A difficult equilibrium: torture narratives and the ethics of reciprocity in apartheid South Africa and its aftermath

This thesis takes the form of an enquiry into the development of the ―generic contours (Bakhtin 4) for the narration of torture in South Africa during apartheid and its aftermath. The enquiry focusses on the ethical determinations that underlie the conventions of this genre. My theoretical framework uses Adam Zachary Newton‘s conceptualization of narrative ethics to supplement Paul Ricoeur‘s writings on narrative identity and the ethical intention, thus facilitating the transfer of Ricoeur‘s abstract philosophy to the realm of literary criticism. Part I presents torture as a disruption of narrative identity and a defamiliarization of the intersubjective encounter. The existence of torture narratives thus attests to the critical role of narration in the reconstruction of the tortured person‘s identity and the re-establishment of benign frameworks of intersubjective communication. Literature‘s potential to act as a laboratory for the testing of the limitations of narrative identity and the resilience of ethical mores suggests that the fictional representation of torture also has an important role to play in this attempt at rehabilitation. Part II takes the form of a comparative analysis of non-fictional and fictional accounts of torture originating from apartheid South Africa. This shows that the ethical determinations underlying the narration of torture in South Africa range from intersubjective estrangement to a ―solicitude of reciprocity (Bourgeois 109). However, because the majority of these texts used the presentation of human rights abuses to galvanize international opposition to apartheid, the scope for experimentation was limited by the political exigencies of the time. Part III examines the stylistic and generic shifts in the narration of torture that accompanied South Africa‘s transition to democracy. It suggests that the discursive dominance of the Truth and Reconciliation Commission replaced the fruitful—in literary terms—dialogue between authoritarianism and resistance that characterized the apartheid era with a monologic grand narrative of emotional catharsis, reconciliation and nation building. It also suggests that the ―truth-and-reconciliation genre of writing (Quayson 754) that shaped the literary milieu of the post-TRC period be seen in terms of a resurgence of the apartheid–era paradigms for the narration of human rights abuses that were repressed during the initial phase of democratic transition. By framing the TRC as a catalyst for individual journeys of self-discovery, these novels raise important questions about what it means to be a part of the ―new South Africa. In contrast to the majority of apartheid era literature, the novels of the post-TRC period privilege the literary prerogative over the political, and thus bring to fruition the experimental potential of the previous paradigm. In doing so, they not only go beyond solicitude to achieve an ―authentic reciprocity in exchange (Ricoeur, Oneself 191), but also initiate a process of long-awaited literary expansion, in which authors look beyond the limits of apartheid and begin to critically engage with the region‘s pre-apartheid history and its post-apartheid present

Rash Reading: Rethinking Virginia Woolf's On Being Ill

This article responds to recent criticism of the medical humanities, concentrating on anxieties about the discipline’s failure to take seriously the principles and practices of humanities disciplines such as history and literary studies. Specifically, it argues that in order for literary studies to enter into meaningful and productive conversation with the medical humanities, it must first address its own limited understanding of fiction and life writing about illness. This argument has its origins in the author’s engagement with Virginia Woolf’s essay On Being Ill (1926) and is animated throughout by a commitment to exploring the relevance of her thinking to current scholarship on illness in literature. It shows how Woolf taps into some of the most fundamental issues at stake in the literary representation of illness and gestures towards ways in which writers and readers might begin to work through and beyond these issues. Moving through this analysis into a critique of literary studies approaches to illness, it concludes with a short examination of recent fiction, memoir, and poetry about illness. Looking at the exciting new directions in which these texts extend Woolf’s project, this examination argues that the most radical and sophisticated interventions in the field of illness and literature are to be found in current fiction and memoir about illness – a body of work that has thus far received little attention from scholars in literary studies

Reading and Writing Chronic Illness, 1990-2012: Ethics and Aesthetics at Work

This thesis is about autobiographical and fictional accounts of chronic illness professionally published between 1990 and 2012. It begins with a survey of popular and critical thinking about illness accounts, in which I show how both the medical humanities and literary studies have placed restrictions on what these accounts can mean, and thus on the kinds of cultural work they can do: restrictions that frequently belie the complexity of the aesthetics and ethics at work in many of the texts considered in this thesis. I build on this claim through close reading of a cross-section of contemporary illness accounts in which I flag up the presence of aesthetic elements distinct to the literary—including aspects of imagery, form, symbolic structure, address, and so on—, and show how these elements work not just to underscore the informative content of these illness accounts, but also to create new patterns of meaning, new networks of relation, and new modes of engagement. Though this project focuses on the contemporary, Virginia Woolf’s essay On Being Ill (1926) acts as its theoretical nucleus. In chapter 2, I show how On Being Ill provides a productive framework within which to explore the relationship between illness, literary aesthetics, and ethics. I also tease out the themes that are to define the chapters that follow, for, as Woolf demonstrates, at stake in the representation of the embodied self and the sensations it experiences are issues such as the referentiality of language and of fiction; the workings of metaphor and allegory; and the possibilities and limitations of the discursive sediment that accrues around words, images, and narrative tropes. In chapter 3, I explore this latter issue in a study of the construction of the narrative self and of the body in four autoethnographies by women academics. In chapter 4, I look at the representational experiments that Hilary Mantel and Paul West undertake in their memoirs as they seek to describe the physical and psychological effects of illness. Finally, in chapter 5 I consider how two South African fictions of illness—J. M. Coetzee’s Age of Iron (1990) and Marlene van Niekerk’s Agaat (2006)—provide a valuable case study for thinking about the relationship between illness and allegory in fiction. My conclusion draws these strands together, arguing that illness accounts can contribute not just to our understanding of the illness experience, but to our thinking about the nature of the literary and its participation in the ethical also

