Syndemic Health Disparities and Resilience Processes Related to HIV Transmission Risk among African American/Black Men in South Florida

Rates of HIV infection continue to climb among minority populations and men who have sex with men (MSM), with African American/Black MSM being especially impacted. Numerous studies have found HIV transmission risk to be associated with many health and social disparities resulting from larger environmental and structural forces. Using anthropological and social environment-based theories of resilience that focus on individual agency and larger social and environmental structures, this dissertation employed a mixed methods design to investigate resilience processes among African American/Black MSM. Quantitative analyses compared African American/Black (N=108) and Caucasian/White (N=250) MSM who participated in a previously conducted randomized controlled trial (RCT) of sexual and substance use risk reduction interventions. At RCT study entry, using past 90 day recall periods, there were no differences in unprotected sex frequency, however African American/Black MSM reported higher frequencies of days high (P Qualitative data collected among a sub-sample of African American/Black MSM from the RCT (N=21) described the men’s experiences of living with multiple health and social disparities and the importance of RCT study assessments in facilitating reductions in risk behaviors. A cross-case analysis showed different resilience processes undertaken by men who experienced low socioeconomic status, little family support, and homophobia (N=16) compared to those who did not (N=5). The dissertation concludes that resilience processes to HIV transmission risk and related health and social disparities among African American/Black MSM varies and are dependent on specific social environmental factors, including social relationships, structural homophobia, and access to social, economic, and cultural capital. Men define for themselves what it means to be resilient within their social environment. These conclusions suggest that both individual and structural-level resilience-based HIV prevention interventions are needed.

Asian green mussels (Perna viridis) transplanted between Jakarta Bay and Lada Bay, West Java, Indonesia (April 2012 - November 2013)

The Asian green mussel Perna viridis is tolerant to environmental stress, but its robustness varies between populations from habitats that differ in quality. So far, it is unclear whether local adaptations through stressinduced selection or phenotypic plasticity are responsible for these inter-population differences. We tested for the relevance of both mechanisms by comparing survival under hypoxia in mussels that were transplanted from an anthropogenically impacted (Jakarta Bay, Indonesia) to a natural habitat (Lada Bay, Indonesia) and vice versa. Mussels were retrieved 8 weeks after transplantation and exposed to hypoxia in the laboratory. Additional hypoxia tests were conducted with juvenile mussels collected directly from both sites. To elucidate possible relationships between habitat quality and mussel tolerance, we monitored concentrations of inorganic nutrients, temperature, dissolved oxygen, salinity, phytoplankton density and the mussels' body condition index (BCI) for 20 months before, during and after the experiments. Survival under hypoxia depended mainly on the quality of the habitat where the mussels lived before the hypoxia tests and only to a small degree on their site of origin. Furthermore, stress tolerance was only higher in Jakarta than in Lada Bay mussels when the BCIs were substantially higher, which in turn correlated with the phytoplankton densities. We explain why phenotypic plasticity and high BCIs are more likely the causes of populationspecific differences in hypoxia tolerance in P. viridis than stress-induced selection for robust genotypes. This is relevant to understanding the role of P. viridis as mariculture organism in eutrophic ecosystems and invasive species in the (sub)tropical world.

Organic-walled dinoflagellate cysts and environmental analysis of surface sediments from the Northwest African upwelling area

In order to examine the spatial distribution of organic-walled dinoflagellate cysts (dinocysts) in recent sediments related to environmental conditions in the water column, thirty-two surface sediment samples from the NW African upwelling region (20-32°N) were investigated. Relative abundances of the dinocyst species show distinct regional differences allowing the separation of four hydrographic regimes. (1) In the area off Cape Ghir, which is characterized by most seasonal upwelling and river discharge, Lingulodinium machaerophorum strongly dominates the associations which are additionally characterized by cysts of Gymnodinium nolleri, cysts of Polykrikos kofoidii and cysts of Polykrikos schwartzii. (2) Off Cape Yubi, a region with increasing perennial upwelling, L. machaerophorum, Brigantedinium spp., species of the genus Impagidinium and cysts of Protoperidinium stellatum occur in highest relative abundances. (3) In coastal samples between Cape Ghir and Cape Yubi, Gymnodinium catenatum, species of the genus Impagidinium, Nematosphaeropsis labyrinthus, Operculodinium centrocarpum, cysts of P. stellatum and Selenopemphix nephroides determine the species composition. (4) Off Cape Blanc, where upwelling prevails perennially, and at offshore sites, heterotrophic dinocyst species show highest relative abundances. A Redundancy Analysis reveals fluvial mud, sea surface temperature and the depth of the mixed layer in boreal spring (spring) as the most important parameters relating to the dinocyst species association. Dinocyst accumulation rates were calculated for a subset of samples using well-constrained sedimentation rates. Highest accumulation rates with up to almost 80.000 cysts cm**-2 ky**-1 were found off Cape Ghir and Cape Yubi reflecting their eutrophic upwelling filaments. A Redundancy Analysis gives evidence that primary productivity and the input of fluvial mud are mostly related to the dinocyst association. By means of accumulation rate data, quantitative cyst production of individual species can be considered independently from the rest of the association, allowing autecological interpretations. We show that a combined interpretation of relative abundances and accumulation rates of dinocysts can lead to a better understanding of the productivity conditions off NW Africa.

