MASCULINITIES IN STUDENT POLITICS: GENDERED DISCOURSES OF STRUGGLE AND LIBERATION AT THE UNIVERSITY OF LIMPOPO

The article examines the role of discourses of struggle and liberation in the performance of gender in student politics at the University of Limpopo. Moving from an understanding of how discourses of masculinity intertwine with the discourses of student activism and the struggle against apartheid, the article analyses the elections held for the Students’ Representatives Council (SRC) at Turfloop Campus in October 2006. It is argued that male student politicians draw on struggle history and revocations of African traditionalism in ways that keep them at the centre of student politics, while female students are kept on the margins as a muted group. The article aims to show how male and female students position themselves as gendered beings in the realm of student politics; and how, in the process, discourses of gender and the struggle translate into social practice. The analysis shows that it is not fruitful to view discourses of gender in isolation from other discourses. Rather, the reading of the student elections points to the need for a careful examination of how discourses of gender are entangled in broader discourses of hegemony at the political level; and not least how organisations and individual actors engage with these discourses

Polysomnographic and subjective sleep assessment during sedation with dexmedetomidine or placebo, and the effect of sedation on melatonin concentration in critically ill mechanically ventilated patients

Baggrund: Manglende døgnrytme, abnorm søvn og søvnforstyrrelser er almindelige på intensivafdelingen og er forbundet med ændret kognitiv funktion, delirium og øget dødelighed hos kritisk syge patienter, især når de ligger i respirator. Derfor anvendes sedation og ofte i form af GABA (gamma-aminosmørsyre) agonister såsom Propofol eller Midazolam, hvilket leder til søvn, men den cerebrale restitution udebliver. Da søvn monitorering er essentiel for et forebygger ovenstående komplikationer bruges subjektiv søvnvurdering (SSV) ofte. Dette i mangel af bedre metoder da validiteten ikke til fulde er belyst. Studie 3 havde til formål at sammenligne og validere SSV med PSG da hypotesen var dårlig overensstemmelse mellem SSV og PSG, samt at en overvurdering af total søvntid (TST) vurderet med SSV ville forekomme sammenlignet med PSG. Morfin, Midazolam, Propofol og Dexmedetomidin påvirker alle koncentrationen af cirkulerende hormoner og disse lægemidler påvirker også det endokrine system ved at øge eller mindske koncentrationen af de hormoner der cirkulerer i blodbanen. Nogle af de berørte hormoner er katekolaminer, kortisol, væksthormon og melatonin. Sidstnævnte har man aldrig undersøgt grundigt i relation til sedation. Studie 1 forsøgte at belyse konsekvensen af sedation på melatonin koncentrationen. Melatonin er et vigtigt signal stof i reguleringen af døgnrytmen, men hvorvidt sedation påvirker denne regulering, er ukendt. Derfor var formålet med studie 1 at evaluere effekten på melatonin koncentrationen i blodet hos kritisk syge patienter randomiseret til sedation eller ikkesedation og at undersøge sammenhængen med delirium. Hypotesen var at melatonin koncentrationen blev supprimeret, hvilket korrelerede med øget frekvens af delir. Da søvn med cerebral restitution er essentielt, havde studie 2 havde til formål at evaluere effekten af Dexmedetomidin på søvnkvalitet og kvantitet ved hjælp af PSG, som er guldstandard i forbindelse med søvnvurdering. Dette da hypotesen var at søvn kvalitet og kvantitet øges hos patienter der behandles med Dexmedetomidin.Metoder: Studie 1 var en delundersøgelse til: "Non-sedation or Light Sedation in Critical Ill, Mechanically Ventilated Patients," publiceret i The New England Journal of Medicine. I denne undersøgelse blev hundrede på hinanden følgende patienter randomiseret til sedation eller ikkesedation med en daglig vækning (50 i hver arm). 79 patienter fra hovedundersøgelsen gennemførte undersøgelse 3 (41 sederede og 38 ikke-sederede). Alle patienter blev inkluderet og randomiseret på intensivafdelingen på Sydvestjysk Sygehus, Danmark. Melatonin blev målt tre gange dagligt (3 am., 2 pm og 10 am) i fire på hinanden følgende dage. Prøvetagning startende på dag to efter randomisering og intubation. Primært endepunkt: Melatonin koncentrationen hos sederede vs. ikke-sederede patienter. Sekundært endepunkt: Risiko for delir eller ikke-medicinsk induceret (NMI) koma hos sederede vs. ikke-sederede patienter, vurderet med CAM-ICU. 30 på hinanden følgende patienter blev inkluderet i undersøgelse 2, og undersøgelsen blev udført som et dobbeltblindet, randomiseret, placebo-kontrolleret forsøg med to parallelle grupper: 20 patienter blev behandlet med Dexmedetomidin og 10 med placebo. To 16 timers polysomnografioptagelser blev udført for hver patient to på hinanden følgende nætter. Patienterne blev randomiseret til Dexmedetomidin eller placebo efter den første optagelse, hvilket gav en kontroloptagelse for alle patienter. Dexmedetomidin blev administreret i forbindelse med