SARS-CoV-2 immunity and vaccine strategies in people with HIV

Current SARS-CoV-2 vaccines, based on the ancestral Wuhan strain, were developed rapidly to meet the needs of a devastating global pandemic. People living with HIV (PLWH) have been designated as a priority group for SARS-CoV-2 vaccination in most regions and varying primary courses (2 or 3-dose schedule) and additional boosters are recommended depending on current CD4+ T cell count and/or detectable HIV viraemia. From the current published data, licensed vaccines are safe for PLWH, and stimulate robust responses to vaccination in those well controlled on antiretroviral therapy and with high CD4+ T cell counts. Data on vaccine efficacy and immunogenicity remain, however, scarce in PLWH, especially in people with advanced disease. A greater concern is a potentially diminished immune response to the primary course and subsequent boosters, as well as an attenuated magnitude and durability of protective immune responses. A detailed understanding of the breadth and durability of humoral and T cell responses to vaccination, and the boosting effects of natural immunity to SARS-CoV-2, in more diverse populations of PLWH with a spectrum of HIV-related immunosuppression is therefore critical. This article summarises focused studies of humoral and cellular responses to SARS-CoV-2 infection in PLWH and provides a comprehensive review of the emerging literature on SARS-CoV-2 vaccine responses. Emphasis is placed on the potential effect of HIV-related factors and presence of co-morbidities modulating responses to SARS-CoV-2 vaccination, and the remaining challenges informing the optimal vaccination strategy to elicit enduring responses against existing and emerging variants in PLWH. Lay Abstract People living with Human Immunodeficiency Virus (PLWH), appear to be at a higher risk (approximately 15%) of becoming more seriously unwell if they are infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus that causes COVID-19 disease, and at least twice as likely to die from COVID-19 as the rest of the population. SARS-CoV-2 vaccination and boosters are recommended for all PLWH. However, there is limited information about the protective immune responses to both vaccination (and actual infection), the protection against serious COVID-19 disease, and whether the safety profile of the vaccines, which are very safe in the general population, differs in PLWH. Here we summarise findings from studies which looked specifically at vaccine-related immune responses in PLWH, and discuss factors – such as age, known to impact negatively on immune responses in the general population, to see whether this effect is worse in PLWH. A better understanding of these issues will help guide tailored vaccination and prevention strategies for PLWH

Glucose-6-phosphate dehydrogenase status and risk of hemolysis in Plasmodium falciparum-infected African children receiving single-dose primaquine.

Glucose-6-phosphate dehydrogenase (G6PD) enzyme function and genotype were determined in Ugandan children with uncomplicated falciparum malaria enrolled in a primaquine trial after exclusion of severe G6PD deficiency by fluorescent spot test. G6PD A- heterozygotes and hemizygotes/homozygotes experienced dose-dependent lower hemoglobin concentrations after treatment. No severe anemia was observed

The association between serum biomarkers and disease outcome in influenza A(H1N1)pdm09 virus infection: results of two international observational cohort studies

BACKGROUND Prospective studies establishing the temporal relationship between the degree of inflammation and human influenza disease progression are scarce. To assess predictors of disease progression among patients with influenza A(H1N1)pdm09 infection, 25 inflammatory biomarkers measured at enrollment were analyzed in two international observational cohort studies. METHODS Among patients with RT-PCR-confirmed influenza A(H1N1)pdm09 virus infection, odds ratios (ORs) estimated by logistic regression were used to summarize the associations of biomarkers measured at enrollment with worsened disease outcome or death after 14 days of follow-up for those seeking outpatient care (FLU 002) or after 60 days for those hospitalized with influenza complications (FLU 003). Biomarkers that were significantly associated with progression in both studies (p<0.05) or only in one (p<0.002 after Bonferroni correction) were identified. RESULTS In FLU 002 28/528 (5.3%) outpatients had influenza A(H1N1)pdm09 virus infection that progressed to a study endpoint of complications, hospitalization or death, whereas in FLU 003 28/170 (16.5%) inpatients enrolled from the general ward and 21/39 (53.8%) inpatients enrolled directly from the ICU experienced disease progression. Higher levels of 12 of the 25 markers were significantly associated with subsequent disease progression. Of these, 7 markers (IL-6, CD163, IL-10, LBP, IL-2, MCP-1, and IP-10), all with ORs for the 3(rd) versus 1(st) tertile of 2.5 or greater, were significant (p<0.05) in both outpatients and inpatients. In contrast, five markers (sICAM-1, IL-8, TNF-α, D-dimer, and sVCAM-1), all with ORs for the 3(rd) versus 1(st) tertile greater than 3.2, were significantly (p≤.002) associated with disease progression among hospitalized patients only. CONCLUSIONS In patients presenting with varying severities of influenza A(H1N1)pdm09 virus infection, a baseline elevation in several biomarkers associated with inflammation, coagulation, or immune function strongly predicted a higher risk of disease progression. It is conceivable that interventions designed to abrogate these baseline elevations might affect disease outcome