Reconstructions of eolian dust accumulation in northwest African margin sediments

Reconstructions of eolian dust accumulation in northwest African margin sediments provide important continuous records of past changes in atmospheric circulation and aridity in the region. Existing records indicate dramatic changes in North African dust emissions over the last 20 ka, but the limited spatial extent of these records and the lack of high-resolution flux data do not allow us to determine whether changes in dust deposition occurred with similar timing, magnitude and abruptness throughout northwest Africa. Here we present new records from a meridional transect of cores stretching from 31°N to 19°N along the northwest African margin. By combining grain size endmember modeling with 230Th-normalized fluxes for the first time, we are able to document spatial and temporal changes in dust deposition under the North African dust plume throughout the last 20 ka. Our results provide quantitative estimates of the magnitude of dust flux changes associated with Heinrich Stadial 1, the Younger Dryas, and the African Humid Period (AHP; ~11.7-5 ka), offering robust targets for model-based estimates of the climatic and biogeochemical impacts of past changes in North African dust emissions. Our data suggest that dust fluxes between 8 and 6 ka were a factor of ~5 lower than average fluxes during the last 2 ka. Using a simple model to estimate the effects of bioturbation on dust input signals, we find that our data are consistent with abrupt, synchronous changes in dust fluxes in all cores at the beginning and end of the AHP. The mean ages of these transitions are 11.8±0.2 ka (1Sigma) and 4.9±0.2 ka, respectively.

Relative abundance of euphausiids (Crustacea) in water samples of the Arabian Sea (Table 2)

In the present paper, the ecology and feeding habits of euphausiids are described. The samples were taken at the time of the NE-monsoon (1964/65) by R. V. "Meteor" in the Arabian Sea and adjacent waters. 24 species were determined. According to distribution of the species, the following marine areas can be distinguished: Arabian Sea: 24 species, dominant are Euphausia diomedeae, E. tenera, E. distinguenda, Stylocheiron carinatum. Gulf of Aden: 10 species, dominant are Euphausia diomedeae, E. distinguenda. Red Sea: 6 species, dominant are Euphausia diomedeae, E. distinguenda. Gulf of Oman : 5 Species, dominant are Euphausia distinguenda, Pseudeupbaufia latifrons. Persian Gulf: 1 species - Pseudeuphausia latifrons. The total number of euphausiids indicate the biomass of this group. High densities of euphausiids (200-299 and > 300 individuals/100 m**3) occur in the innermost part of the Gulf cf Aden, in the area south of the equator near the African east coast, near Karachi (Indian west coast) and in the Persian Gulf. Comparison with data relating to production biology confirms that these are eutrophic zones which coincide with areas in which upwelling occurs at the time of the NE-monsoon. The central part of the Arabian Sea differs from adjacent waters by virtue of less dense euphausiid populations (> 199 individuals/100 m**3). Measurements relating to production biology demonstrate a relatively low concentration of primary food sources. Food material was ascertained by analysis of stomach content. The following omnivorous species were examined: Euphausia diomedeae, E. distinguenda, E. tenera, Pseudeuphausia latifrons and Thysanopoda tricuspidata. Apart from crustacean remains large numbers of Foraminifera, Radiolaria, tintinnids, dinoflagellates were found in the stomachs. Quantitatively crustaceans form the most important item in the diet. Food selection on the basis of size and form appears to be restricted to certain genera of tintinnids. The genera Stylocheiron and Nematoscelis are predators. Only crustacean remains were found in the stomachs of Stylocheiron abbreviatum, whereas Radiolaria, Foraminifera and tintinnids occurred to some extent in Nematasceli sp. Different euphausiids in the food chain in the Arabian Sea. In omnivorous species the position is variable, since they not only feed by filtering autotrophic and heterotrophic Protista, but also by predation on zooplankton. Carnivorous species without filtering apparatus feed exclusively on zooplankton of the size of copepods. Only these species are well established as occupying a higher position in the food chain. The parasitic protozoan Tbalassomyces fagei was found on Euphausia diomedeae, E. fenera, E. distinguenda and E. sanzoi.