anden PSG-optagelse (kl. 6 am. – 6 am). Formålet var at sammenligne effekten af Dexmedetomidin vs. placebo på søvn - kvalitet og kvantitet. Primært endepunkt: Overensstemmelse mellem SSV og PSG bestemt ved Bland-Altman-analyse. Sekundært endepunkt: 1) Den overordnede gennemsnitlige total søvn tid (TST) estimeret af SSV sammenlignet med PSG hos alle studie deltagere indrulleret i hovedundersøgelsen i løbet af begge undersøgelsesnætter, 2) TST for alle studiedeltagere evalueret hver time i løbet af begge undersøgelsesnætter, 3) TST vurderet med SSV sammenlignet til PSG hos forsøgsdeltagere, der blev sederet med Dexmedetomidin i løbet af nat 2 og forsøgsdeltagere, der blev behandlet med placebo eller ikke-sedation den første og anden nat. Studie 3 var en sekundær analyse til studie 2, og den omfattede alle 30 patienter fra studie 1. Sygeplejersken der passede patienten, udførte en subjektiv observatørvurdering af søvnmængden, som blev sammenlignet med PSG-optagelserne.Resultater: koncentrationen af melatonin i studie 1 var supremeret hos sederede patienter sammenlignet med de ikke-sederede. Alle patienterne oplevede en forhøjet maksimal melatonin koncentration tidligt i løbet af deres kritiske sygdom (p=0,01). Risikoen for delirium eller koma (NMI) var signifikant lavere i den ikke-sederede gruppe (OR 0,42 CI 0,27;0,66 p&lt;0,0001). Der blev ikke vist nogen signifikant sammenhæng mellem delir og supremeret melatonin koncentration i undersøgelse tre (OR 1,004 P=0,29 95 % CI 0,997;1,010). I studie 2 blev søvn effektivitet øget i Dexmedetomidingruppen med 37,6 % (29,7; 45,6 95 % CI) vs. 3,7 % (-11,4; 18,8 95 % CI) (p&lt;0,001) og total søvntid (TST) blev forlænget med 271 min. (210; 324 95 % CI) vs. 27 min. (-82; 135 95 % CI), (p&lt;0,001). Der blev ikke fundet nogen signifikant forskel i REM-søvn, delirium, fysisk aktivitet eller RASS-score undtagen RASS nat 2. I undersøgelse 3 var graden af overensstemmelse mellem SSV og PSG lav. Gennemsnitlig TST estimeret med SSV i tidsintervallet 4 pm til 7 am var 481 minutter (428;534, 95 % CI) vs. PSG med 437 minutter (386;488, 95 % CI) (p=0,05). Ved sedering med Dexmedetomidin var TST estimeret med SSV 650 minutter (571;729, 95 % CI) vs. PSG, som var 588 minutter (531;645, 95 % CI) (p=0,56). For deltagere behandlet med placebo eller ikke-sedation var TST estimeret med SSV 397 minutter (343;450, 95 % CI) vs. PSG på 362 minutter (302;422, 95 % CI) vs. (p=0,17).Konklusion: Hos patienter randomiseret til sedation eller non-sedation var melatonin koncentrationen supremeret hos de sederede, kritisk syge patienter sammenlignet med ikkesederede kontroller og hyppigheden af delirium var øget. Total søvntid og søvn effektivitet blev signifikant forbedret, uden eliminering af REM-søvnen, hos respirator behandlende intensive patienter randomiseret til Dexmedetomidin sammenlignet med en kontrol-PSG-optagelse udført under ikke-sedation/standardbehandling. Hos mekanisk ventilerede kritisk syge intensiv patienter var der dårlig overensstemmelse mellem SSV og PSG og der var en signifikant overestimering af gennemsnitlig TST. SSV bør derfor kun anvendes såfremt man er bevidst om, at den er upræcis med en tendens til at overvurderer TST.Background: Lack of circadian rhythm and sleep disturbances are common in the intensive care unit and are associated with altered cognitive function, delirium and increased mortality in critically ill patients, especially when mechanically ventilators. Therefore, sedation is often used, and in the absence of a better alternative, GABA (gamma-aminobutyric acid) agonists, such as Propofol or Midazolam, are used. However, these sedatives lead to a lack of restorative sleep. Since sleep monitoring is essential for preventing the above complications, subjective sleep assessment (SSV) is often used. This is in the absence of better methods, as the validity has yet to be fully elucidated. Study 3 aimed to compare and validate SSV with PSG as the hypothesis was that a poor agreement between SSA and PSG was present and that an overestimation of total sleep time (TST) assessed with SSV would occur. Morphine, Midazolam, Propofol and Dexmedetomidine affect the concentration of circulating hormones. These sedatives also affect the endocrine system by increasing or decreasing the concentration of the hormones circulating in the bloodstream. Some hormones involved are catecholamines, cortisol, growth hormone and melatonin. The latter has never been thoroughly investigated concerning sedation. Study 1 aimed to evaluate the effect of sedation on melatonin concentration. Melatonin is an essential hormone in regulating the circadian rhythm, but whether sedation affects this regulation is unknown. Therefore, the aim of study 1 was to evaluate the effect of the melatonin concentration in the blood in critically ill patients randomized to sedation or nonsedation and to investigate the correlation with delirium. The hypothesis was that melatonin concentration was suppressed, which correlated with an increased frequency of delirium. Restorative sleep is essential, as mentioned above. Hence, study 2 aimed to evaluate the effect of Dexmedetomidine on sleep quality and quantity using polysomnography (PSG), as the hypothesis was that sleep quality and quantity increase in patients treated with Dexmedetomidine. Methods: Study 1 was a sub-study to "Non-sedation or light sedation in critically ill, mechanically ventilated patients," published in The New England Journal of Medicine. One-hundred consecutive patients were randomized to sedation or non-sedation with a daily wake-up call (50 in each arm). 