Suchergebnisse

This paper explores the role of knowledge, standards, and metrics in global health. Our point of departure is the observation that the emergence of 'global health' as a domain of research, policy, and practice in the last three decades or so has coincided with an increased interest in the validation and use of measures of health, such as the Disability Adjusted Life Year (DALY), in monitoring and assessing health equity across territories and populations. This 'elective affinity' between global health and health metrics has become the focus of scholarly debate in the social sciences. In this paper, we seek to contextualise and critically discuss the different positions in this debate. We suggest that emplacing health metrics within the neo-liberal logic of health production -one where the 'mechanisms of life' are aligned with the maximisation of economic productivity- does not fully capture the interactive relationship between health measurement and the politics of health. Instead, we argue that this relationship has been characterised by controversy and uncertainty about how to interlock normative ideals and approaches to knowledge-making about health. © 2019 GESIS - Leibniz Institute for the Social Sciences. All rights reserved.

Widening access policy has historically focused on tackling the socioeconomic barriers to university access faced by prospective students from under-represented groups, but increasingly policy makers are seeking to also address the barriers to wider access posed by undergraduate admissions policies. In this vein, the Scottish Government has recently called upon universities to set separate academic entry requirements for socioeconomically disadvantaged applicants which recognise that "the school attainment of disadvantaged learners often does not reflect their full potential" and which better reflect the minimum needed to succeed in higher education. In this paper, we draw on in-depth interviews with admissions personnel at eighteen Scottish universities to explore the scope for more progressive admissions policies of this kind in light of universities' identities as organisations and in light of corresponding organisational strategies for position-taking in global and national higher education fields. We present a theoretical model and an empirical illustration of three hierarchically-ordered ideal types of organisational identity—globally competitive, nationally selective, and locally transformative—and show that the more dominant of these tend to constrain the development of more progressive admissions policies. This is because globally competitive and, to a lesser extent, nationally selective organisational identities are understood to require admission of the 'brightest and best', conceptualised as those with the highest levels of prior academic attainment who can be expected to succeed at university and beyond as a matter of course. We conclude that universities must recognise and redress the implicitly exclusionary nature of their organisational identities if genuine progress on widening access is to be made.

AHKME (Adaptive Hypermedia Knowledge Management E-Learning Platform) is an eLearning Information System that has evolved to fulfill the web-based learning requirements when they are compliant with a Web 3.0 philosophy. The ideas behind Web 3.0 are related to more semantic and intelligent systems. AHKME allows teachers to access standardized resources and evaluate integration and reuse possibilities in eLearning systems, not only content but also learning strategy. The educational resources adaptation in AHKME is supported by a set of collaborative tools, which also allow the users' feedback provision that is stored in system database. The semantic component in AHKME is based on a set of tools for the instructional designer to create and customize specifications and ontologies to give structure and meaning to resources, manual and automatic search with recommendation of resources and instructional design based on the context, and recommendation of adaptations in learning resources. Finally, AHKME takes into account the mobile learning (mLearning) capabilities, allowing access by teachers and students to learning resources, regardless of time and space.

The Brazilian Amazon has the highest concentration of indigenous peoples in the world. Recently, the Brazilian government sent a bill to Congress to regulate commercial mining in indigenous lands. This work analyzes the risks of the proposed mining bill to Amazonian indigenous peoples and their lands. To evaluate the possible impact of the new mining bill, we consider all mining license requests registered in Brazil's National Mining Agency that overlap indigenous lands as potential mining areas in the future. The existing mining requests cover 176 000 km2 of indigenous lands, a factor 3000 more than the area of current illegal mining. Considering only these existing requests, about 15% of the total area of ILs in the region could be directly affected by mining if the bill is approved. Ethnic groups like Yudjá, Kayapó, Apalaí, Wayana, and Katuena may have between 47% and 87% of their lands impacted. Gold mining, which has previously shown to cause mercury contamination, death of indigenous people due to diseases, and biodiversity degradation, accounts for 64% of the requested areas. We conclude that the proposed bill is a significant threat to Amazonian indigenous peoples, further exposing indigenous peoples to rural violence, contamination by toxic pollutants, and contagious diseases. The obligation of the government is to enforce existing laws and regulations that put indigenous rights and livelihoods above economic consideration and not to reduce such protections.

[Background and objective] We aimed to evaluate the safety and outcomes of thrombectomy in anterior circulation acute ischaemic stroke recorded in the SITS–International Stroke Thrombectomy Register (SITS-ISTR) and compare them with pooled randomized controlled trials (RCTs) and two national registry studies. ; [Methods] We identified centres recording ≥10 consecutive patients in the SITS-ISTR with at least 70% of available modified Rankin Scale (mRS) at 3 months during 2014–2019. We defined large artery occlusion as intracranial internal carotid artery, first and second segment of middle cerebral artery and first segment of anterior cerebral artery. Outcome measures were functional independence (mRS score 0-2) and death at 3 months and symptomatic intracranial haemorrhage (SICH) per modified SITS-MOST. ; [Results] Results are presented in the following order: SITS-ISTR, RCTs, MR CLEAN Registry and German Stroke Registry (GSR). Median age was 73, 68, 71 and 75 years; baseline NIHSS score was 16, 17, 16 and 15; prior intravenous thrombolysis was 62%, 83%, 78% and 56%; onset to reperfusion time was 289, 285, 267 and 249 min; successful recanalization (mTICI score 2b or 3) was 86%, 71%, 59% and 83%; functional independence at 3 months was 45.5% (95% CI: 44–47), 46.0% (42–50), 38% (35–41) and 37% (35–41), respectively; death was 19.2% (19–21), 15.3% (12.7–18.4), 29.2% (27–32) and 28.6% (27–31); and SICH was 3.6% (3–4), 4.4% (3.0–6.4), 5.8% (4.7–7.1) and not available. ; [Conclusion] Thrombectomy in routine clinical use registered in the SITS-ISTR showed safety and outcomes comparable to RCTs, and better functional outcomes and lower mortality than previous national registry studies. ; SITS (Safe Implementation of Treatment in Stroke) is financed directly and indirectly by grants from Karolinska Institutet, Stockholm County Council, the Swedish Heart-Lung Foundation, the Swedish Order of St. John, Friends of Karolinska Institutet and private donors, as well as from an unrestricted sponsorship from Boehringer Ingelheim. SITS has previously received grants from the European Union Framework 7, the European Union Public Health Authority, Ferrer International and EVER Pharma. SITS is currently conducting studies supported by Boehringer Ingelheim and Biogen, as well as in collaboration with Karolinska Institutet, supported by Stryker, Covidien and Phenox. N Ahmed is supported by grants provided by the Stockholm County Council and the Swedish Heart-Lung Foundation. S Holmin is supported by grants provided by the Söderberg Foundations, the Stockholm County Council, the Erling Persson Foundation, VINNOVA and HMT. Irene Escudero-Martínez has received a grant from 'Fundación Progreso y Salud, Junta de Andalucía' (grant EF-0437-2018). RM has been supported by the project no. LQ1605 from the National Program of Sustainability II (MEYS CR). RH has been supported by the grants no. DRO–UHHK 00179906 from the Ministry of Health of the Czech Republic and no. PROGRES Q40 from Charles University, Czech Republic. ; Peer reviewed