Re-conceptualising VET: responses to covid-19

The paper addresses the impact of Covid-19 on vocational education and training, seeking to discern the outline of possible directions for its future development within the debates about VET responses to the pandemic. The discussion is set in its socio-economic context, considering debates that engage with the social relations of care and neo-liberalism. The paper analyses discourses that have developed around VET across the world during the pandemic, illustrating both possible continuities and ruptures that may emerge in this field, as the health crisis becomes overshadowed in public policy by the prioritisation of economic recovery and social restoration. The paper concludes that, alongside the possibility of a narrowing of VET to its most prosaic aims and practices, the health crisis could also lead to a re-conceptualisation that develops its radical and emancipatory possibilities in both the global south and north.N/

Authority in rebel groups: identity, recognition and the struggle over legitimacy

This article asks how rebel leaders capture and lose legitimacy within their own movement. Analysing these complex and often uneasy relations between elites and grassroots of insurgency is important for understanding the success or failure of peace processes. This is because internal contestation over authority between rival rebel leaders can drive a movement’s external strategy. Based on ethnographic research on the Karen and Kachin rebellions in Myanmar and insights from Political Sociology, the article suggests that leadership authority is linked to social identification and the claim to recognition among insurgent grassroots. If rebel leaders manage to satisfy their grassroots’ claim to recognition, their insurgent orders are stable. Failing this, their authority erodes and is likely to be challenged. These findings contribute to understanding insurgency and peace negotiations in Myanmar and civil wars more generally by showing how struggles over legitimacy within rebel groups drive wider dynamics of war and peace

An observational study to assess if automated diabetic retinopathy image assessment software can replace one or more steps of manual imaging grading and to determine their cost-effectiveness.

BACKGROUND: Diabetic retinopathy screening in England involves labour-intensive manual grading of retinal images. Automated retinal image analysis systems (ARIASs) may offer an alternative to manual grading. OBJECTIVES: To determine the screening performance and cost-effectiveness of ARIASs to replace level 1 human graders or pre-screen with ARIASs in the NHS diabetic eye screening programme (DESP). To examine technical issues associated with implementation. DESIGN: Observational retrospective measurement comparison study with a real-time evaluation of technical issues and a decision-analytic model to evaluate cost-effectiveness. SETTING: A NHS DESP. PARTICIPANTS: Consecutive diabetic patients who attended a routine annual NHS DESP visit. INTERVENTIONS: Retinal images were manually graded and processed by three ARIASs: iGradingM (version 1.1; originally Medalytix Group Ltd, Manchester, UK, but purchased by Digital Healthcare, Cambridge, UK, at the initiation of the study, purchased in turn by EMIS Health, Leeds, UK, after conclusion of the study), Retmarker (version 0.8.2, Retmarker Ltd, Coimbra, Portugal) and EyeArt (Eyenuk Inc., Woodland Hills, CA, USA). The final manual grade was used as the reference standard. Arbitration on a subset of discrepancies between manual grading and the use of an ARIAS by a reading centre masked to all grading was used to create a reference standard manual grade modified by arbitration. MAIN OUTCOME MEASURES: Screening performance (sensitivity, specificity, false-positive rate and likelihood ratios) and diagnostic accuracy [95% confidence intervals (CIs)] of ARIASs. A secondary analysis explored the influence of camera type and patients' ethnicity, age and sex on screening performance. Economic analysis estimated the cost per appropriate screening outcome identified. RESULTS: A total of 20,258 patients with 102,856 images were entered into the study. The sensitivity point estimates of the ARIASs were as follows: EyeArt 94.7% (95% CI 94.2% to 95.2%) for any retinopathy, 93.8% (95% CI 92.9% to 94.6%) for referable retinopathy and 99.6% (95% CI 97.0% to 99.9%) for proliferative retinopathy; and Retmarker 73.0% (95% CI 72.0% to 74.0%) for any retinopathy, 85.0% (95% CI 83.6% to 86.2%) for referable retinopathy and 97.9% (95% CI 94.9 to 99.1%) for proliferative retinopathy. iGradingM classified all images as either 'disease' or 'ungradable', limiting further iGradingM analysis. The sensitivity and false-positive rates for EyeArt were not affected by ethnicity, sex or camera type but sensitivity declined marginally with increasing patient age. The screening performance of Retmarker appeared to vary with patient's age, ethnicity and camera type. Both EyeArt and Retmarker were cost saving relative to manual grading either as a replacement for level 1 human grading or used prior to level 1 human grading, although the latter was less cost-effective. A threshold analysis testing the highest ARIAS cost per patient before which ARIASs became more expensive per appropriate outcome than human grading, when used to replace level 1 grader, was Retmarker £3.82 and EyeArt £2.71 per patient. LIMITATIONS: The non-randomised study design limited the health economic analysis but the same retinal images were processed by all ARIASs in this measurement comparison study. CONCLUSIONS: Retmarker and EyeArt achieved acceptable sensitivity for referable retinopathy and false-positive rates (compared with human graders as reference standard) and appear to be cost-effective alternatives to a purely manual grading approach. Future work is required to develop technical specifications to optimise deployment and address potential governance issues. FUNDING: The National Institute for Health Research (NIHR) Health Technology Assessment programme, a Fight for Sight Grant (Hirsch grant award) and the Department of Health's NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and the University College London Institute of Ophthalmology

Infrastructure and the regional strategy

1.00SIGLELD:8430.8(SC--1624R) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Development and urban policy: Johannesburg’s city development strategy

City development strategies (CDS) have emerged as an important new initiative in international policy and practice. This paper considers their significance by exploring recent initiatives to formulate a city strategy for Johannesburg, South Africa. The Johannesburg CDS emerged out of the local demand for a post- apartheid vision for South African cities as well as a renewed enthusiasm for city-level economic planning within international development agencies and consultancies. As with CDSs in other resource-stretched cities, in order to address the distinctive challenges of their highly unequal city, Johannesburg's policy-makers had to draw on ideas which transcend conventional divisions between poverty relief and urban growth strategies. The Joburg CDS process provides an important basis for overcoming longstanding divisions between accounts of wealthier Western cities and poorer cities in developing country contexts. Johannesburg's distinctive challenges, stretching from accommodating cutting-edge global economic activities to supporting basic service delivery in informal settlements, highlights the paucity of existing urban policy discourses—which offer few ready-made solutions for any city, but especially not to those faced with significant structural inequities. Attending to strategic challenges in cities that have limited resources, it is suggested, could provoke new agendas and insights for city managers and urban scholars everywhere. Here, we explore the tensions between the policy agendas of economic growth and development, and the policy processes of participation and formal institutional politics. [ABSTRACT FROM AUTHOR