79 patients from the main study completed the sub-study (41 sedated and 38 non-sedated). All included patients were randomized at the intensive care unit (ICU) at the hospital of southwest Jutland, Denmark. Melatonin was measured thrice daily (3 am, 2 pm, and 10 pm) for four consecutive days, starting on the second day upon randomization/intubation. Primary outcome: melatonin concentration in sedated vs. non-sedated patients. Secondary outcome: risk of developing delirium or non-medically induced (NMI) coma in sedated vs. non-sedated patients, assessed by CAM-ICU (Confusion Assessment Method for the Intensive Care Unit). 30 consecutive patients were included in study 2, and the study was performed as a double-blinded, randomized, placebo-controlled trial with two parallel groups: 20 patients were treated with dexmedetomidine and 10 with placebo. Two 16 h of polysomnography recordings were completed for each patient on two consecutive nights. Patients were randomized to dexmedetomidine or placebo after the first recording, thus providing a control recording for all patients. Dexmedetomidine was administered during the second recording (6 pm – 6 am) and the objective was to compare the effect of dexmedetomidine vs. placebo on sleep - quality and quantity. The primary outcome was sleep quality, total sleep time (TST), sleep efficiency (SE), and REM sleep determined by PSG. Secondary outcome was delirium and daytime function determined by CAM ICU (Confusion Assessment Method of the Intensive Care Unit) and physical activity. Alertness and wakefulness determined by RASS (Richmond Agitation and Sedation Scale). Study 3 was a secondary analysis to study 2, and it included all 30 patients from study 2. The attending nurse performed a subjective observer rating of sleep quantity, and this assessment was compared to the PSG recordings and the primary outcome was the level of agreement between SSA and PSG determined by Bland-Altman analysis. The secondary outcome was the overall mean TST estimated by SSA compared to PSG in all study participants enrolled in the main study during both study nights. Secondly to estimate TST for all study participants evaluated hourly during both study nights, and thirdly to estimate TST assessed with SSA compared to PSG in study participants sedated with dexmedetomidine during the second night and for study participants treated with placebo or non-sedation the first and second nights. Results: Melatonin concentration in study 1 were suppressed in sedated patients compared to the non-sedated. All patients showed an elevated peak melatonin concentration early in their ICU admission (p=0.01). The risk of delirium or coma (NMI) was significantly inferior in the nonsedated group (OR 0,42 CI 0.27;0.66 p&lt;0.0001). No significant relationship between delirium development and suppressed melatonin concentration was shown in this study (OR 1.004 P=0.29 95% CI 0.997;1.010). In study 2 Sleep efficiency was increased in the dexmedetomidine group by; 37.6% (29.7;45.6 95% CI) vs. 3.7% (-11.4;18.8 95% CI) (p&lt;0.001) and TST were extended by 271 min. (210;324 95% CI) vs. 27 min. (-82;135 95% CI), (p&lt;0.001). No significant difference in REM sleep, delirium, physical activity, or RASS score was found except RASS night two. In study 3 the level of agreement between SSA and PSG was low. The mean TST estimated by SSA during the time interval 4.00 pm to 7.00 am was 481 minutes (428;534, 95% CI) vs. PSG at 437 minutes (386;488, 95% CI) (p=0.05). When sedated with dexmedetomidine, TST assessed using SSA was 650 minutes (571;729, 95% CI) vs. PSG which was 588 minutes (531;645, 95% CI) (p=0.56). In participants treated with placebo or non-sedation TST assessed with SSA was 397 minutes (343;450, 95% CI) vs. PSG at 362 minutes (302;422, 95% CI) vs. (p=0.17). Conclusion: In patients randomized to sedation or non-sedation, melatonin concentration was suppressed in the sedated, critically ill ICU patients compared to non-sedated controls, and the frequency of delirium development was elevated in these patients. Total sleep time and sleep efficiency were significantly increased, and REM sleep was not eliminated, in mechanically ventilated critically ill patients randomized to dexmedetomidine compared to a control PSG recording performed during non-sedation (standard care). The level of agreement between SSA and PSG in the above-mentioned preexisting cohort data base was low, and there was a significant overestimation of mean total sleep time. SSA should only be used under the awareness that it is imprecise and overestimates total sleep time.<br/

