Sub-Saharan African randomised clinical trials into male circumcision and HIV transmission: methodological, ethical and legal concerns

In 2007, WHO/UNAIDS recommended male circumcision as an HIV-preventive measure based on three sub-Saharan African randomised clinical trials (RCTs) into female-to-male sexual transmission. A related RCT investigated male-to-female transmission. However, the trials were compromised by inadequate equipoise; selection bias; inadequate blinding; problematic randomisation; trials stopped early with exaggerated treatment effects; and not investigating non-sexual transmission. Several questions remain unanswered. Why were the trials carried out in countries where more intact men were HIV-positive than in those where more circumcised men were HIV-positive? Why were men sampled from specific ethnic subgroups? Why were so many participants lost to follow-up? Why did men in the male circumcision groups receive additional counselling on safe sex practices? While the absolute reduction in HIV transmission associated with male circumcision across the three female-to-male trials was only about 1.3%, relative reduction was reported as 60%, but, after correction for lead-time bias, averaged 49%. In the Kenyan trial, male circumcision appears to have been associated with four new incident infections. In the Ugandan male-to-female trial, there appears to have been a 61% relative increase in HIV infection among female partners of HIV-positive circumcised men. Since male circumcision diverts resources from known preventive measures and increases risk-taking behaviours, any long-term benefit in reducing HIV transmission remains uncertain.     

Spectacular Security: Mega-Events and the Security Complex

In Discipline and Punish Foucault famously declares that "our society is one not of spectacle, but of surveillance." Our theoretical aim in this paper is to problematize Foucault's strict demarcation between spectacle and surveillance through an analysis of urban mega-events. In the process, we detail emerging features of contemporary mega-events that shape and are shaped by shifts in the field of security and surveillance more broadly. Three dynamics in particular warrant consideration: the move toward a precautionary logic among security planners, a "semiotic shift" wherein security iconography is integrally bound up with the production of contemporary urban spectacles, and various forms of security and surveillance legacies that circulate beyond the spatial and temporal frame of the event itself. While mega-events support Foucault's assertion of the dispersal of discipline across the social field, they also suggest that this dispersal occurs in concert with, not in spite of, the power of the spectacle in contemporary society.     

The Analysis of Black Powder Substitutes Containing Ascorbic Acid by Ion Chromatography/Mass Spectrometry*†

Abstract: Black powder substitutes containing ascorbic acid are a group of low explosives that utilize ascorbic acid as the fuel. The analysis of these powders is complicated by the degradation of ascorbic acid which occurs rapidly in solution and may also occur as the powder ages. Aqueous extracts of both intact powders and postblast residues were analyzed by an existing ion chromatography/mass spectrometry (IC/MS) method used at the Bureau of Alcohol, Tobacco, Firearms and Explosives. Results have shown that while ascorbic acid itself is not detected in this method, its diagnostic degradation products (threonic acid, monohydrated diketogulonic acid, and oxalic acid) can be identified. In addition, anions from the inorganic oxidizers (perchlorate and nitrate) and combustion products such as chloride, chlorate, and nitrite, can be identified within the same experiment. While this IC/MS method shows promise, future modifications are necessary because of limitations in identifying threonate in postblast residues, as well as coeluting compounds observed in postblast residues.     

Teaching Young Children to Discriminate Abusive From Nonabusive Situations Using Multiple Exemplars in a Modified Discrete Trial Teaching Format

Personal safety programs can teach young children knowledge and skills they can utilize to avoid or escape abduction and sexual abuse (Wurtele, 1990). An appropriate escape response will not occur, however, if the child is unable to discriminate an innocuous situation from a potentially abusive one. This study examines the crucial elements involved in training the recognition or discrimination phase in personal safety programs. A multiple probe design across three typically developing children, ages 5-years 7-months through 6-years 7-months, was used to determine whether rules and discrete trial training of discriminations of appropriate and inappropriate touch and situations generalized to puppet role-play scenarios. All participants showed increases in correct responding on generalization role-play probes and maintained these increases over a 3-and 6-week follow-up.