Fostering Inclusive Technologies: Being Alongside Care in the Workplace

The potential of technologies for fostering inclusive employment of people with disabilities is increasingly being explored. Despite this potential, ‘inclusive’ technologies in practice often produce further, unintended exclusions for people with disabilities. To mitigate the risk of such exclusions through technology, striking a balance between the commitments of the people involved in developing and introducing such technologies and the in- or exclusionary consequences that emerge in a specific situation is crucial. We pose that matters of care can be a useful conceptual repertoire to help strike such a balance. Reporting on a reflexive evaluation of two pilots experimenting with technologies for inclusion, we show how care was enacted in two layers of care; the care ‘out there’ as mobilized within these pilots and the care we as researchers bring to the setting. We show how the commitments of all those involved in the pilots and the reflexive evaluation interacted and evolved in- and between these layers. We introduce the notion of being alongside to help us conceptualize how caring practices can flourish in the two layers of care. Throughout, we illustrate how our approach, based on reflexive monitoring in action, made being alongside possible for both pilot actors and us as researchers

the future of knowledge brokering perspectives from a generational framework of knowledge management for international development

Knowledge brokering has a crucial role in the field of international development because it is able to act as a cognitive bridge between many different types of knowledge, such as between local and global knowledge. Much of the research on knowledge brokering has focused on knowledge brokering between research, policy and practice, rather than looking at its wider implications. In addition, there appears to be no literature on the future of knowledge brokering, either within or outside the development sector. Given the apparent absence of literature on the future of knowledge brokering, a discussion group was held with experts in the field of knowledge management for development (KM4D) in April 2017 to consider their opinions on the future of knowledge brokering. Their opinions are then compared to the generational framework of KM4D, developed in a series of iterations by researchers in mainstream (non-development) knowledge management (KM) and KM4D researchers. In this framework, five generations of KM4D with different key perspectives, methods and tools have been identified. Based on the inputs from the experts in the discussion group, the future of knowledge brokering practice in international development appears to resemble practice-based, fourth generation KM4D, while there is some evidence of the emergence of fifth generation KM4D with its more systematic, societal perspective on knowledge. Given that the Sustainable Development Goals are providing a universal framework which is relevant to both organizational and societal KM4D, a new systemic conceptualization of KM4D is proposed which brings both of these strands together in one integrated framework linked to the SDGs. The SDGs also support the call for a new knowledge brokering practice with a greater emphasis on brokering knowledge between organizational and societal actors

Baseline assessment of WHO's target for both availability and affordability of essential medicines to treat non-communicable diseases

Background: WHO has set a voluntary target of 80% availability of affordable essential medicines, including generics, to treat major non-communicable diseases (NCDs), in the public and private sectors of countries by 2025. We undertook a secondary analysis of data from 30 surveys in low- and middle-income countries, conducted from 2008-2015 using the World Health Organization (WHO)/Health Action International (HAI) medicine availability and price survey methodology, to establish a baseline for this target. Methods Data for 49 medicines (lowest priced generics and originator brands) to treat cardiovascular diseases (CVD), diabetes, chronic obstructive pulmonary diseases (COPD) and central nervous system (CNS) conditions were analysed to determine their availability in healthcare facilities and pharmacies, their affordability for those on low incomes (based on median patient prices of each medicine), and the percentage of medicines that were both available and affordable. Affordability was expressed as the number of days' wages of the lowestpaid unskilled government worker needed to purchase 30 days' supply using standard treatment regimens. Paying more than 1 days' wages was considered unaffordable. Findings In low-income countries, 15.2% and 18.9% of lowest-priced generics met WHO's target in the public and private sectors, respectively, and 2.6% and 5.2% of originator brands. In lower-middle income countries, 23.8% and 23.2% of lowest priced generics, and 0.8% and 1.4% of originator brands, met the target in the public and private sectors, respectively. In upper-middle income countries, the situation was better for generics but still suboptimal as 36.0% and 39.4% met the target in public and private sectors, respectively. For originator brands in upper-middle income countries, none reached the target in the public sector and 13.7% in the private sector. Across the therapeutic groups for lowest priced generics, CVD medicines in low-income countries (11.9%), and CNS medicines in lower-middle (10.2%) and upper-middle income countries (33.3%), were least available and affordable in the public sector. In the private sector for lowest priced generics, CNS medicines were least available and affordable in all three country income groups (11.4%, 5.8% and 29.3% in low-, lower-middle and upper-middle income countries respectively). Interpretation This data, which can act as a baseline for the WHO target, shows low availability and/or poor affordability is resulting in few essential NCD medicines meeting the target in low- and middle-income countries. In the era of Sustainable Development Goals, and as countries work to achieve Universal Health Coverage, increased commitments are needed by governments to improve the situation through the development of evidence-informed, nationallycontextualised interventions, with regular monitoring of NCD medicine availability, patient prices and affordability.IS

