School and Community Screening Shows Malawi, Africa, to Have a High Prevalence of Latent Rheumatic Heart Disease

Rheumatic heart disease (RHD) is the largest cardiac cause of morbidity and mortality in the world's youth. Early detection of RHD through echocardiographic screening in asymptomatic children may identify an early stage of disease, when secondary prophylaxis has the greatest chance of stopping disease progression. Latent RHD signifies echocardiographic evidence of RHD with no known history of acute rheumatic fever and no clinical symptoms.

OBJECTIVE: Determine the prevalence of latent RHD among children ages 5-16 in Lilongwe, Malawi.

DESIGN: This is a cross-sectional study in which children ages 5 through 16 were screened for RHD using echocardiography.

SETTING: Screening was conducted in 3 schools and surrounding communities in the Lilongwe district of Malawi between February and April 2014.

OUTCOME MEASURES: Children were diagnosed as having no, borderline, or definite RHD as defined by World Heart Federation criteria. The primary reader completed offline reads of all studies. A second reader reviewed all of the studies diagnosed as RHD, plus a selection of normal studies. A third reader served as tiebreaker for discordant diagnoses. The distribution of results was compared between gender, location, and age categories using Fisher's exact test.

RESULTS: The prevalence of latent RHD was 3.4% (95% CI = 2.45, 4.31), with 0.7% definite RHD and 2.7% borderline RHD. There was no significant differences in prevalence between gender (P = .44), site (P = .6), urban vs. peri-urban (P = .75), or age (P = .79). Of those with definite RHD, all were diagnosed because of pathologic mitral regurgitation (MR) and 2 morphologic features of the mitral valve. Of those with borderline RHD, most met the criteria by having pathological MR (92.3%).

CONCLUSION: Malawi has a high rate of latent RHD, which is consistent with other results from sub-Saharan Africa. This study strongly supports the need for a RHD prevention and control program in Malawi.

Measuring children’s experience of their right to participate in school and community: a rights-based approach

This paper discusses the development of a children’s rights-based measure of participation and the findings from its use in a survey of 10 to 11 year old children (n= 3773). The measure, which was developed in collaboration with a group of children, had a high reliability (Cronbach’s alpha = .89). Findings suggest that children’s positive experience of their participation rights is higher in school than in community, and higher for girls compared to boys. It is argued that involving children in the ‘measurement’ of their own lives has the potential to generate more authentic data on children’s lived experiences.

Shared Photography: (Photo)journalism and political mobilisation in Rio de Janeiro's favelas

One of the most important civic phenomena emerging from favelas in Rio de Janeiro today is “community (photo)journalism”, which is practised by favela residents who are trained in journalistic and artistic techniques to raise critical awareness and promote political mobilisation in- and outside favelas. This paper looks at some of the work produced at one training place for community photographers, the agency-school Imagens do Povo (“Images of the People”) in Nova Holanda, a favela located in Rio’s North Zone. Using an ethnographic approach, this article first provides an account of the working practices of the School and its photographers. This is followed by a discussion of a small sample of their photographic work, for which we employ a social semiotic paradigm of image analysis. This methodological synergy provides insights into how these journalists document long-term structural as well as “spectacular” violence in favelas, while at the same time striving to capture some of the “beauty” of these communities. The paper concludes that this form of photographic work constitutes an important step towards a more analytical brand of journalism with different news values that encourage a more context-sensitive approach to covering urban violence and favela life.

KEYWORDS: alternative media, Imagens do Povo, multimodality, news values, photojournalism.

We need to talk about managerialism: On the Importance of values dialogue and renewal within Catholic schools

Whilst reports of value tensions between new managerialism and Catholic education have emerged as a key theme in the academic literature there remains little empirical understanding of how teachers negotiate these complex terrains in Catholic schools. Drawing on qualitative data from teachers in two Catholic post-primary schools in Northern Ireland, this paper sought to explore how Catholic teachers developed a distinctively Catholic ethos against a culture of ‘creeping managerialism’. The paper has shown that despite the predominance of managerial practices, tensions between managerialist values and the ‘Catholic ethos’ did not emerge in either context: in one school managerialism permeated the school and the Catholic ethos was constructed within this context. In the other school a staff process of spiritual renewal had consolidated a commitment to the Catholic faith and social inclusion. It was argued that the dialogical engagement around Catholic values may help Catholic schools defend against the harsher manifestations of managerialism without compromising the pupils’ capacity to realise their academic potential