The Kafkaesque Pursuit of ‘World Class’: Audit Culture and the Reputational Arms Race in Academia

Since the 1980s universities have been subjected to a seemingly continuous process of policy reforms designed to make them more economical, efficient and effective, according to yardsticks defined by governments and university managers. The pursuit of ‘excellence’, ‘international standing’ and ‘world class’ status have become key drivers of what Hazelkorn (High Educ Pol 21(2):193–215, 2008) has termed the ‘rankings arms race’ that now dominates the world of academia. These policies are changing the mission and meaning of the public university and, more profoundly, the culture of academia itself. While some authors have sought to capture and analyse these trends in terms of ‘academic capitalism’ and the ‘enterprise university model’, we suggest they might also be usefully understood theoretically as illustrations of the rise of audit culture in higher education and its effects. Drawing on ethnographic examples from the UK, Denmark and New Zealand, we ask: how are higher education institutions being reconfigured by these new disciplinary regimes of audit? How are ranking and performance indicators changing institutional behaviour and transforming academic subjectivities? What possibilities are there for alternative university futures? And what insights can anthropology offer to address these questions

Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment

Background Breast cancer survivors often encounter physiological and psychological problems related to their diagnosis and treatment that can influence long-term prognosis. The aim of this research is to investigate the effects of a lifestyle intervention on body weight and psychological well-being in women recovering from breast cancer treatment, and to determine the relationship between changes in these variables and biomarkers associated with disease recurrence and survival. Methods/design Following ethical approval, a total of 100 patients will be randomly assigned to a lifestyle intervention (incorporating dietary energy restriction in conjunction with aerobic exercise training) or normal care control group. Patients randomised to the dietary and exercise intervention will be given individualised healthy eating dietary advice and written information and attend moderate intensity aerobic exercise sessions on three to five days per week for a period of 24 weeks. The aim of this strategy is to induce a steady weight loss of up to 0.5 Kg each week. In addition, the overall quality of the diet will be examined with a view to (i) reducing the dietary intake of fat to ~25% of the total calories, (ii) eating at least 5 portions of fruit and vegetables a day, (iii) increasing the intake of fibre and reducing refined carbohydrates, and (iv) taking moderate amounts of alcohol. Outcome measures will include body weight and body composition, psychological health status (stress and depression), cardiorespiratory fitness and quality of life. In addition, biomarkers associated with disease recurrence, including stress hormones, estrogen status, inflammatory markers and indices of innate and adaptive immune function will be monitored. Discussion This research will provide valuable information on the effectiveness of a practical, easily implemented lifestyle intervention for evoking positive effects on body weight and psychological well-being, two important factors that can influence long-term prognosis in breast cancer survivors. However, the added value of the study is that it will also evaluate the effects of the lifestyle intervention on a range of biomarkers associated with disease recurrence and survival. Considered together, the results should improve our understanding of the potential role that lifestyle-modifiable factors could play in saving or prolonging lives