Factors associated with homelessness among women:A cross-sectional survey of outpatient mental health service users at the Banyan, India

Background Homelessness has multifaceted and damaging effects on women with mental illness. This makes it imperative to identify and address the factors leading to homelessness among women with mental illness in order to inform policy on providing relevant services for this vulnerable population. Method A cross-sectional survey was conducted among 346 women in active contact with one of four outpatient clinics at The Banyan, a non-profit organization in the Indian state of Tamil Nadu. A semi-structured instrument and modified version of the List of Threatening Experiences Questionnaire was used for data collection. Multivariate logistic regression analysis was used to examine predictive variables for homelessness among women with mental illness. Result 32.65% of participants reported a history of homelessness. Less than 5 years of schooling (OR = 2.914, 95% CI = 1.027-8.269, P < 0.05) and disrupted relationships (OR = 1.807, 95% CI = 1.23-2.655, P < 0.01) were associated with a greater likelihood of women with mental illness to experience homelessness. Conclusion In the study cohort, this was explained mainly by factors rooted in gender-based disadvantage. Further practice and research are needed to develop interventions that address issues with a sociological basis to mental illness and prevent these predictive factors

Critical discourse analysis of perspectives on knowledge and the knowledge society within the Sustainable Development Goals

Critical discourse analysis (CDA) is employed to analyze discourses of knowledge and the knowledge society in the Sustainable Development Goals (SDGs). Discourse analysis is a collective name for a number of scientific methodologies for analyzing semiosis, namely how meaning is created and communicated though written, vocal or sign language. Employing a genealogical approach which locates discourses in the field of prior discourses, two prior discourses of the knowledge society are identified in the key document of the SDGs. The concepts knowledge and knowledge society are found to have a marginal position within the main policy document “Transforming our world,” adopted by the United Nations in September 2015. The techno‐scientific‐economic discourse is found to be dominant at the level of implementation and of goals, while there is some evidence of the pluralist‐participatory discourse at the level of vision and strategy. Analysis of some of the policy advice provided by international organizations and civil society indicates that more pluralist‐participatory discourses on knowledge were represented when the SDGs were being formulated. Developed countries and the corporate sector were very influential in determining the final text and were probably instrumental in excluding more transformational discourses and maintaining the status quo

Research and innovation as a catalyst for food system transformation

Background: Food systems are associated with severe and persistent problems worldwide. Governance approaches aiming to foster sustainable transformation of food systems face several challenges due to the complex nature of food systems. Scope and approach: In this commentary we argue that addressing these governance challenges requires the development and adoption of novel research and innovation (R&I) approaches that will provide evidence to inform food system transformation and will serve as catalysts for change. We first elaborate on the complexity of food systems (transformation) and stress the need to move beyond traditional linear R&I approaches to be able to respond to persistent problems that affect food systems. Though integrated transdisciplinary approaches are promising, current R&I systems do not sufficiently support such endeavors. As such, we argue, we need strategies that trigger a double transformation - of food systems and of their R&I systems. Key Findings and Conclusions: Seizing the opportunities to transform R&I systems has implications for how research is done - pointing to the need for competence development among researchers, policy makers and society in general - and requires specific governance interventions that stimulate a systemic approach. Such interventions should foster transdisciplinary and transformative research agendas that stimulate portfolios of projects that will reinforce one another, and stimulate innovative experiments to shape conditions for systemic change. In short, a thorough rethinking of the role of R&I as well as how it is funded is a crucial step towards the development of the integrative policies that are necessary to engender systemic change - in the food system and beyond