The Cultural and Creative Industries: Organisational and Spatial Challenges to their Governance

The Cultural and Creative Industries (CCI) have a distinct geography, one that is dynamic and that has until recently been poorly documented and underexplained. The aim of this paper is to briefly review the changing terrain of analyses of the CCI in order to turn an analytic focus onto the challenge of policy-making in the field of the cultural and creative industries. The structure of the paper follows four steps. First, we outline the shifting nature of governance in nation states and regions; second, we highlight the corresponding shifts occurring in the organisation of the cultural and creative industries, and the field of cultural policy; third, we consider the need to resolve governance and the cultural and creative industries. Finally, we outline some responses to this challenge

Reconceptualising the relationship between the creative economy and the city: Learning from the financial crisis

This paper uses the financial crisis as an opportunity to examine a number of key questions about the relationship of the creative economy and the city. We argue that weak conceptualisation of the nature of the relationship between the creative economy and the city, as well as a lack of clarity about what the creative economy is, has subverted debates about this important topic. This paper comprises four major sections: the first introduces the field of the creative economy, the second section seeks to clarify what exactly we mean by the term financial crisis; here we highlight the multifaceted character of the financial crisis and is variable impacts across the field of the creative economy. The third part outlines the range and diversity of the actually existing relations between the creative economy and the city. In the fourth section we reflect upon the earlier argument to consider what we can learn about the impacts (actual and expected) of the financial crisis on the creative economy and the city, and additionally to reflect upon what this might indicate about the changing and perhaps transformed relationship between the creative economy and the city in the last quarter century

In the social factory? Immaterial labour, precariousness and cultural work

This article introduces a special section concerned with precariousness and cultural work. Its aim is to bring into dialogue three bodies of ideas -- the work of the autonomous Marxist 'Italian laboratory'; activist writings about precariousness and precarity; and the emerging empirical scholarship concerned with the distinctive features of cultural work, at a moment when artists, designers and (new) media workers have taken centre stage as a supposed 'creative class' of model entrepreneurs. The paper is divided into three sections. It starts by introducing the ideas of the autonomous Marxist tradition, highlighting arguments about the autonomy of labour, informational capitalism and the 'factory without walls', as well as key concepts such as multitude and immaterial labour. The impact of these ideas and of Operaismo politics more generally on the precarity movement is then considered in the second section, discussing some of the issues that have animated debate both within and outside this movement, which has often treated cultural workers as exemplifying the experiences of a new 'precariat'. In the third and final section of the paper we turn to the empirical literature about cultural work, pointing to its main features before bringing it into debate with the ideas already discussed. Several points of overlap and critique are elaborated -- focusing in particular on issues of affect, temporality, subjectivity and solidarity

Assessment of the Red Cell Proteome of Young Patients with Unexplained Hemolytic Anemia by Two-Dimensional Differential In-Gel Electrophoresis (DIGE)

Erythrocyte cytosolic protein expression profiles of children with unexplained hemolytic anemia were compared with profiles of close relatives and controls by two-dimensional differential in-gel electrophoresis (2D-DIGE). The severity of anemia in the patients varied from compensated (i.e., no medical intervention required) to chronic transfusion dependence. Common characteristics of all patients included chronic elevation of reticulocyte count and a negative workup for anemia focusing on hemoglobinopathies, morphologic abnormalities that would suggest a membrane defect, immune-mediated red cell destruction, and evaluation of the most common red cell enzyme defects, glucose-6-phosphate dehydrogenase and pyruvate kinase deficiency. Based upon this initial workup and presentation during infancy or early childhood, four patients classified as hereditary nonspherocytic hemolytic anemia (HNSHA) of unknown etiology were selected for proteomic analysis. DIGE analysis of red cell cytosolic proteins clearly discriminated each anemic patient from both familial and unrelated controls, revealing both patient-specific and shared patterns of differential protein expression. Changes in expression pattern shared among the four patients were identified in several protein classes including chaperons, cytoskeletal and proteasome proteins. Elevated expression in patient samples of some proteins correlated with high reticulocyte count, likely identifying a subset of proteins that are normally lost during erythroid maturation, including proteins involved in mitochondrial metabolism and protein synthesis. Proteins identified with patient-specific decreased expression included components of the glutathione synthetic pathway, antioxidant pathways, and proteins involved in signal transduction and nucleotide metabolism. Among the more than 200 proteins identified in this study are 21 proteins not previously described as part of the erythrocyte proteome. These results demonstrate the feasibility of applying a global proteomic approach to aid characterization of red cells from patients with hereditary anemia of unknown cause, including the identification of differentially expressed proteins as potential candidates with a role in disease pathogenesis

Épisodes d’inactivité et revenus criminels dans une trajectoire de délinquance

L’instabilité de l’activité criminelle dans le temps est déjà bien documentée. On connaît toutefois peu les circonstances qui expliquent ces variations à court terme. Une meilleure connaissance de ces facteurs est souhaitable puisqu’il est possible que les transitions et les changements à court terme précèdent les points tournants des carrières criminelles. Les conditions qui rendent compte d’une interruption temporaire des activités peuvent, par exemple, contribuer à expliquer un désistement définitif. L’étude se fonde sur les trajectoires de 172 délinquants impliqués dans des crimes à but lucratif et analyse les variations mensuelles de leurs revenus criminels ainsi que les épisodes d’inactivité criminelle à l’intérieur d’une période fenêtre de 36 mois. La méthode des calendriers d’histoire de vie combinée aux modèles hiérarchiques permet d’examiner conjointement le rôle de facteurs statiques (les caractéristiques individuelles des sujets) et dynamiques (les circonstances de vie). Les résultats mettent en évidence l’importance des événements qui marquent le style de vie des délinquants et des paramètres qui caractérisent l’engagement criminel dans la compréhension des variations dans les trajectoires à l’étude. Ils soulignent également l’importance de la finalité derrière les activités criminelles pour expliquer la décision des délinquants de cesser temporaire leurs activités illicites

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

An economic geography of the cultural industries

This chapter outlines in four sections the recent development of the study of the cultural industries, the challenges that have shaped it, and what the consequences of the growth and development of the cultural industries are. We begin by positioning the cultural industries within academic debate s discuss how they have been conceptualised. The second section is concerned with the problems of defining the cultural industries. In the third section we examine the range of secondary impacts, and in the fourth section we consider the primary impacts of the cultural industries under five headings: production process, the speed of circulation, intermediation, project based firms, and spatial clustering