Examination of body image among Canadian adolescents: Relations with physical activity and screen time

Background: Adolescence is a period of life associated with self-perceptions of negative body image. Physical activity levels are low and screen time levels are also high during this stage. These perceptions and behaviours are associated with poor health outcomes, making research on their determinants important. With adolescent populations, certain groups may be at higher risk of body dissatisfaction than others, and body dissatisfaction may influence individual physical activity and screen time levels. Objectives: The objectives of this thesis were to: 1) describe body image among young Canadians, examining possible health inequalities 2) estimate the strength and significance of associations between body satisfaction, physical activity and screen time, and 3) examine the potential etiological role of biological sex. Methods: Objective 1: The 2013/2014 Health Behaviour in School-aged Children study was employed. Sex-stratified Rao-Scott chi-square analyses were conducted to examine associations between socio-demographic factors and body satisfaction. Objective 2: The 2005/2006 and 2013/2014 cross-sectional and 2006 longitudinal HBSC data sets were used. Sex-stratified modified Poisson regressions were conducted and risk estimates and associated confidence intervals obtained. Results: Objective 1: Among males, being older, of East and Southeast Asian ethnicity, and reporting low SES all were associated with body dissatisfaction. Among females, being older, of Arab and West Asian or African ethnicity, being born in Canada, and reporting low SES were all associated with being body dissatisfied. Objective 2: Cross-sectionally, males who reported ‘too fat’ body dissatisfaction were more likely to be physically inactive. Adolescents of both sexes who reported ‘too fat’ body dissatisfaction were more likely to engage in high levels of screen time. Data from the longitudinal component supported the idea that male ‘too fat’ body dissatisfaction temporally leads to physical inactivity, but showed an inverse relationship between body dissatisfaction and screen time. Conclusions: Objective 1: Future prevention efforts in Canada should target subgroups to effectively help those at greatest risk of body dissatisfaction, and ameliorate potential inequalities at the population level. Objective 2: The presence of these relationships may inform future interventions as part of a multi-factorial etiology, in order to increase physical activity and decrease screen time among youth.

Systematics of African Amphicyonidae, with descriptions of new material from Napak (Uganda) and Grillental (Namibia)

The Early Miocene Napak XV locality (ca 20.5 Ma), Uganda, has yielded an interesting assemblage of fossils, including the very well represented amphicyonid Hecubides euryodon. The remarkable find of a nearly complete mandible, unfortunately with poorly preserved dentition, together with new dental remains allow us to obtain a better idea about the morphology and variability of this species. Additionally, we describe a newly discovered mandible of Hecubides euryodon from the Grillental-VI locality (Sperrgebiet, Namibia), which is the most complete and diagnostic Amphicyonidae material found in this area. Comparisons with Cynelos lemanensis from Saint Gérand le Pouy (France), the type locality, and with an updated sample of the species of amphicyonids described in Africa leads us to validate the genus Hecubides. Hecubides would be phylogenetically related to the medium and large size species of Amphicyonidae from Africa, most of them now grouped into the genera Afrocyon and Myacyon, both endemic to this continent.

Individual-based modelling of the development and transport of a Karenia mikimotoi bloom on the North-West European continental shelf

In 2006, a large and prolonged bloom of the dinoflagellate Karenia mikimotoi occurred in Scottish coastal waters, causing extensive mortalities of benthic organisms including annelids and molluscs and some species of fish ( Davidson et al., 2009). A coupled hydrodynamic-algal transport model was developed to track the progression of the bloom around the Scottish coast during June–September 2006 and hence investigate the processes controlling the bloom dynamics. Within this individual-based model, cells were capable of growth, mortality and phototaxis and were transported by physical processes of advection and turbulent diffusion, using current velocities extracted from operational simulations of the MRCS ocean circulation model of the North-west European continental shelf. Vertical and horizontal turbulent diffusion of cells are treated using a random walk approach. Comparison of model output with remotely sensed chlorophyll concentrations and cell counts from coastal monitoring stations indicated that it was necessary to include multiple spatially distinct seed populations of K. mikimotoi at separate locations on the shelf edge to capture the qualitative pattern of bloom transport and development. We interpret this as indicating that the source population was being transported northwards by the Hebridean slope current from where colonies of K. mikimotoi were injected onto the continental shelf by eddies or other transient exchange processes. The model was used to investigate the effects on simulated K. mikimotoi transport and dispersal of: (1) the distribution of the initial seed population; (2) algal growth and mortality; (3) water temperature; (4) the vertical movement of particles by diurnal migration and eddy diffusion; (5) the relative role of the shelf edge and coastal currents; (6) the role of wind forcing. The numerical experiments emphasized the requirement for a physiologically based biological model and indicated that improved modelling of future blooms will potentially benefit from better parameterisation of temperature dependence of both growth and mortality and finer spatial and temporal hydrodynamic resolution.

