Boston University. University Professors Program Senior theses. / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-02

D. Lit. et Phil. / The process of change can be complex and the introduction of affirmative action in South Africa against an apartheid backdrop is undoubtedly one such change. In 1998 the Employment Equity Act was passed. The purpose of the Act was to achieve equity in the workplace by promoting equal opportunity and fair treatment in employment through the elimination of unfair discrimination and; implementing affirmative action measures to redress the disadvantages in employment experienced by designated groups, in order to ensure their equitable representation iIi all occupational categories and levels in the workforce (Government Gazette, 1998). Whilst the concept is not new and has been extensively researched in several countries, it was introduced under unique circumstances in South Africa (Luhabe, 1993). There is therefore, a need for the generation of additional theories that are relevant and applicable to South Africa's unique circumstances -theories that are grounded in, and account for this area in South Africa. As Stamp (1999) put it, a grounded theory that is generated form the ground up". The present study aimed to generate theory from the lived experiences of black affi'rmative action participants in South African organisations. The study intended to look at how affirmative action is experienced by beneficiaries without prior judgement from previous literature on the subject. It aimed not to verify past theories but to understand the situation as it is experienced. Hence, the grounded theory method of analysis was chosen by the researcher. Grounded theory is a qualitative method that generates theory by the systematic collection and analysis of data (Glaser,1992). The grounded theory method of research aims to generate new theory that is grounded in the data of a substantive area. It therefore aims to create theory from the central themes and categories that emerge form the data.

Colorectal cancer (CRC) is one of the most common forms of neoplasia in Western populations but is uncommon in sub-Saharan Africa. In developing countries such as South Africa, differences in lifestyles and environment exist between the various population groups. These differences and the diverse patterns of cancer that exist, provide an ideal opportunity to study the pathogenesis of colorectal cancer. In South Africa, the incidence of CRC in black patients is approximately ten fold lower than that of white South African patients. The majority of black South African CRC patients presents with tumours without macroscopic polyps. Recently five genes involved in DNA mismatch repair (MMR) have been implicated in hereditary nonpolyposis colorectal cancer (HNPCC). In this retrospective study, paraffin-embedded normal and tumour tissues from 109 black, and 110 Caucasian CRC patients were studied. To screen for the possible involvement of DNA mismatch repair genes, the presence of microsatellite instability (MSI) was investigated. In total 40 patients presented with MSI-H tumours, 27/109 (24,8%) tumours from black patients and 13/110 (11,8%) tumours from Caucasian patients. The proportion of MSI-H tumours from black patients attending Chris Hani Baragwanath Hospital (CHB) (12,2%; 5/41) and that of Caucasian patients is in accordance to published results on sporadic tumours. However the finding that 32,4% of black patients attending Kalafong and Pretoria Academic Hospitals, have tumours with MSI-H is much higher than is commonly reported in Western populations and is significantly higher than that of the Caucasian patients (p = 0.002; χ2-test). It has been observed that patients who present at CHB live mainly in urban Johannesburg/Soweto, in comparison to those seen at KPH who are mostly from peri-urban and rural areas. Failure of PCR amplification, owing to the absence of high quality tissue, allowed 32 of the 40 MSI-H tumours to be fully screened for mutations in hMLH1 and hMSH2 using exon-by-exon PCR single strand conformation polymorphism (SSCP) analysis. Sixteen pathogenic mutations were found in 14 tumours, 10/22 (45%) from black patients and 4/10 (40%) from caucasian patients. Five tumours presented with two mutations each, one is a compound heterozygote and the other four tumours are double heterozygotes. Ten of the sixteen mutations identified, are novel. Five (5/32; 16%) of the pathogenic mutations are germline in origin, four (4/22; 18%) of which were detected in tumours from black patients. Thus HNPCC was diagnosed in ~0,93% (1/107) of Caucasian and 3,85% (4/104) of black patients via germline mutations. The frequency of recognised DNA repair gene mutations in black patients with HNPCC is four times higher than that in Caucasian patients with HNPCC. This is consistent with the notion that penetrance of HNPCC cancer is independent of environmental factors which is true as the frequency of HNPCC in a low incidence population (black South Africans) is much higher than that of a high incidence population (Caucasian South Africans). A missense mutation in hMSH2 (codon 127) was identified in three black patients. It is listed in the ICG-HNPCC database as a pathogenic mutation (in a Nigerian family). However, further investigation demonstrated that this is a polymorphic change exclusive to black Africans. Somatic mutations were detected in 6 (27%) tumours from black and 3 (30%) tumours from Caucasian patients. In conclusion, the observed microsatellite instability and mutations in hMLH1 and hMSH2 thus clearly implicate the involvement of DNA mismatch repair genes in the pathogenesis of colorectal cancers of black and Caucasian South African patients. This study represents the first investigation of DNA mismatch repair genes in tumours from both population groups. It is also the first report of black South Africans with HNPCC. / Dissertation (MSc (Human Genetics))--University of Pretoria, 2005. / Genetics / unrestricted

