New Audiences for the Arts: The New Audiences Programme Report

This 269 page report gives a detailed overview of a £20 million funding programme ‘New Audiences’, designed to foster new practice in audience development by arts organisations in England. It was the culmination of a five-year scheme which supported 1200 audience development initiatives across the country. Glinkowski was one of a team of seven researchers who compiled the report: ACE Research Officers, Clare Fenn, Adrienne Skelton and Alan Joy compiled the statistical information for the report appendices; the main body of the report, from Executive Summary to Conclusions, was written by a team of three consultant researchers, Glinkowski, Pam Pfrommer and Sue Stewart, working under the supervision of the ACE Head of New Audiences, Gill Johnson. The report was a summary, compilation and interpretation of key themes emerging from the material contained within around 1150 evaluations of projects funded by the £20 million ‘New Audiences’ programme during the 5-year period from 1998-2003. The interpretative work and writing up was undertaken collaboratively by the consultant researchers and Glinkowski’s particular input was to the Executive Summary; Introduction; General Audiences; Disability; Social Inclusion; Rural; Older People; General Findings; and Conclusion sections of the report. He was also the principal author (although in keeping with ACE practice on advocacy material, not formally credited) of the ‘New Audiences Advocacy Document’ (ISBN 0728710331), produced in conjunction with the main report with introduction by Tessa Jowell, Secretary of State, Department of Culture, Media and Sport and Peter Hewitt, Chief Executive of Arts Council England. The full report is published online, with a companion volume summarising all projects undertaken within the ‘New Audiences’ programme. Additionally, Glinkowski was commissioned to contribute case studies to the ‘New Audiences’ website (http://www.newaudiences.org.uk/index.php), including 'Open Studios/Artists Presentation Research' (http://www.newaudiences.org.uk/project.php?id=680)

Improving the Effectiveness of CounterTobacco.org as a Hub for Tobacco Control Point of Sale Advocates

Smoking is the leading cause of preventable death in the United States. The retail environment, also known as the point of sale (POS), has been a lead channel for tobacco industry marketing, advertising, and promotions. In 2010, the tobacco industry spent over seven billion dollars to create a branded presence at the POS with price discounts and marketing materials such as signs and displays. Exposure to POS advertising and promotions prompts smoking initiation, encourages tobacco use, and undermines quit attempts. In response to this issue, Counter Tobacco created CounterTobacco.org as a one-stop"warehouse" for a growing POS tobacco control community comprised of advocates from city, county, and state health departments, non-profit organizations, and technical assistance organizations. The site aims to provide and maintain an up-to-date online resource center for tobacco control advocates interested in implementing POS regulations. The student team worked with Counter Tobacco to complete seven deliverables. Among those was a process evaluation that used qualitative and quantitative research methods to produce an analysis of the website's content and ease of use. Additionally, the team developed two pre-packaged lesson plans (Youth Engagement Activities) designed to raise awareness among youth on POS exposure and marketing. The team also created a storyboard for a YouTube-style web video to highlight the emphasis the tobacco industry places on creating a retail presence, the link between retail tobacco advertising and the health behaviors of youth and adults, and the disparities that exist in both retail density and advertising. The deliverables produced during the course of the Capstone project will have a measurable impact on Counter Tobacco and the POS advocacy field at-large. Student team deliverables have resulted in recommendations to improve users' experiences with CounterTobacco.org, such as shifting the site from a resource archive to a creative hub to help grow the nascent field of POS advocacy. Additionally, the two Youth Engagement Activities and web video are new and innovative tools for advocates to use in their own tobacco control efforts. Stakeholder engagement played a large role in accomplishing the goal of building CounterTobacco.org and its user community. The Capstone team engaged with stakeholders at all levels of the Social Ecological Framework (SEF), and this project reinforced the importance of ongoing stakeholder engagement, particularly when a program is to be evaluated for improvement. Given the emergence and growth of POS issues in tobacco control, sustainability efforts on the part of Counter Tobacco must meet the needs of the new field. The recommendations outlined by the Capstone student team in the process evaluation report will support CounterTobacco.org to establish itself as a creative hub for POS solutions. Through strategic planning, Counter Tobacco will continue to grow its brand presence and cement its position as the primary resource for tobacco control advocates working on POS issues.Master of Public Healt

Can oral healthcare for older people be embedded into routine community aged care practice? A realist evaluation using normalisation process theory

