When does a major outbreak become a Public Health Emergency of International Concern?

The process of determining whether a Public Health Emergencies of International Concern (PHEIC) exists and should be declared has drawn increasing criticism over the past few years with allegations that it is more political than technical. Delaying declaration, where appropriate, means that the opportunity of garnering international solidarity and necessary resources in the early phases of epidemics, when public health measures may be more effective, is lost. A reform agenda aimed at enhancing WHO/Emergency Committee transparency and objectivity for the PHEIC declaration process is required

Rethinking cognitive style in psychology

Bibliography: leaves 240-257.This thesis proposes to answer a single question: do the stylistic features of cognition operate independently of cognitive contents? The question itself has a history, and the way it has been framed, and the types of answers it has attracted have been related to ideological and political interests. Chapter 1 reviews four social psychological theories of the relationship between cognitive style and ideological beliefs - authoritarianism, extremism theory, context theory, and value pluralism theory. It argues that these (empiricist) accounts have been bedeviled by a tension between theoretical universalism and political critique, and have fostered the view that cognitive traits are stable, general, and pervasive properties of individual psychology. Chapter 2 focuses on the construct of intolerance of ambiguity, and shows how - in the manner of Danziger's (1985) "methodological circle" - universalistic assumptions have become incorporated into measurement instruments; and how all evidence of individual variability in cognitive style has been accommodated by interactionist models of personality, leaving the empiricist view intact. Roy Bhaskar's critical realism is used as an alternative to a empiricist psychology, and Michael Billig's rhetorical psychology is used as an alternative to universalistic theories of cognitive style. A measurement procedure is developed which can assess cross-content variability in ambiguity tolerance. Three studies are performed in order to justify a move towards an anti-universalistic conception of cognitive style. Study l evaluates the hypothesized generality of ambiguity tolerance on a sample of university students. Factor analysis and correlational matrices show that ambiguity tolerance toward different authorities is domain specific, and that different factors are related to each other positively, negatively, and orthogonally. Study 2 employs the same sample, and uses polynomial regression analysis to show that the relationship between ambiguity tolerance and ideological conservatism is highly variable across content domain. Study 3 replicates these central findings with another student sample and with different scale contents. The results of all three studies arc contrary to the predictions of the social psychological accounts of cognitive style. They show that expressions of cognitive style are context- and content-dependent, and suggest that the empiricist "thing-like" ontology be replaced with a praxis- and concept-dependent ontology

Racializing teenage pregnancy : ‘culture’ and ‘tradition’ in the South African scientific literature

The signifiers, ‘race’, ‘culture’ or ‘ethnicity’ are utilized in the teenage pregnancy literature (1) to highlight ‘differences’ in adolescent sexual and reproductive behaviour and (2) as explanatory tools. When ‘white’ teenagers are the focus of research, psychological explanations are usually invoked, while for ‘black’ teenagers, explanations are socio-cultural in nature. In this paper, we explore how, through a process of racialization, the psycho-medical literature on teenage pregnancy in South Africa contributes to the entrenchment of ‘race’, ‘culture’ and ‘ethnicity’ as fixed, ‘natural’ signifiers. We utilize Derrida’s notion of différance, together with Phoenix and Woollett’s adaptation – ‘normalized absence/pathologized presence’ – to indicate how ‘black’ people are cast as the Other, the pathologized presence which relies on the normalized absent trace, ‘whiteness’, for definition. We analyse how the notions of ‘tradition’ and ‘culture’ are deployed to sanitize or disguise the underlying racializing project. ‘Black’ is exoticized and rendered strange and thus open to scrutiny, monitoring and intervention. ‘Culture’ and ‘tradition’ appeal to the myth of origin, thus providing pseudo-historical explanations which essentialize and naturalize racialized collectivities.Rhodes Universit

Foucauldian feminism: the implications of governmentality

Foucauldian discourse has been received with varying degrees of enthusiasm within feminist circles. Some authors (e.g. Balbus, 1988; Di Leonardo, 1991; Hartsock, 1990) see a Foucauldian stance as incompatible with feminist theory, while others (e.g. Grimshaw, 1993; Hoy, 1988; McNay, 1992; Sawicki, 1988) advocate a positive relationship between Foucauldian discourse and feminism. And then there are those theorists (e.g. Burman, 1990) who stand between these two positions, stating that while Foucault offers useful insights and methods to feminists, it can also be dangerous

Psycho-medical discourse in South African research on teenage pregnancy

Catriona Macleod and Kevin Durrheim apply a Foucauldian analysis to the scientific literature on teenage pregnancy

Sentinel malaria surveillance - more than a research tool

No Abstrac

Measles elimination - Is it achievable? Lessons from an immunisation coverage survey

Objectives. To detennine routine measles coverage at district level and to explore reasons for immunisation failure in Mpumalanga Province, South Africa.Design. An adaptation of the World Health Organisation (WHO) Expanded Programme on Immunisation (EFl) cluster sampling method was used to make a random selection of 30 clusters in each of 21 health districts, 630 clusters in total. Seven individuals from the age group 12 - 23 months were randomly selected from each cluster and immunisation status and source were transcribed from their child health records. Where no immunisations were administered, reasons provided by parents or guardians were recorded.Setting. Mpumalanga Province, South Africa.Results. The weighted valid population coverage with measles vaccine for children aged 12 - 23 months in Mpumalanga Province was 71.1% (95% confidence interval 64.9 - 78.5%); this was the lowest of all EPI antigens. There was marked heterogeneity in measles coverage across the province, with a coefficientof variation of 22.2%. Districts with the lowest coverage shared borders with neighbouring provinces. District measles coverage was highly positively correlated with diphtheria, pertussis and tetanus (DPT3) coverage (r = 0.960, P = 0.000). There was a strong negative correlation between ranked measles campaign coverage and routine measles immunisation coverage. Obstacles to immunisation accounted· for nearly half (49%) of all reasons for immunisation failure, while lack of information and lack of motivation accounted for 30% and 22%, respectively.Conclusions. Survey results highlight the need for supplementary immunisation, including non-selective campaigns, if Mpumalanga is to achieve the South African goal of measles elimination by 2002. The value of determining district resolution coverage in order to identify areas with low measles coverage requiring supplementary intervention was also demonstrated. A strong negative correlation between routine and campaign coverage deserves further study in other settings

Inadequate chemoprophylaxis and the risk of malaria

BACKGROUND: Malaria is an important disease for Australian travellers, particularly to Papua New Guinea. Travellers often seek health advice from their general practitioner before travel or if they develop illness after travel. METHOD: A retrospective cohort investigation into malaria risk in a group of adult Australians that trekked the Kokoda trail in Papua New Guinea. RESULTS: Six of 38 group members were diagnosed with malaria on return from Papua New Guinea. None of the 12 individuals who took chemoprophylaxis for the recommended period post-travel developed malaria compared to 4/24 travellers who terminated prophylaxis prematurely or 2/2 who took no chemoprophylaxis. DISCUSSION: Chemoprophylaxis is effective if taken for the full recommended period following travel to a malaria endemic area; 4 weeks for doxycycline and mefloquine, and 7 days for atovaquone+proguanil. Malaria is a likely cause of illness in recently returned travellers from Papua New Guinea who develop a febrile illness