogens. For Francisella, GSH is thought to be a critical in vivo source of cysteine; however, the cellular pathways permitting GSH utilization by Francisella differ between strains and have remained poorly understood. Using genetic screening, we discovered a unique pathway for GSH utilization in Francisella. Whereas prior work suggested GSH catabolism initiates in the periplasm, the pathway we define consists of a major facilitator superfamily (MFS) member that transports intact GSH and a previously unrecognized bacterial cytoplasmic enzyme that catalyzes the first step of GSH degradation. Interestingly, we find that the transporter gene for this pathway is pseudogenized in pathogenic Francisella, explaining phenotypic discrepancies in GSH utilization among Francisella spp. and revealing a critical role for GSH in the environmental niche of these bacteria

    Verbal overshadowing of perceptual discrimination

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    We examined effects of verbal interference on a perceptual discrimination task. Participants were presented with a series of faces, described (or did not describe) an additional face, and then made face/ nonface decisions to both the original faces and new faces, intermingled with nonfaces. This enabled us to examine the effect of making a verbal description, relative to an unrelated filler task in a control condition, on the perceptual discrimination of faces seen for the first time and faces encountered previously, and also on repetition priming (i.e., the facilitative effect of an encounter with a stimulus on subsequent processing of the same stimulus). Verbalization interfered with performance on both new and studied faces, but it did not interfere with priming. We argue that verbalization encouraged a relatively long-lasting shift (over a number of trials) toward greater visual processing of individual facial features at the expense of more global visual processing, which is generally beneficial for the recognition of faces and important for discriminating faces from nonfaces in the face decision task
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