Th.--Méd.--Reims, 1980. N°: 1.

This thesis traces the paths and trajectories that one substance - the plant stimulant Catha edulis (Forssk.), known in Kenya as 'miraa' - takes in the course of its 'social life' from production, through exchange, to its points of consumption. The thesis attempts to draw out the richness in this social life through an in-depth ethnographic examination of these trajectories, emphasising in particular their socially-embedded nature. By following an approach influenced by the volume The social life of things (Appadurai [ed.] 1986) the thesis is able to tease out much of the significance the substance has for those people who animate its social life. The trajectories covered vary greatly in range, from those involving local consumption in the area in which it is grown - the Nyambene Hills district of Kenya - to those that take it thousands of miles away to Europe and North America. The vast range of the substance allows for the generation of many different meanings and associations, and many of these are brought out over the course of the thesis. The trade of the substance (trade that relies much on trust) and its consumption are seen as in many ways socially cohesive, while in other respects socially divisive: while substances like miraa can build bridges, they can also build fences. Of especial importance to the thesis is the character of Nicholas, whose relationship with miraa demonstrates how individuals can take on board shared meanings concerning a substance, whilst creating many new meanings of their own through processes of convergence and divergence. The study addresses both the significance of miraa and its social life for wider debates in anthropology and its significance within the lives of farmers, traders, and consumers, and anyone engaged in debating its merits.

The levels of the psychoactive alkaloids S-(-)-cathinone and its primary metabolite cathine, consisting of the diastereomers (+) -norpseudoephedrine and (-)- norephedrine were determined in Catha edulis (Vahl) Forssk. ex Endl., Catha transvaalensis Codd and Catha abbottii Van Wyk & Prins. Alkaloid levels were investigated in C. edulis plants collected from three different localities in South Africa, and one from a Nairobi khat market. The efficiency of three different methods for the extraction and isolation of cathinone and cathine were investigated, viz. an aqueous acid extraction, an organic solvent extraction and an aqueous acid extraction using the commercially available Extrelutᴿ procedure. The aqueous acid extraction resulted in the rapid loss of cathinone and yielded variable alkaloid levels in replicate studies. This was also observed when this method was coupled with the Extrelutᴿ procedure. In contrast, the organic solvent extraction did not result in a loss of cathinone and provided consistent results over a number of replicates; it also proved to be a simple and rapid method for extracting and isolating cathinone and cathine. A trifluoroacetic acid (TFA) derivatization procedure which has been suggested to produce characteristic diagnostic fragments for gas chromatography / mass spectrometry (GC/MS) identification, was investigated, but failed to produce consistent TFA derivatives of cathinone and cathine. However, underivatized cathinone and cathine were easily identified by GCMS due to their unambiguous mass spectra. All subsequent studies were undertaken using the organic solvent extraction and isolation method, coupled with GC analysis and GC/MS identification of underivatized cathinone and cathine. Leaves of C. edulis were found to contain cathinone and cathine at levels 100 times higher than those of C. transvaalensis. The alkaloids were undetectable in C. abbottii. Plants grown from cuttings of C. edulis collected from the Durban Botanical Gardens were found to contain cathinone and cathine at levels of 0.410 mg per gram fresh weight and 0.157 mg per gram fresh weight in leaves, respectively, while these levels in plants derived from different localities decreased in the order: Eastern Cape (0.319 mg/g f.w cathinone and 0.029 mg/g f.w cathine), Mpumalanga (0.139 mg/g f.w. cathinone and 0.171 mg/g f.w. cathine) and Nairobi (0.032 mg/g f.w. cathinone and 0.025 mg/g f. w. cathine). In an investigation of the cathinone levels in the different plant parts it was found that the highest levels were found in leaves of the shoot tip (0.243 mg/g f.w.) but decreased with the age of the leaf and developmental stage of the plant in the order: juvenile leaves (0.124 mg/g f.w.), mature leaves (0.035 mg/g f.w.), young stem (0.033 mg/g f.w.) and mature stem (0.004 mg/g f.w.). Concomitantly, cathine levels increased with the age of the leaf: leaves of the shoot tip (0.006 mg/g f.w.), juvenile leaves (0.011 mg/g f.w.), mature leaves (0.019 mg/g f.w.). The cathine level in the young stem material was found to be the highest in the entire plant (0.270 mg/g f.w.) but decreased markedly in the mature stem (0.052 mg/g f.w.). Both cathinone and cathine levels in the mature root were greater than levels in the mature stern, being 0.012 mg cathinone per gram fresh weight, and 0.063 mg cathine per gram fresh weight. Neither cathinone nor cathine were detectable in young root material. / Thesis (M.Sc.)-University of Natal, Pietermaritzburg, 2001.