Individual-based modelling of the development and transport of a Karenia mikimotoi bloom on the North-West European continental shelf

In 2006, a large and prolonged bloom of the dinoflagellate Karenia mikimotoi occurred in Scottish coastal waters, causing extensive mortalities of benthic organisms including annelids and molluscs and some species of fish ( Davidson et al., 2009). A coupled hydrodynamic-algal transport model was developed to track the progression of the bloom around the Scottish coast during June–September 2006 and hence investigate the processes controlling the bloom dynamics. Within this individual-based model, cells were capable of growth, mortality and phototaxis and were transported by physical processes of advection and turbulent diffusion, using current velocities extracted from operational simulations of the MRCS ocean circulation model of the North-west European continental shelf. Vertical and horizontal turbulent diffusion of cells are treated using a random walk approach. Comparison of model output with remotely sensed chlorophyll concentrations and cell counts from coastal monitoring stations indicated that it was necessary to include multiple spatially distinct seed populations of K. mikimotoi at separate locations on the shelf edge to capture the qualitative pattern of bloom transport and development. We interpret this as indicating that the source population was being transported northwards by the Hebridean slope current from where colonies of K. mikimotoi were injected onto the continental shelf by eddies or other transient exchange processes. The model was used to investigate the effects on simulated K. mikimotoi transport and dispersal of: (1) the distribution of the initial seed population; (2) algal growth and mortality; (3) water temperature; (4) the vertical movement of particles by diurnal migration and eddy diffusion; (5) the relative role of the shelf edge and coastal currents; (6) the role of wind forcing. The numerical experiments emphasized the requirement for a physiologically based biological model and indicated that improved modelling of future blooms will potentially benefit from better parameterisation of temperature dependence of both growth and mortality and finer spatial and temporal hydrodynamic resolution.

Reproductive effects of endocrine disrupting chemicals, bisphenol-A and 17β-oestradiol, on Cerastoderma edule from south-west England: field study and laboratory exposure

Endocrine disruption has rarely been reported in field populations of the edible cockle and the context with the general health of the shellfish is unclear. This study examined the reproductive state of two Cerastoderma edule populations over a 6-month period to assess their reproductive condition, the incidence of intersex and presence of parasitic infection. A further seven native sites from south-west England were examined during the peak reproductive season to identify the presence of intersex within the region. Laboratory exposures of organisms collected from field populations showed a significantly female-biased sex ratio compared with controls when exposed to the endocrine disrupting chemicals, bisphenol-A (nominal concentration: 0.1 µg L−1) and 17β-oestradiol (nominal concentration: 0.1 µg L−1), but none of the chemical exposures induced intersex. Intersex was revealed in seven out of the nine native populations of C. edule sampled at peak reproductive season. The highest incidence and most severe case of intersex were reported at Lower Anderton on the River Tamer which also had a significantly female-biased sex ratio. Additionally, the dominant trematode family was the Bucephalaidae. Parasitic infection influences the maturity of C. edule by lowering both mean gonad index and condition index. These results suggest that endocrine disrupting chemicals could be contributing factors towards the development of intersex in C. edule.