Multiphase modelling of tumour growth and extracellular matrix interaction: mathematical tools and applications

Resorting to a multiphase modelling framework, tumours are described here as a mixture of tumour and host cells within a porous structure constituted by a remodelling extracellular matrix (ECM), which is wet by a physiological extracellular fluid. The model presented in this article focuses mainly on the description of mechanical interactions of the growing tumour with the host tissue, their influence on tumour growth, and the attachment/detachment mechanisms between cells and ECM. Starting from some recent experimental evidences, we propose to describe the interaction forces involving the extracellular matrix via some concepts coming from viscoplasticity. We then apply the model to the description of the growth of tumour cords and the formation of fibrosis

Cervical collagen and biomechanical strength in non-pregnant women with a history of cervical insufficiency

<p>Abstract</p> <p>Background</p> <p>It has been suggested that cervical insufficiency (CI) is characterized by a "muscular cervix" with low collagen and high smooth muscle concentrations also in the non-pregnant state. Therefore, the aim of this study was to investigate the biomechanical properties, collagen concentration, smooth muscle cell density, and collagen fiber orientation in cervical biopsies from non-pregnant women with a history of CI.</p> <p>Methods</p> <p>Cervical punch biopsies (2 × 15 mm) were obtained from 57 normal non-pregnant women and 22 women with a history of CI. Biomechanical tensile testing was performed, and collagen content was determined by hydroxyproline quantification. Histomorphometry was used to determine the volume densities of extracellular matrix and smooth muscle cells from the distal to the proximal part of each sample. Smooth muscle cells were identified using immunohistoche-mistry. Finally, collagen fiber orientation was investigated. Data are given as mean +/- SD.</p> <p>Results</p> <p>Collagen concentration was lower in the CI group (58.6 +/- 8.8%) compared with the control group (62.2 +/- 6.6%) (p = 0.033). However, when data were adjusted for age and parity, no difference in collagen concentration was found between the two groups. Maximum load of the specimens did not differ between the groups (p = 0.78). The tensile strength of cervical collagen, i.e. maximum load normalized per unit collagen (mg of collagen per mm of specimen length), was increased in the CI group compared with controls (p = 0.033). No differences in the volume density of extracellular matrix or smooth muscle cells were found between the two groups. Fibers not oriented in the plane of sectioning were increased in CI patients compared with controls.</p> <p>Conclusions</p> <p>Cervical insufficiency does not appear to be associated with a constitutionally low collagen concentration or collagen of inferior mechanical quality. Furthermore, the hypothesis that a "muscular cervix" with an abundance of smooth muscle cells contributes to the development of cervical insufficiency is not supported by the present study.</p

