Accounting for the Shift Towards ‘Multifaith’ Religious Education in Zambia, 1964 -2017

This article sheds light on the factors that contributed to the development of ‘multifaith’ Religious Education (RE) in Zambia after 1964. Our analysis makes a contribution to the discourse on inter-religious RE in Zambia by demonstrating how Zambia became a multifaith society, a context in which political statements and ideologies have influenced the framing of the aim, and selection of, the content of the subject. Research for this article consisted of interviews with Christian missionaries who shared with us their involvement in developing, teaching and evaluating standards of the teaching of RE. We also carried out an appraisal of literature related to the topic so as to complement our arguments. Contrary to widely held perceptions which attribute RE to the missionaries’ influence, this article argues that Christian missionaries, immigrants and local politics all had their own influence on the move to develop a ‘multifaith’ RE. Missionaries developed the kind of RE that responded to Zambia’s religious context, local politics, the multiracial, multicultural and multifaith situation in the country, and invested their time, energy and money in the subject. These efforts to move towards ‘multifaith’ RE were challenged by internal and external forces. In the context of shifting political ideologies, the current nature and content of RE has been challenged to reflect a multifaith RE which mirrors the religious context of the country. We argue that Zambian scholars of RE can learn a number of valuable lessons from the missionaries such as their hard work and passion to ensure that RE remains a curriculum subject with required books. As the next RE research agenda in Zambia, we propose researching on the subject in terms of its rationale and its educational basis

Accounting for the Shift Towards ‘Multifaith’ Religious Education in Zambia, 1964 -2017

This article sheds light on the factors that contributed to the development of ‘multifaith’ Religious Education (RE) in Zambia after 1964. Our analysis makes a contribution to the discourse on inter-religious RE in Zambia by demonstrating how Zambia became a multifaith society, a context in which political statements and ideologies have influenced the framing of the aim, and selection of, the content of the subject. Research for this article consisted of interviews with Christian missionaries who shared with us their involvement in developing, teaching and evaluating standards of the teaching of RE. We also carried out an appraisal of literature related to the topic so as to complement our arguments. Contrary to widely held perceptions which attribute RE to the missionaries’ influence, this article argues that Christian missionaries, immigrants and local politics all had their own influence on the move to develop a ‘multifaith’ RE. Missionaries developed the kind of RE that responded to Zambia’s religious context, local politics, the multiracial, multicultural and multifaith situation in the country, and invested their time, energy and money in the subject. These efforts to move towards ‘multifaith’ RE were challenged by internal and external forces. In the context of shifting political ideologies, the current nature and content of RE has been challenged to reflect a multifaith RE which mirrors the religious context of the country. We argue that Zambian scholars of RE can learn a number of valuable lessons from the missionaries such as their hard work and passion to ensure that RE remains a curriculum subject with required books. As the next RE research agenda in Zambia, we propose researching on the subject in terms of its rationale and its educational basis

Accounting for the Shift Towards ‘Multifaith’ Religious Education in Zambia, 1964 -2017

This article sheds light on the factors that contributed to the development of ‘multifaith’ Religious Education (RE) in Zambia after 1964. Our analysis makes a contribution to the discourse on inter-religious RE in Zambia by demonstrating how Zambia became a multifaith society, a context in which political statements and ideologies have influenced the framing of the aim, and selection of, the content of the subject. Research for this article consisted of interviews with Christian missionaries who shared with us their involvement in developing, teaching and evaluating standards of the teaching of RE. We also carried out an appraisal of literature related to the topic so as to complement our arguments. Contrary to widely held perceptions which attribute RE to the missionaries’ influence, this article argues that Christian missionaries, immigrants and local politics all had their own influence on the move to develop a ‘multifaith’ RE. Missionaries developed the kind of RE that responded to Zambia’s religious context, local politics, the multiracial, multicultural and multifaith situation in the country, and invested their time, energy and money in the subject. These efforts to move towards ‘multifaith’ RE were challenged by internal and external forces. In the context of shifting political ideologies, the current nature and content of RE has been challenged to reflect a multifaith RE which mirrors the religious context of the country. We argue that Zambian scholars of RE can learn a number of valuable lessons from the missionaries such as their hard work and passion to ensure that RE remains a curriculum subject with required books. As the next RE research agenda in Zambia, we propose researching on the subject in terms of its rationale and its educational basis

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19. Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days (rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Safety and immunogenicity of seven COVID-19 vaccines as a third dose (booster) following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK (COV-BOOST): a blinded, multicentre, randomised, controlled, phase 2 trial

