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The challenges facing the health system in South Africa are likely to impact on life-long adherence for patients in the context of the rollout of ART. Smaller ART programs have been able to demonstrate good adherence rates, but the question remains if this can be achieved by large public sector ART programs. Most adherence researchers share the basic understanding that patients are adherent when they take their medications as prescribed by the health provider. An approach to adherence that combines both clinical and social knowledge—a biosocial approach— is likely to move us to a better understanding of adherence and how to improve adherence to ART. This study on social support and ART adherence aims to gather and document information that could be used to improve services and program strategies for strengthening and maintaining adherence at ART rollout sites in Gauteng. The two study sites Carletonville Hospital and Zola Clinic were chosen randomly from all second-generation rollout sites in the Province. Data were collected from a total of 359 respondents, 164 in Carletonville and 195 in Zola. The response rate was 98.3%. The results showed that the majority of the respondents were female (72.1%) and about 44.9% were within the age group 30-39 years. In terms of educational attainment, most respondents (70.1%) had received secondary education and 2.5% had not attended school. Based on assets quintiles scores of 1-5, with 5 being the highest score, about one-third of the respondents scored 1, and only 7% scored 5. Compared with Carletonville, respondents from Zola were more educated and better resourced. At the facilities, treatment preparation and support and adherence assessment procedures are routine features of the ART program and entail pre and post test counseling, group education and adherence counseling and serve as mechanisms for adherence support. This is enhanced by routine follow-up appointments where ART patients are provided information on side effects of ARVs, effectiveness of treatment, CD4 cell and viral load counts and referral to services not provided at the facility. Additionally, support groups accessed by patients undertake a range of educational activities on staying healthy, viral load and CD4 cell counts and ARVs. Although respondents were largely positive about their interactions with health providers and the support they provided, some expressed concern about health workers being too busy to address their problems, not treating patients with enough respect and sometimes patients leaving without receiving treatment because staff were either absent or late or queues were too long. The HIV disclosure rate was high (95.5%). However, respondents were more likely to disclosure to a family member, but less likely to a friend, neighbor or religious leader. Selfreported adherence and viral load adherence rates were high (97.6% and 76.6% respectively) but CD4 adherence was lower at 51.0%. The study did not document a convincing association between social support and ART adherence. Only two variables (receiving food supplements and age groups) were significantly associated with CD4 and viral load adherence. Given the limitations of the study, a longitudinal study is needed in these sites to better understand the predictors of short and long-term adherence and to explore ways to better measure the relevance, content and quality of the social support services being utilized by ART patients at facility and community levels. Interventions and policies are needed to respond to the concerns identified from the study regarding inadequate attention and respect by health providers, absence or lateness of doctors and pharmacists and challenges pertaining to access to food, income and disability grants.

Considéré par la plupart de la critique comme une littérature putride (cf. ULBACH, 1868) ou ignominieuse (cf. VERISSIMO, 1894), accusé de confondre naïvement la science et la littérature, ainsi que de rendre le langage littéraire scientifique, et surtout au Brésil, en outre, remis en question en tant que plagiat ou importation dune mode étrangère, le naturalisme a été relégué aux marges de lhistoriographie littéraire. Prenant comme point de départ ce panorama critique, la thèse propose une réévaluation critique et historiographique de lesthétique naturaliste, commençant par décrire et analyser son origine au cours de lhistoire à partir de la constitution du réalisme moderne dans les oeuvres de Stendhal et de Balzac (cf. AUERBACH, 2004). On se concentre notamment sur la lente affirmation des termes réalisme et naturalisme et sur limportance de la contribution de différents romanciers français au processus de consolidation de lesthétique réaliste et de son prolongement dans le naturalisme. On discute également le projet esthétique proposé par Zola, de même quon déconstruit des mythes corroborés par lhistoriographie littéraire à propos de la théorie et du mouvement naturalistes. Enfin, en établissant les rapports entre lidéologie esthétique naturaliste et lidéal républicain, on discute lacclimatation des principes esthétiques naturalistes au Brésil, dans loeuvre de celui qui a été son principal représentant, Aluísio Azevedo. A partir dune étude comparative entre le naturalisme en France et au Brésil, on cherche, en effet, à contribuer au processus de révision critique et historiographique dune période littéraire énormément productive dans les deux pays, malgré la tendance à sa dévalorisation généralement observée dans les manifestations de la critique du XXe siècle / Considerado pela maioria da crítica como uma literatura pútrida (cf. ULBACH, 1868) ou torpe (cf. VERÍSSIMO, 1894), acusado de confundir ingenuamente ciência e literatura, bem como de cientizar a linguagem literária, e em particular no Brasil, além disso, questionado por plágio ou importação de uma moda estrangeira, o naturalismo foi relegado às margens da historiografia literária. Assumindo como ponto de partida esse panorama crítico, a tese propõe uma reavaliação crítica e historiográfica da estética naturalista, começando por descrever e analisar sua origem no decurso da história, a partir do advento do realismo moderno nas obras de Stendhal e de Balzac (cf. AUERBACH, 2004). Enfoca a lenta afirmação dos termos realismo e naturalismo, bem como a importância da contribuição de diferentes romancistas franceses no processo de consolidação da estética realista e de seu prolongamento no naturalismo. Discute-se também o projeto estético proposto por Zola, assim como se desconstroem mitos corroborados pela historiografia literária a respeito da teoria e do movimento naturalistas. Por fim, correlacionando a estética naturalista com o ideal republicano, aborda-se a aclimatação dos princípios naturalistas no Brasil, na obra daquele que foi seu principal representante, Aluísio Azevedo. A partir de uma abordagem comparativa entre o naturalismo na França e no Brasil, busca-se, em síntese, contribuir para o processo de revisão crítica e historiográfica de um período literário muito produtivo nos dois países, não obstante a tendência para sua desvalorização em geral observada nas manifestações da crítica novecentista