Of “Bad Behaviour” and “Dangerous Sex”:Moral Responses to the Threat of HIV/AIDS among Children and Youth in Rural Burundi

Burundi has been tormented by armed conflict for decades. In the midst of reconstructing rural communities, young people are concerned with their future and the need to avoid “bad behaviours” in order to have a better future. This article is based on findings from an interview-based survey conducted among nine to 18 year-old boys and girls who live in rural Burundi and participated in an HIV prevention and empowerment project run by an international NGO. The findings show how the children and young people perceive sexual relations and the threat of HIV/AIDS, and how they attempt to deal with these by assuming a moral high ground and becoming role models in their community. The article argues that the research participants draw on a binary moral discourse of good and bad behaviour in which sex is dangerous and should be avoided. From their accounts, it is clear that the message they have adopted of sexual abstinence demands a continuous effort on their part to avoid a whole range of temptations and pressures in their daily lives. Moreover, the findings presented in the article reveal that the threat of HIV/ AIDS is just one among many concerns. In the local context, burning issues pertaining to sex, including issues of sexual assault, transactional sexual relations, early pregnancies and unwanted pregnancies, loomed large and were the primary concern of young people. The article reaches the conclusion that the HIV prevention project did not address these crucial issues, and that the abstinence message the participants appropriated is not a sufficient measure to combat the rising HIV prevalence among youth in rural Burundi

Elastin is Localised to the Interfascicular Matrix of Energy Storing Tendons and Becomes Increasingly Disorganised With Ageing

Tendon is composed of fascicles bound together by the interfascicular matrix (IFM). Energy storing tendons are more elastic and extensible than positional tendons; behaviour provided by specialisation of the IFM to enable repeated interfascicular sliding and recoil. With ageing, the IFM becomes stiffer and less fatigue resistant, potentially explaining why older tendons become more injury-prone. Recent data indicates enrichment of elastin within the IFM, but this has yet to be quantified. We hypothesised that elastin is more prevalent in energy storing than positional tendons, and is mainly localised to the IFM. Further, we hypothesised that elastin becomes disorganised and fragmented, and decreases in amount with ageing, especially in energy storing tendons. Biochemical analyses and immunohistochemical techniques were used to determine elastin content and organisation, in young and old equine energy storing and positional tendons. Supporting the hypothesis, elastin localises to the IFM of energy storing tendons, reducing in quantity and becoming more disorganised with ageing. These changes may contribute to the increased injury risk in aged energy storing tendons. Full understanding of the processes leading to loss of elastin and its disorganisation with ageing may aid in the development of treatments to prevent age related tendinopathy

Of “Bad Behaviour” and “Dangerous Sex”:Moral Responses to the Threat of HIV/AIDS among Children and Youth in Rural Burundi

Burundi has been tormented by armed conflict for decades. In the midst of reconstructing rural communities, young people are concerned with their future and the need to avoid “bad behaviours” in order to have a better future. This article is based on findings from an interview-based survey conducted among nine to 18 year-old boys and girls who live in rural Burundi and participated in an HIV prevention and empowerment project run by an international NGO. The findings show how the children and young people perceive sexual relations and the threat of HIV/AIDS, and how they attempt to deal with these by assuming a moral high ground and becoming role models in their community. The article argues that the research participants draw on a binary moral discourse of good and bad behaviour in which sex is dangerous and should be avoided. From their accounts, it is clear that the message they have adopted of sexual abstinence demands a continuous effort on their part to avoid a whole range of temptations and pressures in their daily lives. Moreover, the findings presented in the article reveal that the threat of HIV/ AIDS is just one among many concerns. In the local context, burning issues pertaining to sex, including issues of sexual assault, transactional sexual relations, early pregnancies and unwanted pregnancies, loomed large and were the primary concern of young people. The article reaches the conclusion that the HIV prevention project did not address these crucial issues, and that the abstinence message the participants appropriated is not a sufficient measure to combat the rising HIV prevalence among youth in rural Burundi