Die Plek - Kaat DeJonghe interview

An interview with Belgian curator Kaat DeJonghe, the woman behind Die Plek, a gallery with no fixed address or schedule as its founding ethos

Trevor Paglen, From “Apple” to “Anomaly” (Pictures and Labels)

A preview of new work by Trevor Paglen, which explores how AI judges humankind in 'From "Apple" to "Anomoly"', an exhibition at the Barbican’s The Curve gallery in London from 26 September 2019 until 16 February 2020

Cindy Sherman Retrospective

A preview of Cindy Sherman's first UK retrospective, spanning 40 years of the influential artist's life ouevre, at the National Portrait Gallery, London

The House of Commons: a historic precedent for post-occupancy evaluation

Building scientists have retraced the origins of modern post-occupant evaluations (POEs) to the 1960s, but this paper aims to illustrate that the use of POEs, and their integration with the process of improving building performance, has been a more longstanding practice. Focusing on the post-occupancy history of the House of Commons from 1854 until 1941 as a case study, this paper examines the nature and functions of these earlier precursors of modern POEs. A review of original archive material has illuminated how POEs allowed parliament as an organisation to establish a large repository of knowledge on building performance, offering insights into technological, environmental and human factors. To understand the nature of these historic practices, however, it is critical to distinguish between POE functions that were embedded within the routine operational procedures, led by an in-house team of attendants, and those covered by several larger studies. The latter were more in-depth inquiries conducted by the Office of Works in collaboration with parliamentary committees,scientific researchers and in-house technical staff. These historic practices have also highlighted the role of institutional structures in enabling better collaboration between end-users and facilities management in the process of operating, assessing and improving buildings in use

Revising acute care systems and processes to improve breastfeeding and maternal postnatal health: a pre and post intervention study in one English maternity unit

Background Most women in the UK give birth in a hospital labour ward, following which they are transferred to a postnatal ward and discharged home within 24 to 48 hours of the birth. Despite policy and guideline recommendations to support planned, effective postnatal care, national surveys of women’s views of maternity care have consistently found in-patient postnatal care, including support for breastfeeding, is poorly rated. Methods Using a Continuous Quality Improvement approach, routine antenatal, intrapartum and postnatal care systems and processes were revised to support implementation of evidence based postnatal practice. To identify if implementation of a multi-faceted QI intervention impacted on outcomes, data on breastfeeding initiation and duration, maternal health and women’s views of care, were collected in a pre and post intervention longitudinal survey. Primary outcomes included initiation, overall duration and duration of exclusive breastfeeding. Secondary outcomes included maternal morbidity, experiences and satisfaction with care. As most outcomes of interest were measured on a nominal scale, these were compared pre and post intervention using logistic regression. Results Data were obtained on 741/1160 (64%) women at 10 days post-birth and 616 (54%) at 3 months post-birth pre-intervention, and 725/1153 (63%) and 575 (50%) respectively postintervention. Post intervention there were statistically significant differences in the initiation (p = 0.050), duration of any breastfeeding (p = 0.020) and duration of exclusive breastfeeding to 10 days (p = 0.038) and duration of any breastfeeding to three months (p = 0.016). Post intervention, women were less likely to report physical morbidity within the first 10 days of birth, and were more positive about their in-patient care. Conclusions It is possible to improve outcomes of routine in-patient care within current resources through continuous quality improvement

Older People with Learning Disabilities: Workforce Issues

The life expectancy of people with learning disabilities has increased substantially. Services for older people with learning disabilities are provided by various sectors and practitioners (generic health and social care, or specialist learning disability or old age). The literature suggests that practitioners do not feel well-equipped to support people with learning disabilities as they grow older, and older people's services do not always have the opportunity to share experiences and skills. This paper highlights areas such as dementia support, where the intersection between services is not clear, and explores what might help practitioners to meet the needs of people with learning disabilities as they grow older

Cross-Sector Review of Drivers and Available 3Rs Approaches for Acute Systemic Toxicity Testing

Acute systemic toxicity studies are carried out in many sectors in which synthetic chemicals are manufactured or used and are among the most criticized of all toxicology tests on both scientific and ethical grounds. A review of the drivers for acute toxicity testing within the pharmaceutical industry led to a paradigm shift whereby in vivo acute toxicity data are no longer routinely required in advance of human clinical trials. Based on this experience, the following review was undertaken to identify (1) regulatory and scientific drivers for acute toxicity testing in other industrial sectors, (2) activities aimed at replacing, reducing, or refining the use of animals, and (3) recommendations for future work in this area

Biopsychosocial management of chronic low back pain patients with psychological assessment and management tools

The volume of evidence questioning the efficacy of traditional treatment methods for chronic low back pain sufferers is equalled only by that condoning a more biopsychosocial approach to assessment and treatment. Unfortunately literature on this subject is often academic and does little to offer practical advice to clinicians on how they can apply psychosocial principles to practice. This paper briefly explores the reasons behind the increasing number of chronic back pain patients, reviews the psychological models relevant to understanding this client group, and offers basic practical advice on psychosocial assessment and treatment methods

Ethics and images of suffering bodies in humanitarian medicine

Media representations of suffering bodies from medical humanitarian organisations raise ethical questions, which deserve critical attention for at least three reasons. Firstly, there is a normative vacuum at the intersection of medical ethics, humanitarian ethics and the ethics of photojournalism. Secondly, the perpetuation of stereotypes of illness, famine or disasters, and their political derivations are a source of moral criticism, to which humanitarian medicine is not immune. Thirdly, accidental encounters between members of the health professions and members of the press in the humanitarian arena can result in misunderstandings and moral tension. From an ethics perspective the problem can be specified and better understood through two successive stages of reasoning. Firstly, by applying criteria of medical ethics to the concrete example of an advertising poster from a medical humanitarian organisation, I observe that media representations of suffering bodies would generally not meet ethical standards commonly applied in medical practice. Secondly, I try to identify what overriding humanitarian imperatives could outweigh such reservations. The possibility of action and the expression of moral outrage are two relevant humanitarian values which can further be spelt out through a semantic analysis of 'témoignage' (testimony). While the exact balance between the opposing sets of considerations (medical ethics and humanitarian perspectives) is difficult to appraise, awareness of all values at stake is an important initial standpoint for ethical deliberations of media representations of suffering bodies. Future pragmatic approaches to the issue should include: exploring ethical values endorsed by photojournalism, questioning current social norms about the display of suffering, collecting empirical data from past or potential victims of disasters in diverse cultural settings, and developing new canons with more creative or less problematic representations of suffering bodies than the currently accepted stereotypes

The ethical contours of research in crisis settings: five practical considerations for academic institutional review boards and researchers.

The number of research studies in the humanitarian field is rising. It is imperative, therefore, that institutional review boards (IRBs) consider carefully the additional risks present in crisis contexts to ensure that the highest ethical standards are upheld. Ethical guidelines should represent better the specific issues inherent to research among populations grappling with armed conflict, disasters triggered by natural hazards, or health-related emergencies. This paper seeks to describe five issues particular to humanitarian settings that IRBs should deliberate and on which they should provide recommendations to overcome associated challenges: staged reviews of protocols in acute emergencies; flexible reviews of modification requests; addressing violence and the traumatic experiences of participants; difficulties in attaining meaningful informed consent among populations dependent on aid; and ensuring reviews are knowledgeable of populations' needs. Considering these matters when reviewing protocols will yield more ethically sound research in humanitarian settings and hold researchers accountable to appropriate ethical standards