Background. While much progress has been made, HIV remains a major global public health problem. South Africa remains home to the highest number of people living with HIV (7.1 million) in the world. Despite remarkable progress in the past decade, adolescent girls and young women aged 15-24 (AGYW) remain at higher risk of HIV exposure and infection than other groups. We do not know enough about AGYW HIV knowledge and perceptions, although it is likely an important factor to consider in AGYW's HIV risk. This paper investigates knowledge and perceptions about HIV risk behaviours and explores associations with demographic and behavioral characteristics among AGYW in South Africa. Methods. This sub-study is based on the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey, a cross-sectional population-based household survey. A multistage stratified cluster sampling approach was employed to select the study population. Multivariate logistic regression was used to determine associations or factors which were associated with HIV knowledge. Results. Among the sample of 3700 AGYW aged 15-24 years, White [OR=2.44 (95% CI: 1.48-4.03), p=0.001] and Indian [OR=3.85 (95% CI: 2.39-6.18), p=0.000] AGYW were associated with high HIV knowledge compared to Black Africans. AGYW in urban informal [OR=0.64 (95% CI: 0.45-0.90), p=0.011] and rural informal [OR=0.57 (95% CI: 0.33-0.98), p=0.043] were associated with low HIV knowledge compared to urban formal settings. AGYW in Eastern Cape [OR=0.69 (95% CI: 0.48-1.00), p=0.048], KwaZulu-Natal [OR=0.69 (95% CI: 0.48-0.99), p=0.044], North West [OR=0.50 (95% CI: 0.32-0.77), p=0.002] and Limpopo [OR=0.44 (95% CI: 0.27-0.71), p=0.001] provinces were associated with low HIV knowledge compared to AGYW in Western Cape. Unemployed AGYW were associated with low HIV knowledge [OR=0.57, p=0.001]. While AGYW with higher levels of education: grade 12 [OR=1.66 (95% CI: 1.04-2.64), p=0.034] and tertiary [OR=2.68 (95% CI: 1.47-4.89), p=0.001] were associated with high HIV knowledge. AGYW having had sex in the last 12 months were associated with high HIV knowledge [OR=1.70 (95% CI: 1.08-2.72), p=0.023]. On the contrary, having multiple sexual partners in the last 12 months was associated with low HIV knowledge [OR= 0.60 (95%CI: 0.39-0.99), p=0.045] compared to AGYW that had 1 sexual partner in the last 12 months. AGYW with a low risk of alcohol use were associated with high HIV knowledge [OR=1.4 (95% CI: 1.02-1.87), p=0.039] compared to AGYW that abstained from alcohol. The final multivariate logistic regression model showed that AGYW in urban informal settings have low HIV knowledge [aOR=0.59 (95% CI: 0.35-0.99), p=0.046] among all geotypes. Conclusion. Overall, the main findings show a lack of knowledge among AGYW across race, geotype, province and sexual activity. More specifically that low HIV knowledge was associated with AGYW who were Black South Africans, living in informal settings, from Eastern Cape, KwaZulu Natal, North West and Limpopo, unemployed, had lower levels of education, and have multiple sexual partners. However, in the final multivariate analysis, only geotype stood out, indicating that there is an HIV knowledge deficit in urban informal settings. This can be addressed through the promotion of knowledge through education, equitable and accessible availability of education and sexual and reproductive health services, and HCT and support among AGYW living in urban informal settings.

