The erasures of racism in education and international development: re-reading the ‘global learning crisis’

Despite pervasive forms of racism on a global scale, the field of education and international development continues to fail to substantively engage with the production and effects of racial domination across its domains of research, policy and practice. Considerations of racism remain silent, or indeed, are erased, within teaching and research, often in favour of colour-blind and technocratic approaches to ‘development’. This not only ignores the sector’s historical links to systems of racial domination, but also the current ways in which the field is implicated in producing unequal outcomes along racial lines. The authors present a re-reading of the ‘global learning crisis’–as the dominant discourse of contemporary educational development–to demonstrate how the framing of the ‘crisis’ and the responses it engenders and legitimises operate as a ‘racial project’. The paper offers theoretical and methodological resources with which to interrogate the field’s entanglements in systems of racial domination and challenge its erasures of racism

The impact of research on policy: a case of qualifications reform

The relationship between research and policymaking has been discussed repeatedly. However, the debate tends to be in general, abstract terms or from a macro-economic perspective with any examples described in a fairly cursory way. Despite the inherent complexity of the research-policy interface, analyses tend to homogenize ‘research’ and ‘policy’ as coherent entities with discussions often focusing on products (research and policies) rather than on the relationships between producers (researchers and policy makers). Here we take one piece of research on qualifications that has influenced policy rhetoric over the last 5 years. We trace the career of the research from its production in the late 1990s in order to understand the conditions of its dormancy, reemergence and use over the ensuing years. The paper serves to document the case, which is important in its own right, but also proposes a typology of ways in which research gets adopted and adapted into policy

The prevalence and functional impact of musculoskeletal conditions amongst clients of a primary health care facility in an under-resourced area of Cape Town

BACKGROUND:The extent of disease burden of musculoskeletal conditions (MSC) not due to injury has not been well determined in sub-Saharan Africa. The 1999 Global Burden of Disease study estimated the prevalence of osteoarthritis and rheumatoid arthritis to be 150/100,000 compared to 1,500/100,000 in Europe. The objective of the study was to determine the prevalence of MSC and the functional implications in a sample of people attending community health centres in Cape Town, South Africa. METHODS: A cross-sectional, descriptive study was conducted in clinics in two resource poor communities. Phase I consisted of screening and those who screened positive for peripheral or spinal joint pain went on to complete Phase II, which included the Stanford Health Assessment Questionnaire. RESULTS: 1005 people were screened in Phase I. Of these, 362 (36%) reported MSC not due to injury in the past three months. Those with MSC had higher rates of co-morbidities in every category than those without. The mean Disability Index for those with MSC was mild to moderate and moderate to severe in those over 55 years. CONCLUSIONS: Although the sample may not be representative of the general community, the prevalence is considerably greater than those reported elsewhere even when the population of the catchment area is used as a denominator, (367/100 000). The common presentation of MSC with co-morbid diabetes and hypertension requires holistic management by appropriately trained health care practitioners. Any new determination of burden of disease due to MSC should recognise that these disorders may be more prevalent in developing countries than previously estimated

Inequalities in higher education in low‐ and middle‐income countries:A scoping review of the literature

Motivation:  Higher  education  is  regarded  as  a  key  instrument  to  enhance  socioeconomic  mobility  andreduce inequalities. Recent literature reviews have examined inequalities in the higher education systemsof  high-income  countries,  but  less  is  known  about  the  situation  in  low-  and  middle-income  countries,where higher education is expanding fast.Purpose:  The  article  reviews  the  academic  literature  on  higher  education  in  low-  and  middle-incomecountries using a research framework inspired by social justice and capability approaches. It considers the financial,  socio-cultural,  human,  and  political  resource  domains  on  which  people  draw,  and  how  they relate to access, participation, and outcomes in higher education.Methods: A literature search for studies explicitly discussing in-country  inequalities  in  higher  education revealed  22  publications. Substantial  knowledge  gaps remain,  especially  regarding  the  political  (and decision-making)  side  of  inequalities;  the  ideologies  and  philosophies  underpinning  higher  education systems; and the linkages between resource domains, both micro and macro.Findings:  The  review  highlights  key  elements  for  policy-makers  and  researchers:  (1)  the  financial  lens alone  is  insufficient  to  understand  and  tackle  inequalities,  since  these  are  also  shaped  by  human  and other non-financial factors; (2) socio-cultural constructs are central in explaining unequal outcomes; and (3) inequalities develop throughout one’s life and need to be considered during, but also before and afterhigher education.  The scope  of  inequalities  is  wide, and  the literature  offers a  few ideas  for short-term fixes such as part-time and online education.Policy implications: Inclusive policy frameworks for higher education should include explicit goals related to (in)equality,  which  are  best  measured in  terms  of  the  extent  to  which  certain  actions  or  choices are feasible for all. Policies in these frameworks, we argue, should go beyond providing financial support, and also address socio-cultural and human resource constraints and challenges in retention, performance, and labour market outcomes. Finally, they should consider relevant contextual determinants of inequalities.</p