Reproductive effects of endocrine disrupting chemicals, bisphenol-A and 17β-oestradiol, on Cerastoderma edule from south-west England: field study and laboratory exposure

Endocrine disruption has rarely been reported in field populations of the edible cockle and the context with the general health of the shellfish is unclear. This study examined the reproductive state of two Cerastoderma edule populations over a 6-month period to assess their reproductive condition, the incidence of intersex and presence of parasitic infection. A further seven native sites from south-west England were examined during the peak reproductive season to identify the presence of intersex within the region. Laboratory exposures of organisms collected from field populations showed a significantly female-biased sex ratio compared with controls when exposed to the endocrine disrupting chemicals, bisphenol-A (nominal concentration: 0.1 µg L−1) and 17β-oestradiol (nominal concentration: 0.1 µg L−1), but none of the chemical exposures induced intersex. Intersex was revealed in seven out of the nine native populations of C. edule sampled at peak reproductive season. The highest incidence and most severe case of intersex were reported at Lower Anderton on the River Tamer which also had a significantly female-biased sex ratio. Additionally, the dominant trematode family was the Bucephalaidae. Parasitic infection influences the maturity of C. edule by lowering both mean gonad index and condition index. These results suggest that endocrine disrupting chemicals could be contributing factors towards the development of intersex in C. edule.

The perception of the African-American community through the eyes of the Hispanic media in the U.S.: a critical discourse analysis of the reporting of the death of Michael Brown

In this paper, 36 English and 38 Spanish news articles were selected from English and Spanish newspapers and magazines published in the U.S.A. from August 2014 to November 2014. All articles discuss the death of Michael Brown, the ensuing protests and police investigations. A discourse analysis shows that there are few differences between reporting by the mainstream and the Hispanic media. Like the mainstream media, the Hispanic media adopts a neutral point of view with regard to the African-American minority. However, it presents a negative opinion with regard to the police. It appears that the Hispanic media does not explicitly side with the African-American community, but rather agrees more with the mainstream media’s opinion and is substantially influenced by it.

Obésité abdominale et autres déterminants du risque cardiométabolique dans deux populations urbaines noires apparentées : Port-au-Prince (Haïti) et Cotonou (Bénin)

L’obésité est un problème de santé publique reconnu. Dans la dernière décennie l’obésité abdominale (OA) a été considérée comme une maladie métabolique qui contribue davantage au risque de diabète et de maladies cardiovasculaires que l’obésité générale définie par l’indice de masse corporelle. Toutefois, dans les populations d’origine africaine, la relation entre l’OA et les autres biomarqueurs de risque cardiométabolique (RCM) demeure obscure à cause du manque d’études chez ces populations et de l’absence de valeurs-seuils spécifiques pour juger d’une OA. Cette étude visait à comparer la prévalence des biomarqueurs de RCM (OA, hypertension artérielle, hyperglycémie, dyslipidémie, résistance à l'insuline et inflammation pré-clinique) chez les Béninois de Cotonou et les Haïtiens de Port-au-Prince (PAP), à étudier l’association de l’OA avec les autres biomarqueurs de RCM, à documenter le rôle du niveau socio-économique (NSE) et du mode de vie dans cette association et à ’identifier les indicateurs anthropométriques de l’OA -tour de taille (TT) et le ratio TT/hauteur (TT/H)- et les seuils qui prédisent le mieux le RCM à Cotonou et à PAP. Il s’est agi d’une analyse de données transversales chez 452 adultes (52 % hommes) apparemment en bonne santé, âgés de 25 à 60 ans, avec 200 sujets vivant à Cotonou (Bénin) et 252 sujets à PAP (Haïti). Les biomarqueurs de RCM considérés étaient : le syndrome métabolique (SMet) d’après les critères harmonisés de 2009 et ses composantes individuelles - une OA à partir d’un TT ≥ 94cm chez les hommes et ≥ 80cm chez les femmes, une hypertension, une dyslipidémie et une hyperglycémie; la résistance à l’insuline définie chez l’ensemble des sujets de l’étude à partir du 75e centile de l’Homeostasis Model Assessment (HOMA-IR); un ratio d’athérogénicité élevé (Cholestérol sérique total/HDL-Cholestérol); et l’inflammation pré-clinique mesurée à partir d’un niveau de protéine C-réactive ultrasensible (PCRus) entre 3 et 10 mg/l. Le ratio TT/H était aussi considéré pour définir l’OA à partir d’un seuil de 0,5. Les données sur les habitudes alimentaires, la consommation d’alcool, le tabagisme, les caractéristiques sociodémographiques et les conditions socio-économiques incluant le niveau d’éducation et un proxy du revenu (basé sur l’analyse par composante principale des biens et des possessions) ont été recueillies au moyen d’un questionnaire. Sur la base de données de fréquence de consommation d’aliments occidentaux, urbains et traditionnels, des schémas alimentaires des sujets de chaque ville ont été identifiés par analyse typologique. La validité et les valeurs-seuils de TT et du ratio TT/H prédictives du RCM ont été définies à partir des courbes ROC (Receiver Operating Characteristics). Le SMet était présent chez 21,5 % et 16,1 % des participants, respectivement à Cotonou et à PAP. La prévalence d’OA était élevée à Cotonou (52,5 %) qu’à PAP (36%), avec une prévalence plus élevée chez les femmes que chez les hommes. Le profil lipidique sérique était plus athérogène à PAP avec 89,3 % d’HDL-c bas à PAP contre 79,7 % à Cotonou et un ratio CT/HDL-c élevé de 73,4 % à PAP contre 42 % à Cotonou. Les valeurs-seuils spécifiques de TT et du TT/H étaient respectivement 94 cm et 0,59 chez les femmes et 80 cm et 0,50 chez les hommes. Les analyses multivariées de l’OA avec les biomarqueurs de RCM les plus fortement prévalents dans ces deux populations montraient que l’OA était associée à un risque accru de résistance à l’insuline, d’athérogénicité et de tension artérielle élevée et ceci, indépendamment des facteurs socio-économiques et du mode de vie. Deux schémas alimentaires ont émergé, transitionnel et traditionnel, dans chaque ville, mais ceux-ci ne se révélaient pas associés aux biomarqueurs de RCM bien qu’ils soient en lien avec les variables socio-économiques. La présente étude confirme la présence de plusieurs biomarqueurs de RCM chez des sujets apparemment sains. En outre, l’OA est un élément clé du RCM dans ces deux populations. Les seuils actuels de TT devraient être reconsidérés éventuellement à la lumière d’études de plus grande envergure, afin de mieux définir l’OA chez les Noirs africains ou d’origine africaine, ce qui permettra une surveillance épidémiologique plus adéquate des biomarqueurs de RCM.