This author accepted manuscript is made available following 12 month embargo from date of publication (December 2018) in accordance with the publisher’s archiving policyBackground An intervention ‘Better Oral Health in Home Care’ was introduced (2012–2014) to improve the oral health of older people receiving community aged care services. Implementation of the intervention was theoretically framed by the Promoting Action on Research Implementation in Health Services framework. Process outcomes demonstrated significant improvements in older people’s oral health. Objective To evaluate the extent to which the intervention has been embedded and sustained into routine community aged care practice 3 years after the initial implementation project. Design A Realist Evaluation applying Normalisation Process Theory within a single case study setting. Setting Community aged care (home care) provider in South Australia, Australia. Participants Purposeful sampling was undertaken. Twelve staff members were recruited from corporate, management and direct care positions. Two consumers representing high and low care recipients also participated. Methods Qualitative methods were applied in two subcases, reflecting different contextual settings. Data were collected via semi-structured interviews and analysed deductively by applying the Normalisation Process Theory core constructs (with the recommended phases of the Realist Evaluation cycle). Retrospective and prospective analytic methods investigated how the intervention has been operationalised by comparing two timeframes: Time 1 (Implementation June 2012–December 2014) and Time 2 (Post-implementation July 2017–July 2018). Results At Time 1, the initial program theory proposed that multi-level facilitation contributed to a favourable context that triggered positive mechanisms supportive of building organisational and workforce oral healthcare capacity. At Time 2, an alternative program theory of how the intervention has unfolded in practice described a changed context following the withdrawal of the project facilitation processes with the triggering of alternative mechanisms that have made it difficult for staff to embed sustainable practice. Conclusion Findings concur with the literature that successful implementation outcomes do not necessarily guarantee sustainability. The study has provided a deeper explanation of how contextual characteristics have contributed to the conceptualisation of oral healthcare as a low priority, basic work-ready personal care task and how this, in turn, hindered the embedding of sustainable oral healthcare into routine community aged care practice. This understanding can be used to better inform the development of strategies, such as multi-level facilitation, needed to navigate contextual barriers so that sustainable practice can be achieved

Osteosarcoma

Osteosarcoma is the most common primary malignant tumour of the bone. Osteosarcoma incidence is bimodal, peaking at 18 and 60 years of age, and is slightly more common in males. The key pathophysiological mechanism involves several possible genetic drivers of disease linked to bone formation, causing malignant progression and metastasis. While there have been significant improvements in the outcome of patients with localized disease, with event-free survival outcomes exceeding 60%, in patients with metastatic disease, event-free survival outcomes remain poor at less than 30%. The suspicion of osteosarcoma based on radiographs still requires pathological evaluation of a bone biopsy specimen for definitive diagnosis and CT imaging of the chest should be performed to identify lung nodules. So far, population-based screening and surveillance strategies have not been implemented due to the rarity of osteosarcoma and the lack of reliable markers. Current screening focuses only on groups at high risk such as patients with genetic cancer predisposition syndromes. Management of osteosarcoma requires a multidisciplinary team of paediatric and medical oncologists, orthopaedic and general surgeons, pathologists, radiologists and specialist nurses. Survivors of osteosarcoma require specialized medical follow-up, as curative treatment consisting of chemotherapy and surgery has long-term adverse effects, which also affect the quality of life of patients. The development of osteosarcoma model systems and related research as well as the evaluation of new treatment approaches are ongoing to improve disease outcomes, especially for patients with metastases

Targeted full energy and protein delivery in critically ill patients : A pilot randomized controlled trial (FEED Trial)

Background International guidelines recommend greater protein delivery to critically ill patients than they currently receive. This pilot randomized clinical trial aimed to determine whether a volume-target enteral protocol with supplemental protein delivered greater amounts of protein and energy to critically ill patients compared with standard care. Methods Sixty participants received either the intervention (volume-based protocol, with protein supplementation) or standard nutrition care (hourly-rate-based protocol, without protein supplementation) in the intensive care unit (ICU). Coprimary outcomes were average daily protein and energy delivery. Secondary outcomes included change in quadriceps muscle layer thickness (QMLT, ultrasound) and malnutrition (subjective global assessment) at ICU discharge. Results Mean (SD) protein and energy delivery per day from nutrition therapy for the intervention were 1.2 (0.30) g/kg and 21 (5.2) kcal/kg compared with 0.75 (0.11) g/kg and 18 (2.7) kcal/kg for standard care. The mean difference between groups in protein and energy delivery per day was 0.45 g/kg (95% CI, 0.33–0.56; P < .001) and 2.8 kcal/kg (95% CI, 0.67–4.9, P = .01). Muscle loss (QMLT) at discharge was attenuated by 0.22 cm (95% CI, 0.06–0.38, P = .01) in patients receiving the intervention compared with standard care. The number of malnourished patients was fewer in the intervention [2 (7%) vs 8 (28%); P = .04]. Mortality and duration of admission were similar between groups. Conclusions A high-protein volume-based protocol with protein supplementation delivered greater amounts of protein and energy. This intervention was associated with attenuation of QMLT loss and reduced prevalence of malnutrition at ICU discharge

