Will the "fight" ever end? : a critical reading of the metaphors and discourses that construct HIV/AIDS in an African context

In this thesis, I critically examine the discourses that inform how we conceptualise HIV/AIDS in Sub-Saharan Africa as they are produced in a sample of Canadian news articles, two nonfiction texts - Stephanie Nolen's 28 Stories of AIDS in Africa and Jonathan Morgan and the Bambanani Women's Group's Long Life ... Positive HIV Stories - as well as two literary texts - John Le Carre's popular fiction novel The Constant Gardener and an anthology of stories and poems from Southern Africa titled Nobody Ever Said AIDS, compiled and edited by Nobantu Rasebotsa, Meg Samuelson and Kylie Thomas. Paying particular attention to the role of metaphor in discursive formation, I have found that military metaphors, usually used in conjunction with biomedical discourses, continue to dominate what is said about HIV/AIDS. However, the use of military metaphors to conceptualise HIV/AIDS contributes to stigma and limits the effectiveness of responses to the pandemic. I argue that accessing alternative metaphors and discourses, such as biopsychosocial discourse, can lead to a more layered - and more beneficial - conceptualisation of HIV/AIDS, encouraging a more active response to the pandemic.

Devotional reading and dissolving the self: a critical reading of the late medieval Scottish Legendary using Kristevan theory

The Scottish Legendary is a fourteenth century collection of saints’ lives in Older Scots. The prologue describes the lives as ‘merroure’ (mirror) to readers from which ‘men ma ensample ta’ (people may take example). Thus, the Legendary sets out to reveal how the reader is (mirror) thereby moving her to wish to become how she should be (exemplarity). This dissertation argues that, rather than encouraging devotion to saints along purely dogmatic lines, the Legendary transforms the reader’s selfhood by engaging her affectively, i.e. on an emotional and somatic level. By provoking the reader affectively, the text puts the reader into what Julia Kristeva has described as a ‘semiotic state’ which harks back to the reader’s or listener’s pre-cultural, pre-subjective self (Kristeva, 1984). Thus, the text disrupts the reader’s conception of herself as a complete, hermetic subjectivity, thereby dissolving the boundaries of the reader’s self. The Legendary most powerfully infiltrates the reader’s sense of self along these lines in the moments in which female saints’ bodies are tortured and dismembered. These scenes foreground the permeability of human flesh as well as its powerful influence over selfhood. Such images of abjection are, in Kristeva’s words, ‘opposed to I’; by confronting the reader with the disintegration of subjectivity in abjection, the text incites the reader to likewise experience herself as abject, i.e. disintegrable and permeable (Kristeva 1982). As I shall demonstrate, Kristeva’s psychoanalytic theory of the formation of the self offers a fruitful framework for understanding the processes of self-knowledge through reading that these saints’ lives inspire.

Lecture d'articles médicaux: quelques pièges à éviter [Reading medical articles--what pitfalls to avoid]

Critical reading and careful interpretation of results of the medical literature is a difficult task for primary care physicians. Being aware of common potential pitfalls that may bias results of a study is helpful. Among common pitfalls, odds ratios are often interpreted as relative risks, which overestimate the impact of a risk factor. Randomized controlled trials assessing the effectiveness of a new drug or a new target disease often use surrogate markers instead of clinical events as outcomes. Results of these trials should be considered with caution before using their results for clinical practice. For screening, observational studies often yield potentially biased or conflicting results. As clinical guidelines and expert opinions are often conflicting, primary care physicians should wait for results of large clinical trials in clinical events before changing their practice for screening or new drugs.

Randomised controlled trial of the READER method of critical appraisal in general practice

Objective: To evaluate the READER model for critical reading by comparing it with a free appraisal, and to explore what factors influence different components of the model.

Learning to read with a critical eye: cultivating discerning readers of media reports with a science component.