Even as the numbers of migrants waiting in North Africa to continue their journeys to Europe continue to grow, the social and political consequences of this time spent “en route” remain marginal to conversations around migration across the Mediterranean. There is a focus on migrants’ movement through space, with emphasis on origin and destination, presumed to be Europe, but not much attention paid to the time in between. Rather than centering on how borders regulate, impede, and allow or not, migratory flow, and what happens when European borders are crossed, this dissertation focuses on another of the predominant phenomena to which borders give rise: waiting. This dissertation emerges from the social worlds and subjective transformations that take place in and around the borderlands of the Strait of Gibraltar. These worlds include communities of West African migrants who have become immigrants in Morocco, Moroccan and Spanish day-laborers who work as commodity porters moving back and forth between Morocco and Spain, and activist and mutual aid networks that have emerged around the rapidly growing immigrant community in Tangier, Morocco. Lives lived while waiting, whether in the city of Tangier among im/migrants or in the commodity warehouses that abut the border between Spanish Ceuta and Morocco, form consequential habits that sediment into social life and become fields for potential political claims grounded in communal sentiments. As such, this dissertation explores the consequences of these communal sentiments across the many borders of the Strait of Gibraltar, and draws on intensive fieldwork between 2017 and 2019 in the context of a decade of research in Tangier and Ceuta. It does so through a critical ethnographic analysis exploring the emergent languages, labors, and infrastructures of belonging and difference that emerge among immigrant and migrant communities in Tangier, Morocco and Ceuta, Spain. Theoretically, this dissertation builds from theories of metapragmatic discourse analysis, infrastructural flow and breakdown, and borderland political economies in order to emphasize the worlds emergent along these borders. When seen through the lens of waiting, understanding the growth and transformations of migratory dynamics and border politics in the region means paying more attention to this time spent “en route,” its consequences beyond just the regulation of access to spatial territories, and the categories of belonging and difference that emerge along the way.

No description available.

There is evidence that some sub-Saharan African individuals suspect that they are HIV positive before diagnosis but delay being tested for HIV. This increases the likelihood of being diagnosed late (with a severely compromised immune system), a phenomenon that has been observed in sub-Saharan Africans diagnosed in the UK. Late diagnosis has negative personal and public health consequences. There is a lack of understanding of the psychological processes associated with delayed HIV-testing. This study used a Grounded Theory methodology. It aimed to produce a theoretical model to explain the psychological processes associated with delayed HIV testing in sub-Saharan Africans in the UK but also how these processes changed over time and contributed to the decision to test. Seven HIV-positive sub-Saharan African individuals from a London HIV clinic and one from a HIV charity were interviewed about their experiences. Analysis led to the development of a theoretical model of delayed HIV testing. This model consisted of three theoretical codes: moving in and out of uncertainty about HIV infection; preferring not to know HIV status; and making the decision to test for HIV. Participants' HIV risk perception fluctuated and was characterised by uncertainty. This, in combination with a preference to not know their HIV status due to a number of feared consequences of being HIV-positive, deterred them from testing. Participants' thoughts and feelings about knowing their HIV status changed over time. These changes were that they: wanted certainty, had hope of being HIV-negative and/or a hope for treatment and life and preparing for and accepting a potentially positive result. The findings can inform interventions to reduce delayed testing and suggest: a) intervening with ambivalence on an individual level and b) promoting awareness of HIV c) promoting the benefits of testing/costs of not testing at a population level. The findings are discussed in relation to existing research and theory. Strengths and limitations of the study are discussed, as are clinical implications and suggestions for future research.

Thesis (Ph. D.)--Ohio State University, 2009. / Title from first page of PDF file. Includes bibliographical references (p. 404-434).

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Indiana University-Purdue University Indianapolis (IUPUI) / In the United States, there is very little knowledge about the health of African immigrants. Although their population exceeds 2 million and still on the rise exponentially, a big gap exists regarding knowledge about health care access and outcomes for this population. Before relocating to the US, many African immigrants face health-threatening conditions, including civil wars and poverty, which are exacerbated by the lack of understanding and attention to their health care needs in the US. Methods: To examine the health care experiences of African immigrants in the US, two distinct studies were conducted. A scoping review examined literature between 1980 and 2016 using four databases, to identify knowledge-gaps concerning African immigrant in the US. A qualitative study comprising 33 semi-structured (one-on-one) interviews and 4 focus groups was conducted using Nigerian immigrant participants in Indianapolis, to assess how discrimination affects their health care experiences and quality of care, and the factors their influence their health care meanings, respectively. Results: For the scoping review, 14 articles were included. All the studies were focused on barriers to the health care access of African immigrants in the US. Along with religion and culture, lack of culturally-competent healthcare and distrust of the US health system, were identified as the major barriers. Both the one-on-one interviews and focus groups revealed provider attitudes, through implicit and open biases, were a key contributing factor to the participants’ health care meanings and healthcare utilization. Additionally, results showed an important intersectionality within the healthcare experiences of the participants, as a result of their perception as “black,” along with African Americans and other physically-related groups. Conclusion: African immigrants in the US grapple with the critical process of reconciling their original identities with their emerging realities, including negative provider attitudes and discrimination, and lack of identify in the US health system. This study highlights the importance of understanding African immigrant health in the US, through the examination of the role of the African framework of understanding of their health in their approaches to healthcare and well-being. / 2021-03-06