Ecological and Genomic Attributes of Novel Bacterial Taxa That Thrive in Subsurface Soil Horizons.

While most bacterial and archaeal taxa living in surface soils remain undescribed, this problem is exacerbated in deeper soils, owing to the unique oligotrophic conditions found in the subsurface. Additionally, previous studies of soil microbiomes have focused almost exclusively on surface soils, even though the microbes living in deeper soils also play critical roles in a wide range of biogeochemical processes. We examined soils collected from 20 distinct profiles across the United States to characterize the bacterial and archaeal communities that live in subsurface soils and to determine whether there are consistent changes in soil microbial communities with depth across a wide range of soil and environmental conditions. We found that bacterial and archaeal diversity generally decreased with depth, as did the degree of similarity of microbial communities to those found in surface horizons. We observed five phyla that consistently increased in relative abundance with depth across our soil profiles: Chloroflexi, Nitrospirae, Euryarchaeota, and candidate phyla GAL15 and Dormibacteraeota (formerly AD3). Leveraging the unusually high abundance of Dormibacteraeota at depth, we assembled genomes representative of this candidate phylum and identified traits that are likely to be beneficial in low-nutrient environments, including the synthesis and storage of carbohydrates, the potential to use carbon monoxide (CO) as a supplemental energy source, and the ability to form spores. Together these attributes likely allow members of the candidate phylum Dormibacteraeota to flourish in deeper soils and provide insight into the survival and growth strategies employed by the microbes that thrive in oligotrophic soil environments.IMPORTANCE Soil profiles are rarely homogeneous. Resource availability and microbial abundances typically decrease with soil depth, but microbes found in deeper horizons are still important components of terrestrial ecosystems. By studying 20 soil profiles across the United States, we documented consistent changes in soil bacterial and archaeal communities with depth. Deeper soils harbored communities distinct from those of the more commonly studied surface horizons. Most notably, we found that the candidate phylum Dormibacteraeota (formerly AD3) was often dominant in subsurface soils, and we used genomes from uncultivated members of this group to identify why these taxa are able to thrive in such resource-limited environments. Simply digging deeper into soil can reveal a surprising number of novel microbes with unique adaptations to oligotrophic subsurface conditions

Markers of Inflammation, Coagulation, and Renal Function Are Elevated in Adults with HIV Infection

(See the article by Kalayjian et al, on pages 1796-1805, and the editorial commentary by Dubé and Sattler, on pages 1783-1785.) Background. Human immunodeficiency virus (HIV) replication and immune activation may increase inflammation and coagulation biomarkers. Limited data exist comparing such biomarkers in persons with and without HIV infection. Methods. For persons 45-76 years of age, levels of high-sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, D-dimer, and cystatin C were compared in 494 HIV-infected individuals in the Strategies for Management of Anti-Retroviral Therapy (SMART) study and 5386 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) study. For persons 33-44 years of age, hsCRP and IL-6 levels were compared in 287 participants in the SMART study and 3231 participants in the Coronary Artery Development in Young Adults (CARDIA) study. Results. hsCRP and IL-6 levels were 55% (P<.001) and 62% (P<.001) higher among HIV-infected participants than among CARDIA study participants. Compared with levels noted in MESA study participants, hsCRP, IL-6, D-dimer, and cystatin C levels were 50%, 152%, 94%, and 27% higher, respectively (P<.001 , for each), among HIV-infected participants. HIV-infected participants receiving antiretroviral therapy who had HIV RNA levels ≤400 copies/mL had levels higher (by 21% to 60%) (P<.001) than those in the general population, for all biomarkers. Conclusions. hsCRP, IL-6, D-dimer, and cystatin C levels are elevated in persons with HIV infection and remain so even after HIV RNA levels are suppressed with antiretroviral therapy. Additional research is needed on the pathophysiology of HIV-induced activation of inflammatory and coagulation pathways, to guide potential intervention