It is important for young people to be able to read science-related media reports with discernment. ‘Getting Newswise’ was a research project designed to enable science and English teachers, working collaboratively, to equip pupils through the curriculum with critical reading skills appropriate for science news. Phase one of the study found that science and English teachers respond differently to science news articles and eight categories of critical response were identified. These findings informed phase two, in which classroom activities were devised whereby pupils examined, evaluated and responded to science-related news reports. Science-English collaboration had positive outcomes for pupil understanding

As formas de participação na construção do projecto político pedagógico : diferentes realidades escolares

RESUMO: Na sociedade da comunicação e da informação, as escolas ainda não conseguiram compreender o seu papel de facilitadoras do conhecimento que o mundo está promovendo entre a realidade da escola e o interesse do educando. Um dos fatores para isso é o crescimento das escolas ao longo dos séculos e a necessidade de superação decorrente do alargamento da educação, que têm gerado um conhecimento complexo que descreve as reflexões e conscientizações sobre o nosso próprio desenvolvimento humano e sobre a nossa participação no mundo em que estamos vivendo. Essas complexidades possibilitam mudanças, principalmente nas questões epistemológicas e paradigmáticas, que proporcionaram outra forma de conceber o conhecimento e os saberes, chamado de “ecologia dos saberes”. Nesse contexto, existe a necessidade de se fazer uma leitura crítica na e da escola e de sua participação junto à comunidade escolar, objetivando minimizar as relações de dominação, de normatizações, de disciplinamento, de concentração de poder, para direcionar a educação num processo emancipatório, democrático, consciente das mudanças, de forma a incluir todos os saberes possíveis para acompanhar e valorizar a realidade escolar, através da participação de alta intensidade na construção e reconstrução do seu projeto político pedagógico. Para tanto, iremos discorrer sobre três escolas, a partir da análise de cada uma dentro da realidade construída por elas, buscando demonstrar que as escolas, dentro dos seus contextos educacionais, possuem diferentes realidades que não podem ser generalizadas, mas que devem ser compreendidas no sentido de que sejam promovidas a autonomia escolar e o fortalecimento da democracia educacional, objetivando a superação das condições atuais da educação para se adequar à sociedade e ao mundo atual. ABSTRACT: In the present society of communication and information, schools have not yet been able to understand their roles as facilitators of the knowledge that the world is promoting between the reality of school and the interest of the learner. One of the reasons for that is the growth of schools along the centuries as well as their constant need for getting over old problems, due to the expansion of education. These questions lead to a complex knowledge which describes reflections on our own human development and on our participation in the world we live in. These complexities lead to changes, especially in epistemological and paradigmatic questions, making it possible for new ways of conceiving knowledge, known as “ecology of knowledge”. In this context, there is a need for making a critical reading about school and its participation in the school community, with the objective to minimize the relations of domination, power concentration and discipline and to direct education towards a process of emancipation and democracy, in which there is conscience of the necessary changes to include all possible knowledge as a way to value the reality of school through a high intensity participation in the construction and reconstruction of its political and pedagogical project. Thus, this study will discuss three schools, basing this discussion on the analysis of each school within the reality built by them, trying to demonstrate that, within their educational contexts, each one possesses different realities that cannot be generalized. These differences must, however, be understood, in order to allow the promotion of school autonomy and the strengthening of educational democracy with the objective to get over education`s present conditions and adjust them to society and to the present world.

Lipids under stress - a lipidomic approach for the study of mood disorders

The emerging field of lipidomics has identified lipids as key players in disease physiology. Their physicochemical diversity allows precise control of cell structure and signaling events through modulation of membrane prop- erties and trafficking of proteins. As such, lipids are important regulators of brain function and have been implicated in neurodegenerative and mood disorders. Importantly, environmental chronic stress has been associated with anxiety and depression and its exposure in rodents has been extensively used as a model to study these diseases. With the accessibility to modern mass- spectrometry lipidomic platforms, it is now possible to snapshot the extensively interconnected lipid network. Here, we review the fundamentals of lipid biology and outline a framework for the interpretation of lipidomic studies as a new approach to study brain pathophysiology. Thus, lipid profiling provides an exciting avenue for the identification of disease signatures with important implications for diagnosis and treatment of mood disorders.