Evaluation use within a humanitarian non-governmental organization’s health care user-fee exemption program in West Africa

L’évaluation de l’action humanitaire (ÉAH) est un outil valorisé pour soutenir l’imputabilité, la transparence et l’efficience de programmes humanitaires contribuant à diminuer les inéquités et à promouvoir la santé mondiale. L’EAH est incontournable pour les parties prenantes de programme, les bailleurs de fonds, décideurs et intervenants souhaitant intégrer les données probantes aux pratiques et à la prise de décisions. Cependant, l’utilisation de l’évaluation (UÉ) reste incertaine, l’ÉAH étant fréquemment menée, mais inutilisé. Aussi, les conditions influençant l’UÉ varient selon les contextes et leur présence et applicabilité au sein d’organisations non-gouvernementales (ONG) humanitaires restent peu documentées. Les évaluateurs, parties prenantes et décideurs en contexte humanitaire souhaitant assurer l’UÉ pérenne détiennent peu de repères puisque rares sont les études examinant l’UÉ et ses conditions à long terme. La présente thèse tend à clarifier ces enjeux en documentant sur une période de deux ans l’UÉ et les conditions qui la détermine, au sein d’une stratégie d’évaluation intégrée au programme d’exemption de paiement des soins de santé d’une ONG humanitaire. L’objectif de ce programme est de faciliter l’accès à la santé aux mères, aux enfants de moins de cinq ans et aux indigents de districts sanitaires au Niger et au Burkina Faso, régions du Sahel où des crises alimentaires et économiques ont engendré des taux élevés de malnutrition, de morbidité et de mortalité. Une première évaluation du programme d’exemption au Niger a mené au développement de la stratégie d’évaluation intégrée à ce même programme au Burkina Faso. La thèse se compose de trois articles. Le premier présente une étude d’évaluabilité, étape préliminaire à la thèse et permettant de juger de sa faisabilité. Les résultats démontrent une logique cohérente et plausible de la stratégie d’évaluation, l’accessibilité de données et l’utilité d’étudier l’UÉ par l’ONG. Le second article documente l’UÉ des parties prenantes de la stratégie et comment celle-ci servit le programme d’exemption. L’utilisation des résultats fut instrumentale, conceptuelle et persuasive, alors que l’utilisation des processus ne fut qu’instrumentale et conceptuelle. Le troisième article documente les conditions qui, selon les parties prenantes, ont progressivement influencé l’UÉ. L’attitude des utilisateurs, les relations et communications interpersonnelles et l’habileté des évaluateurs à mener et à partager les connaissances adaptées aux besoins des utilisateurs furent les conditions clés liées à l’UÉ. La thèse contribue à l’avancement des connaissances sur l’UÉ en milieu humanitaire et apporte des recommandations aux parties prenantes de l’ONG.