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Akademisk avhandling : Humanistika fakultetens : Åbo : 2004. / Bibliogr. p. 207-221. Index.

Zugl.: Berlin, Freie Univ., Diss., 2007

Thesis (Ph. D.)--Ohio State University, 2003. / Title from OhioLink abstract page. Abstract. Abstract available online via OhioLINK's ETD Center.

I locate my dissertation at the critical intersection of philosophy, medical discourse and literature, and anchor it around five intertwining concepts: modernity, subjectivity, masculinity, immunity and Frenchness. I contend that immunity, as a concept at which life and law converge, offers an alternative and largely overlooked episteme shaping contemporary French literary consciousness as a primary regulator/negotiator between health and sickness, belonging and not belonging, volition and involition, and, finally, self and other. I treat immunity metaphorically and scientifically, and then trace the episteme through the works of three French authors—Émile Zola, Albert Camus and Hervé Guibert—all of whom adopt the medical novel as a way of addressing the relationship of the individual to society and to the self. Anne-Marie Moulin frames the immunological revolution as an ever-evolving "semantic event." In this vein, I devote my first chapter to examining how immunity instituted itself as a common trope of "becoming" embraced—and left naturalized—by post-structural thinkers grappling with their corporal limits. This rhetorical turn culminates in Jean-Luc Nancy's characterization of the immune system as the body’s “physiological signature," inhibiting the potential of man to transcend his biology. In my second chapter, I move from the metaphor of immunity to a brief exposition of the history of the science, ending my survey with Elie Metchnikoff (and his legacy), the "father" of cellular immunology who envisioned the internal body as a dynamic, every-changing structure. I focus the next three chapters of my study on literary examples where the male protagonist’s immunity has been compromised. For my first two examples—Le Docteur Pascal by Emile Zola and La Peste by Albert Camus—I analyze the portrait of the supposedly immune doctor, considering what the “costs and benefits" of this immunity are and how this "exceptional status" is destabilized. Then, in my last chapter, I switch perspectives from the doctors to the patient, examining the texts of Hervé Guibert who, I argue, models his writing strategy on the retrovirus’s tactics, challenging literary conventions so as better to exteriorize his experience and “contaminate” (in the etymological sense as "touch together") his readers. / Romance Languages and Literatures

The description of odour, frequent in Zola's work, has been little studied, most researchers having focused only on the visual description of this novelist. This dissertation, taking as its corpus Les Rougon-Macquart, explores this issue. The working hypothesis is that Zola reveals his impressionist tendencies in this type of description. The first chapter presents a brief history of the status of olfaction and description of odour in its philosophical, social as well as in literary context. The following chapter, after having defined a few concepts (notions from Hamon and Adam), presents the status of the description of odour in Zola's work. Four recurrent devices emerge: redundancy, multi-sensorial description, clausulae and turning points. The third chapter begins the study of the internal working of the description by examining the lexicon of odour. The lexicon of odour as used by Zola resorts mostly to the emotional and poetical functions of language. The final chapter continues the examination of modes of structuration, using Adam's notion of plan of text. The text concludes by maintaining that Zola's uniqueness is based on his marriage of impressionism and realism-naturalism. (Abstract shortened by UMI.)