Die Studie wurde durchgeführt, um die mögliche Rolle von Qat und Zigarettenrauchen in der Prävalenz sichtbarer bzw. zytologisch nachweisbarer Veränderungen in der Mundschleimhaut bei Jemeniten zu untersuchen. Wir rekrutierten 30 nicht-rauchende und 30 rauchende, nur auf einer Seite und seit mindestens 5 Jahren Qat-kauende Jemeniten. Patienten mit anderen Gewohnheiten, die diese Assoziation verzerren könnten, wurden ausgeschlossen. Wir inspizierten die Mundhöhle auf das Vorliegen von Läsionen und nahmen Bürstenbiopsien von der bukkalen Mukosa und Gingiva der Kauseite, aber auch der kontralateralen. Alle sichtbaren Läsionen waren flach und homogen, zytologische Veränderungen wurden häufig entdeckt. Bei 77% aller 60 Teilnehmer wurden weiße Läsionen und gleichzeitig zytologische Veränderungen entdeckt. Auf der Kauseite variierte der Anteil mit weißen Läsionen – in Abhängigkeit von der anatomischen Region und dem Raucherstatus - zwischen 47% und 93%. Dies war statistisch signifikant häufiger als auf der kontralateralen (Nicht-Kau-) Seite (3% - 47%). Der Anteil der untersuchten Regionen mit Abnormalitäten war bei Rauchern und Nicht-Rauchern ähnlich. Die kappa-Statistik bezüglich der Übereinstimmung von Inspektion und Zytologie war niedrig. Die hohe Prävalenz sichtbarer Läsionen und zytologischer Abnormalitäten unter Qat-Konsumenten war unabhängig vom Raucherstatus. Die moderate Übereinstimmung zwischen Inspektion und Zytologie demonstriert, wie schwierig das klinische Management chronischer Qat-Konsumenten ist. Bürstenbiopsien könnten zukünftig im diagnostischen Vorgehen von Nutzen sein.