Background: Few data exist on the comparative safety and immunogenicity of different COVID-19 vaccines given as a third (booster) dose. To generate data to optimise selection of booster vaccines, we investigated the reactogenicity and immunogenicity of seven different COVID-19 vaccines as a third dose after two doses of ChAdOx1 nCov-19 (Oxford–AstraZeneca; hereafter referred to as ChAd) or BNT162b2 (Pfizer–BioNtech, hearafter referred to as BNT). Methods: COV-BOOST is a multicentre, randomised, controlled, phase 2 trial of third dose booster vaccination against COVID-19. Participants were aged older than 30 years, and were at least 70 days post two doses of ChAd or at least 84 days post two doses of BNT primary COVID-19 immunisation course, with no history of laboratory-confirmed SARS-CoV-2 infection. 18 sites were split into three groups (A, B, and C). Within each site group (A, B, or C), participants were randomly assigned to an experimental vaccine or control. Group A received NVX-CoV2373 (Novavax; hereafter referred to as NVX), a half dose of NVX, ChAd, or quadrivalent meningococcal conjugate vaccine (MenACWY) control (1:1:1:1). Group B received BNT, VLA2001 (Valneva; hereafter referred to as VLA), a half dose of VLA, Ad26.COV2.S (Janssen; hereafter referred to as Ad26) or MenACWY (1:1:1:1:1). Group C received mRNA1273 (Moderna; hereafter referred to as m1273), CVnCov (CureVac; hereafter referred to as CVn), a half dose of BNT, or MenACWY (1:1:1:1). Participants and all investigatory staff were blinded to treatment allocation. Coprimary outcomes were safety and reactogenicity and immunogenicity of anti-spike IgG measured by ELISA. The primary analysis for immunogenicity was on a modified intention-to-treat basis; safety and reactogenicity were assessed in the intention-to-treat population. Secondary outcomes included assessment of viral neutralisation and cellular responses. This trial is registered with ISRCTN, number 73765130. Findings: Between June 1 and June 30, 2021, 3498 people were screened. 2878 participants met eligibility criteria and received COVID-19 vaccine or control. The median ages of ChAd/ChAd-primed participants were 53 years (IQR 44–61) in the younger age group and 76 years (73–78) in the older age group. In the BNT/BNT-primed participants, the median ages were 51 years (41–59) in the younger age group and 78 years (75–82) in the older age group. In the ChAd/ChAD-primed group, 676 (46·7%) participants were female and 1380 (95·4%) were White, and in the BNT/BNT-primed group 770 (53·6%) participants were female and 1321 (91·9%) were White. Three vaccines showed overall increased reactogenicity: m1273 after ChAd/ChAd or BNT/BNT; and ChAd and Ad26 after BNT/BNT. For ChAd/ChAd-primed individuals, spike IgG geometric mean ratios (GMRs) between study vaccines and controls ranged from 1·8 (99% CI 1·5–2·3) in the half VLA group to 32·3 (24·8–42·0) in the m1273 group. GMRs for wild-type cellular responses compared with controls ranged from 1·1 (95% CI 0·7–1·6) for ChAd to 3·6 (2·4–5·5) for m1273. For BNT/BNT-primed individuals, spike IgG GMRs ranged from 1·3 (99% CI 1·0–1·5) in the half VLA group to 11·5 (9·4–14·1) in the m1273 group. GMRs for wild-type cellular responses compared with controls ranged from 1·0 (95% CI 0·7–1·6) for half VLA to 4·7 (3·1–7·1) for m1273. The results were similar between those aged 30–69 years and those aged 70 years and older. Fatigue and pain were the most common solicited local and systemic adverse events, experienced more in people aged 30–69 years than those aged 70 years or older. Serious adverse events were uncommon, similar in active vaccine and control groups. In total, there were 24 serious adverse events: five in the control group (two in control group A, three in control group B, and zero in control group C), two in Ad26, five in VLA, one in VLA-half, one in BNT, two in BNT-half, two in ChAd, one in CVn, two in NVX, two in NVX-half, and one in m1273. Interpretation: All study vaccines boosted antibody and neutralising responses after ChAd/ChAd initial course and all except one after BNT/BNT, with no safety concerns. Substantial differences in humoral and cellular responses, and vaccine availability will influence policy choices for booster vaccination. Funding: UK Vaccine Taskforce and National Institute for Health Research