Open Access-Zeitschriften an der WWU Münster (Westfälische Wilhelms-Universität)
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Trends in neuropathology training in Sub-Saharan Africa – current curricula, resource gaps, and the potential of virtual microscopy and telemedicine
Full text linkIntroduction: Neuropathology is important in the diagnosis of neurologic and neuro-oncologic diseases. But despite its immense importance, it remains underrepresented in medical training across different parts of Sub-Saharan Africa. Training in this region is limited by a low number of specialists (e.g., a ratio of 1.7 million inhabitants per an unspecialized pathologist), fragmented data, poor infrastructure, and minimal exposure. Most times, neuropathology is embedded in general pathology curricula with limited mentorship, specialized facilities, and tailored subspecialty pathways (e.g., Nigeria, Tanzania). But despite these prevailing challenges, digital tools like telepathology and virtual microscopy may help bridge those gaps.
Aim: This scoping review aims to understand the structure of existing neuropathology training and identify important gaps in structure and resources across Sub-Saharan Africa. It also seeks to explore how regional and global collaborations and digital innovations can be integrated to bridge these gaps.
Methodology: Using PRISMA-ScR guidelines, we searched literature published between 2000 and 2025 across major databases such as PubMed, Scopus, Web of Science, AJOL, and grey sources. We included and thematically analyzed studies that focused on training in neuropathology, workforce, and digital tools in Sub-Saharan Africa. We mapped out data to capture country, program type, curriculum content, resource availability, and digital tool integration. Quantitative synthesis summarized the frequency and geographic distribution of programs, while qualitative thematic analysis identified recurring patterns in training gaps, infrastructural limitations, and the application of virtual microscopy and telepathology.
Result: We reviewed eleven studies that indicate limited neuropathology programs, an extremely low number of neuropathologists (e.g., 0.4–0.6 per million in many Sub-Saharan Africa nations), inadequate mentorship, and limited training resources. However, telepathology and virtual microscopy show improved accuracy in diagnosis and quality training (e.g., Tanzania recorded a 35 % increment in accuracy by specialized pathologists using telepathology over general pathologists). Strengthening international collaborations also demonstrates feasibility and enhanced quality training.
Conclusion: Neuropathology in Sub-Saharan Africa is underdeveloped and fragmented; however, the increasing access to newer digital solutions presents low-cost options as practical alternatives for overcoming diagnostic and training obstacles. To narrow these gaps, the track toward becoming a subspecialist in neuropathology should be formed, accessible digital libraries of learning materials must be developed, and regional and international telepathology networks should be strengthened
What’s in the Share? Materialising Tensions Between Strategic Action Fields of Food Sovereignty and Organic Market in Community Supported Agriculture
No full textLange Zeit wurde die Solidarische Landwirtschaft als eine solidarischere Alternative zu den industriellen Ernährungssystemen verstanden. Ursprünglich beruhte dieses Modell auf gemeinschaftlicher Finanzierung und Teilung der Risiken. Heute spiegelt dieses alternative landwirtschaftliche Feld jedoch zunehmend marktorientierte Normen wider, beispielsweise in Bezug auf Preisgestaltung, Qualitätserwartungen und Kundenzufriedenheit. In diesem Beitrag untersuchen wir, wie Initiativen der solidarischen Landwirtschaft zwischen zwei konkurrierenden strategischen Handlungsfeldern interagieren: dem Feld der Ernährungssouveränität einerseits und dem des biologischen Agrarmarkts andererseits. Aufbauend auf der Theorie strategischer Handlungsfelder analysieren wir den wöchentlichen Gemüseanteil („Share“) als materielle Manifestation, durch welche diese Spannungen sichtbar und verhandelbar werden. Die Analyse der Daten von zwölf Initiativen der solidarischen Landwirtschaft in Frankreich – einschließlich kontinuierlicher Dokumentation der Gemüseanteile und Interviews mit den Erzeuger*innen – offenbart, dass die Zusammensetzung, Vielfalt und Preisgestaltung der Gemüseanteile Ausdruck strategischer Aushandlungen zwischen Solidaritätsprinzipien und Markterwartungen sind. Unsere Ergebnisse belegen, dass die Erzeuger*innen der solidarischen Landwirtschaft hybride Strategien verfolgen, um wirtschaftliche Tragfähigkeit mit einer teilweisen Entkommerzialisierung zu verbinden. Die Gemüseanteile fungieren somit als materielle Manifestation interfeldlicher Positionierung und stabilisieren die solidarische Landwirtschaft als hybrides, sich entwickelndes Feld innerhalb alternativer Ernährungssysteme.Community Supported Agriculture (CSA) has long been framed as a solidarity-based alternative to industrial food systems. While initially grounded in collective financing and risk-sharing, CSA partnerships can also reflect market-based norms, such as pricing benchmarks, quality expectations, and consumer satisfaction. In this paper, we investigate how CSA initiatives navigate these competing tensions by positioning themselves between two strategic action fields: the field of food sovereignty and the field of organic agricultural markets. Drawing on the theory of strategic action fields, we analyse weekly CSA shares as a material manifestation through which these tensions become visible. Analysing data from twelve CSA partnerships in France, including weekly share monitoring and interviews with producers, we examine how the content, diversity, and pricing of the shares reflect negotiated compromises between solidarity ideals and market expectations. The results show that while not isolated from market pressures, CSA producers adopt hybrid strategies that allow for both economic viability and partial decommodification. We argue that the CSA share, as a material manifestation of an interfield position, contributes to stabilising CSA as a hybrid, evolving field within alternative food systems