A three month controlled intervention of intermittent whole body vibration designed to improve functional ability and attenuate bone loss in patients with rheumatoid arthritis

Background: Rheumatoid arthritis (RA) is a chronic autoimmune condition that results in pain and disability. Patients with RA have a decreased functional ability and are forced into a sedentary lifestyle and as such, these patients often become predisposed to poor bone health. Patients with RA may also experience a decreased health related quality of life (HRQoL) due to their disease. Whole body vibration (WBV) is a form of exercise that stimulates bone loading through forced oscillation. WBV has also been shown to decrease pain and fatigue in other rheumatic diseases, as well as to increase muscle strength. This paper reports on the development of a semi randomised controlled clinical trial to assess the impact of a WBV intervention aiming to improve functional ability, attenuate bone loss, and improve habitual physical activity levels in patients with RA. Methods/Design: This study is a semi randomised, controlled trial consisting of a cohort of patients with established RA assigned to either a WBV group or a CON (control) group. Patients in the WBV group will undergo three months of twice weekly intermittent WBV sessions, while the CON group will receive standard care and continue with normal daily activities. All patients will be assessed at baseline, following the three month intervention, and six months post intervention. Main outcomes will be an improvement in functional ability as assessed by the HAQ. Secondary outcomes are attenuation of loss of bone mineral density (BMD) at the hip and changes in RA disease activity, HRQoL, habitual physical activity levels and body composition. Discussion: This study will provide important information regarding the effects of WBV on functional ability and BMD in patients with RA, as well as novel data regarding the potential changes in objective habitual physical activity patterns that may occur following the intervention. The sustainability of the intervention will also be assessed

In Patients with Established RA, Positive Effects of a Randomised Three Month WBV Therapy Intervention on Functional Ability, Bone Mineral Density and Fatigue Are Sustained for up to Six Months

Functional ability is often impaired for people with rheumatoid arthritis (RA), rendering these patients highly sedentary. Additionally, patients with RA often take medication known to negatively affect bone mass. Thus improving functional ability and bone health in this group of patients is important. The aim of this study was to investigate the effects of whole body vibration (WBV) therapy in patients with stable, established RA. Thirty one females with RA were randomly assigned to a control group (CON, n = 15) who continued with their normal activities or a WBV group (n = 16) who underwent a three month WBV therapy intervention, consisting of 15 minutes of intermittent vibration, performed twice per week. Patients were assessed at baseline, three months, and three months post intervention for functional ability using the modified Health Assessment Questionnaire; for RA disease activity using the Clinical Disease Activity Index, for quality of life using self-report fatigue and pain scores; for physical activity profiles using accelerometry, and for BMD and body composition using DXA. Patients in both groups were matched for all variables at baseline. After the intervention period, functional ability was significantly improved in the WBV group (1.22(0.19) to 0.92(0.19), p = 0.02). Hip BMD was significantly reduced in the CON group (0.97(0.05) to 0.84(0.05) g.cm-2, p = 0.01), while no decreases were seen in the WBV group (1.01(0.05) to 0.94(0.05) g.cm-2, p = 0.50). Despite no change in RA disease activity in either group at either follow up, fatigue levels were improved in the WBV group (4.4(0.63) to 1.1(0.65), yet remained unchanged in the CON group at both follow ups (p = 0.01). Ten minute bouts of light to moderate physical activity were significantly reduced in the CON group after the intervention (2.8(0.61) to 1.8(0.64) bouts per day, p = 0.01), and were preserved in the WBV group (3.1(0.59) to 3.0(0.61) bouts per day, p = 0.70). Intermittent WBV shows promise for sustained improvements in functional ability, for attenuating loss of bone mass at the hip, as well as for decreasing fatigue in patients with established RA. TRIAL REGISTRATION: Pan African Clinical Trials Registry PACTR201405000823418

The socioeconomic burden of SLE.

Systemic lupus erythematosus (SLE) is a chronic, relapsing-remitting, multisystemic autoimmune inflammatory disorder that predominantly affects women of childbearing age. Much has been written about the clinical course and long-term damage associated with SLE, as well as the reduced life expectancy of patients with this condition. In addition, studies have emphasized the socioeconomic and psychosocial impact of SLE, although the monetary cost of caring for patients with the disorder has only been evaluated in a modest number of studies and a restricted number of countries. SLE has a negative impact on quality of life and is associated with high health-care costs and significant productivity loss. Factors associated with increased cost of SLE include long disease duration, high disease activity and damage, poor physical and mental health, and high education and employment levels. Similarly, high disease activity and damage, poor physical health, certain disease manifestations, as well as poor family and social support are associated with poor health-related quality of life outcomes. SLE incurs a great burden on both the patient and society. Long-term prospective studies should be encouraged to monitor the costs and psychosocial impact of this condition, and to better understand the factors that are associated with poor outcomes.postprin