Dapagliflozina

Dapagliflozin is a new oral antidiabetic agent whose mechanism of action increases renal glucose excretion, independently of insulin secretion or insulin action. The efficacy of dapagliflozin is dependent on renal function. The use of dapagliflozin has been licensed to improve glycaemic control in patients with type 2 diabetes mellitus as: - monotherapy when diet and exercise alone do not provide adequate glycaemic control in patients for whom the use of metformin is considered inappropriate due to intolerance. - Add-on combination therapy with other glucose-lowering agents including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control. Funding has been restricted to the use of dapagliflozin, prior approval, as dual therapy in combination with metformin. This report aims to assess the efficacy and safety of dapagliflozin in the treatment of type 2 diabetes mellitus, rate the added therapeutic value of dapagliflozin in type 2 diabetes mellitus and identify its current place in therapy. A systematic literature search was carried out, for the purpose of this evaluation, using PubMed, Embase, Cochrane and IDIS databases as well as other secondary sources of evidence-based medicine, therapeutic bulletins and national and international drug agencies. Following the critical reading and analysis of the selected articles, a summary is made out of the scientific evidence available, using Scottish Intercollegiate Guidelines Network (SIGN) criteria. Only one randomised clinical trial, out of the ten trials found, was considered to be a suitable comparison (versus a dual therapy in combination with the sulfonylurea glipizide in patients inadequately controlled with metformin, diet and exercise). No trials have evaluated variables of relevance to patients, except for safety variables. The main efficacy variable in the trials was the change from baseline in HbA1c, except for a study which evaluated the change from baseline in total body weight as main variable. Baseline characteristics of the patients enrolled in the trials significantly differ from those of the population with diabetes in our society which tend to be of an older age and have a longer history of type 2 diabetes mellitus. The major limitation of dapagliflozin derives from its mechanism of action, since its efficacy decreases as renal function declines. The use of dapagliflozin is not recommended in patients with moderate to severe renal impairment ((CrCl<60ml/min or GFG <60 ml/min/1.73 m2) nor in elderly patients, in which a decrease in renal function can be expected. The assessment of safety includes the incidence and rate of discontinuations due to adverse events, episodes of hypoglycaemia, signs or symptoms of genital and urinary tract infections, dehydration, hypovolaemia and hypotension. Further pharmacoepidemiological studies are to be carried out to clarify the long-term effects of dapagliflozin on renal function and the potential effect in the development of breast and bladder tumours. Dapagliflozin as monotherapy has not been evaluated against adequate comparators (sulfonylureas, pioglitazone, gliptins). In combination therapy with metformin, the efficacy of dapagliflozin was shown to be non-inferior to glipizide plus metformin, resulting in a mean reduction of 0.52% in HbA1c, with a difference of 0.00 among both groups (95% CI: -0.11 a 0.11). There are no comparative data against other second-line treatment options. As shown in the studies, the overall incidence of adverse events with dapagliflozin as monotherapy (21.5%) was similar to that observed with placebo, and greater to that observed with metformin (15.4%). Hypoglycaemia of any type was the adverse event more frequently reported. The incidence of severe hypoglycaemic events observed in most of the studies was low. The overall incidence of adverse events observed in the study that compared dapagliflozin+metformin against glipizide+metformin was similar for both groups (27%) and incidence of hypoglycaemic events with dapagliflozin (3.5%) was significantly lower to that observed with glipizide (40.8%). Reductions of body weight of about 2 to 3 kg and a slight decrease in blood pressure (1 to 5 mmHg) have been observed in all studies in the groups treated with dapagliflozin together with diet and exercise. Dosing scheme (every 24 hours) is similar to other oral antidiabetic agents and its cost is similar to that for gliptines and higher to that for sulfonylureas or generic pioglitazone. Funding has been limited to the use of dapagliflozin as dual therapy regimen in combination with metformin as an option for patients with contraindication or intolerance to sulfonylureas, such a those experiencing frequent hypoglycaemic events, weight loss associated risks, as long as they are under 75 years of age and have no moderate to severe renal impairment. In the light of the above, we consider dapagliflozin means no therapeutic innovation in the therapy of type 2 diabetes mellitus over other therapeutic alternatives available.