Abstract Background: There is wide variability in the phenotypic manifestation of autism spectrum disorder (ASD). Recognizing autistic traits behind socio-emotional and adaptive problems in children with normal cognitive level can therefore be challenging. Aims and methods: The purpose of this study was to find tools for recognition of autism traits for clinicians working in primary/secondary settings. Two internationally used and empirically valid quantitative screeners, the Autism Spectrum Screening Questionnaire (ASSQ) and the Social Responsiveness Scale (SRS), were translated into Finnish and evaluated among high-functioning elementary school-aged children. An epidemiological target population of 8-year-old children (N=4,408) including 28 children with ASD was rated by parents and teachers using the ASSQ in order to assess cut-off scores for the Finnish ASSQ, and sensory abnormalities (SA) were determined in order to estimate the prevalence of SAs, and to investigate associations between sensory-perceptual problems and quantitative autism traits (QAT). The SRS was evaluated in a clinical ASD case (N=44)-control (N=44) study. It was also studied whether QAT of family members were associated with child QAT using the SRS. Results: Collecting parent and teacher ASSQ ratings and a cut-off of summed 30 points are recommended for ASD diagnostic assessments. The Finnish SRS was able to differentiate children with ASD from a normative child sample. The prevalence of SAs was 8% in the general population and 54% in the ASD sample. Tactile, auditory and olfactory hypersensitivities were associated with an elevated risk for an ASD diagnosis and auditory hypersensitivity explained the variance in the ASSQ scores among the ASD sample. In the normative sample, mother-child SRS QAT were more strongly associated, whereas in the ASD sample, a stronger positive correlation was found between father and child SRS QAT. Conclusions: In ASSQ screening, it is essential to collect both parent and teacher assessments. The SRS offers valuable information for determining the focal points of rehabilitation and evaluating treatment outcome. The SAs of the child as well as high QAT levels of male family members are indicators of an elevated risk for ASD. / Tiivistelmä Tausta: Autismikirjon häiriön kliininen oirekuva vaihtelee henkilöstä toiseen. Tästä johtuen autististen piirteiden tunnistaminen lapsen sosioemotionaalisten ja sopeutumisvaikeuksien taustalta voi olla haasteellista. Tavoitteet ja menetelmät: Tutkimuksen tarkoituksena oli etsiä kognitiivisesti hyvätasoisten peruskouluikäisten parissa työskenteleville kliinikoille apukeinoja autististen piirteiden tunnistamiseen. Kaksi kansainvälisesti käytettyä seulontamittaria, Autismikirjon seulontalomake (ASSQ) ja Sosiaalisen vastavuoroisuuden arviointiasteikko (SRS), käännettiin suomeksi ja niiden psykometrisiä ominaisuuksia arvioitiin. Lisäksi tutkittiin, olivatko aistipoikkeavuudet tai vanhempien autistismipiirteisyys yhteydessä peruskouluikäisen lapsen autismipiirteisyyteen. Vanhemmat ja opettaja täyttivät ASSQ:n 8-vuotiaista epidemiologisen kohderyhmän lapsista (N=4408), joista 28:lla oli autismikirjon häiriö, ja kohderyhmän lasten aistipoikkeavuudet kartoitettiin. ASSQ:n seulontarajat sekä aistipoikkeavuuksien esiintyvyys ja yhteys autismipiirteisyyteen määritettiin. SRS evaluoitiin ja perheen sisäisen autismipiirteisyyden vertailu tehtiin kliinisessä autismikirjo (N=44)-verrokki (N=44)-aineistossa. Tulokset: Vanhempien ja opettajan ASSQ-arviointien yhteenlaskettu pistemäärä 30 oli parhaiten toimiva seulontaraja autismikirjon häiriön diagnostisia tutkimuksia varten. SRS erotteli autismikirjon lapset normiaineistosta. Aistipoikkeavuuksien esiintyvyys kokonaisväestössä oli 8 % ja autismikirjon lapsilla 54 %. Tunto-, kuulo- ja hajuyliherkkyys olivat yhteydessä kohonneeseen autismikirjon häiriön riskiin ja kuuloyliherkkyys selitti autismipiirteisyyden vaihtelua autismikirjon lapsilla. Normiaineistossa lapsen ja äidin autismipiirteisyys olivat vahvemmin yhteydessä toisiinsa, kun taas autismikirjon lasten perheissä lapsen ja isän autismipiirteisyys olivat vahvemmin yhteydessä toisiinsa. Päätelmät: ASSQ-arvioinnissa on ensiarvoisen tärkeää kerätä tietoa lapsen käyttäytymisestä sekä koti- että kouluympäristöstä. SRS on käyttökelpoinen määriteltäessä kuntoutuksen painopistealueita ja kartoitettaessa sen vaikuttavuutta. Lapsen aistipoikkeavuudet sekä hänen miespuolisten perheenjäsentensä vahva autismipiirteisyys viittaavat autismikirjon häiriön mahdollisuuteen.