Imagining Gendered Adulthood

In this article, the authors draw on two qualitative, longitudinal studies of young people’s transitions to adulthood and how they construct these transitions over time in social, cultural and material terms. The authors focus on the hopes, anxieties and imagined futures of young women. They discuss the individualization thesis, and the contradiction for female individualization between expectations of equality and the reality of inequality between the genders. The debate is moved beyond ‘pitiful girls’ and ‘can-do girls’ by exploring how young women in the UK and Finland anticipate and try to avoid being locked into the lives of adult women

‘I’m not your mother’: British social realism, neoliberalism and the maternal subject in Sally Wainwright’s Happy Valley (BBC1 2014-2016)

This article examines Sally Wainwright's Happy Valley (BBC1, 2014–2016) in the context of recent feminist attempts to theorise the idea of a maternal subject. Happy Valley, a police series set in an economically disadvantaged community in West Yorkshire, has been seen as expanding the genre of British social realism, in its focus on strong Northern women, by giving it ‘a female voice’ (Gorton, 2016: 73). I argue that its challenge is more substantial. Both the tradition of British social realism on which the series draws, and the neoliberal narratives of the family which formed the discursive context of its production, I argue, are founded on a social imaginary in which the mother is seen as responsible for the production of the selves of others, but cannot herself be a subject. The series itself, however, places at its centre an active, articulate, mobile and angry maternal subject. In so doing, it radically contests both a tradition of British social realism rooted in male nostalgia and more recent neoliberal narratives of maternal guilt and lifestyle choice. It does this through a more fundamental contestation: of the wider cultural narratives about selfhood and the maternal that underpin both. Its reflective maternal subject, whose narrative journey involves acceptance of an irrecoverable loss, anger and guilt as a crucial aspect of subjectivity, and who embodies an ethics of relationality, is a figure impossible in conventional accounts of subject and nation. She can be understood, however, in terms of recent feminist theories of the maternal

Homologous recombination DNA repair defects in PALB2- associated breast cancers

Abstract: Mono-allelic germline pathogenic variants in the Partner And Localizer of BRCA2 (PALB2) gene predispose to a high-risk of breast cancer development, consistent with the role of PALB2 in homologous recombination (HR) DNA repair. Here, we sought to define the repertoire of somatic genetic alterations in PALB2-associated breast cancers (BCs), and whether PALB2-associated BCs display bi-allelic inactivation of PALB2 and/or genomic features of HR-deficiency (HRD). Twenty-four breast cancer patients with pathogenic PALB2 germline mutations were analyzed by whole-exome sequencing (WES, n = 16) or targeted capture massively parallel sequencing (410 cancer genes, n = 8). Somatic genetic alterations, loss of heterozygosity (LOH) of the PALB2 wild-type allele, large-scale state transitions (LSTs) and mutational signatures were defined. PALB2-associated BCs were found to be heterogeneous at the genetic level, with PIK3CA (29%), PALB2 (21%), TP53 (21%), and NOTCH3 (17%) being the genes most frequently affected by somatic mutations. Bi-allelic PALB2 inactivation was found in 16 of the 24 cases (67%), either through LOH (n = 11) or second somatic mutations (n = 5) of the wild-type allele. High LST scores were found in all 12 PALB2-associated BCs with bi-allelic PALB2 inactivation sequenced by WES, of which eight displayed the HRD-related mutational signature 3. In addition, bi-allelic inactivation of PALB2 was significantly associated with high LST scores. Our findings suggest that the identification of bi-allelic PALB2 inactivation in PALB2-associated BCs is required for the personalization of HR-directed therapies, such as platinum salts and/or PARP inhibitors, as the vast majority of PALB2-associated BCs without PALB2 bi-allelic inactivation lack genomic features of HRD

Burden of obesity in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study

Mokdad AH, El Bcheraoui C, Afshin A, et al. Burden of obesity in the Eastern Mediterranean Region: findings from the Global Burden of Disease 2015 study. INTERNATIONAL JOURNAL OF PUBLIC HEALTH. 2018;63(Suppl. 1):165-176.We used the Global Burden of Disease (GBD) 2015 study results to explore the burden of high body mass index (BMI) in the Eastern Mediterranean Region (EMR). We estimated the prevalence of overweight and obesity among children (2-19 years) and adults (20 years) in 1980 and 2015. The burden of disease related to high BMI was calculated using the GBD comparative risk assessment approach. The prevalence of obesity increased for adults from 15.1% (95% UI 13.4-16.9) in 1980 to 20.7% (95% UI 18.8-22.8) in 2015. It increased from 4.1% (95% UI 2.9-5.5) to 4.9% (95% UI 3.6-6.4) for the same period among children. In 2015, there were 417,115 deaths and 14,448,548 disability-adjusted life years (DALYs) attributable to high BMI in EMR, which constitute about 10 and 6.3% of total deaths and DALYs, respectively, for all ages. This is the first study to estimate trends in obesity burden for the EMR from 1980 to 2015. We call for EMR countries to invest more resources in prevention and health promotion efforts to reduce this burden