"We do have space in Lausanne. We have a large cemetery": The non-controversy of a non-existent Muslim burial ground

In the context of the administration of spaces assigned by municipalities for the burial of the dead, this article provides a critical analysis of the techniques for the governance of political collectives of citizens implemented by public authorities. More broadly, this article shows how funerary practices (i.e. the social practices surrounding death-the rituals, the legislation, etc.) can be used to develop a critical reading of the social relations that structure the social production of space. To this end, the authors use the conceptual tools provided by critical legal geography to explore the controversy surrounding the development of a 'carré confessionnel' (denominational area) within the Bois-de-Vaux Cemetery in Lausanne, Switzerland. Here, a focus on the techniques that allow 'nomosphere' technicians to convene a subset of the citizens within the public space reveals the administration of cemeteries as a means of governance, a method for mobilising bodies and a paradoxical means of managing flux.

Huellas de la escritura materna en el español escrito como L2

Siguiendo los Nuevos Estudios de Literacidad y utilizando técnicas etnográficas (observación, entrevistas), criticamos varios aspectos de la concepción cognitiva de la “lectura en idioma extranjero” y proponemos una alternativa más sociocultural, que incorpora las particularidades reseñadas, que ofrece una visión más realista y completa y que pone el acento en el alfabetismo crítico. A partir de entrevistas a hablantes competentes del español como L2, que fueron alfabetizados en una lengua materna tipológicamente muy diferente y con un sistema de escritura distinto, exploramos el efecto que tienen las prácticas literarias escolares, en varias culturas, en el aprendizaje del español como segunda lengua.

Aproximaciones a la lectura crítica: teoría, ejemplos y reflexiones

Dentro de las ciencias del lenguaje, el Análisis Crítico del Discurso (ACD) aprovecha las aportaciones de los recientes estudios sobre el texto (análisis del discurso, pragmática, sociolingüística, etnografía de la comunicación, teoría de la enunciación, etc.) para definir los propósitos y la metodología del análisis crítico. Ante el mundo multicultural y globalizado en el que vivimos, la única respuesta educativa posible es la necesidad de formar a una ciudadanía, que tenga habilidades críticas de lectura, escritura y pensamiento y participe de modo constructivo en el desarrollo de una comunidad plural, respetuosa y progresista. El artículo explora en la teoría y en la práctica la lectura crítica, para reflexionar sobre la necesidad de fomentar este tipo de práctica lectora en el aula. Para ejemplificar el funcionamiento de la lectura crítica, se trabajan lingüísticamente desde el ACD algunos fragmentos breves de discurso. Se analiza el grado y el tipo de comprensión lectora crítica que muestran 25 exámenes de universitarios españoles de 20 años, estudiantes de Traducción e Interpretación en la Universidad Pompeu Fabra de Barcelona, que habían tenido 80 horas de instrucción sobre lengua escrita y análisis deldiscurso en castellano y catalán (con varias sesiones sobre Análisis Crítico del Discurso), en las que se habían analizado cooperativamente textos parecidos al propuesto en el examen.

Gender and Security Sector Reform: Gendering Differently?

Recent efforts to implement gender mainstreaming in the field of security sector reform have resulted in an international policy discourse on gender and security sector reform (GSSR). Critics have challenged GSSR for its focus on 'adding women' and its failure to be transformative. This article contests this assessment, demonstrating that GSSR is not only about 'adding women', but also, importantly, about 'gendering men differently' and has important albeit problematic transformative implications. Drawing on poststructuralist and postcolonial feminist theory, I propose a critical reading of GSSR policy discourse in order to analyse its built-in logics, tensions and implications. I argue that this discourse establishes a powerful 'grid of intelligibility' that draws on gendered and racialized dualisms to normalize certain forms of subjectivity while rendering invisible and marginalizing others, and contributing to reproduce certain forms of normativity and hierarchy. Revealing such processes of discursive in/exclusion and marginalized subjectivities can serve as a starting point to challenge and transform GSSR practice and identify sites of contestation.