Evaluation of the quality of the management of cancer of the corpus uteri-Selection of relevant quality indicators and implementation in Belgium

Objective Describe the methodology and selection of quality indicators (QI) to be implemented in the EFFECT (EFFectiveness of Endometrial Cancer Treatment) project. EFFECT aims to monitor the variability in Quality of Care (QoC) of uterine cancer in Belgium, to compare the effectiveness of different treatment strategies to improve the QoC and to check the internal validity of the QI to validate the impact of process indicators on outcome. Methods A QI list was retrieved from literature, recent guidelines and QI databases. The Belgian Healthcare Knowledge Center methodology was used for the selection process and involved an expert's panel rating the QI on 4 criteria. The resulting scores and further discussion resulted in a final QI list. An online EFFECT module was developed by the Belgian Cancer Registry including the list of variables required for measuring the QI. Three test phases were performed to evaluate the relevance, feasibility and understanding of the variables and to test the compatibility of the dataset. Results 138 QI were considered for further discussion and 82 QI were eligible for rating. Based on the rating scores and consensus among the expert's panel, 41 QI were considered measurable and relevant. Testing of the data collection enabled optimization of the content and the user-friendliness of the dataset and online module. Conclusions This first Belgian initiative for monitoring the QoC of uterine cancer indicates that the previously used QI selection methodology is reproducible for uterine cancer. The QI list could be applied by other research groups for comparison. © 2013 Elsevier Inc.

Participatory filmmaking with Qur’anic students in Kano, Nigeria: ‘speak good about us or keep quiet!’

‘Participatory’ research is often presented as a means to ‘empower’ stigmatised groups by addressing shame and by promoting attitude changes. Drawing on experiences producing a ‘participatory’ docudrama with traditional Qur’anic students (almajirai) in Kano, northern Nigeria, I reflect on the limits of ‘participatory’ research as a tool for ‘empowerment’. I describe the risks stigmatised groups may incur by participating, and consider to what extent, if at all, it can foster social change. The almajirai have attracted negative attention as presumed victims of child neglect and as ‘cannon fodder’ for Islamic radicalisation. Their participation in the filmmaking gave them an opportunity to voice their concerns and to rebuke those treating them heedlessly. At the same time, they became vulnerable to accusations and suspicions within their communities. To escape the negative connotations of poverty, they deemphasised its role for almajiri enrolment, thus concealing structural inequalities.