A logic model approach: understanding the impact of local Macmillan cancer information and support services in the UK

Health information services are increasingly expected to demonstrate their impacts. One mechanism for doing so is to use a logic model. This article outlines the application of a logic model approach to the development and evaluation of local Macmillan cancer information and support services in the UK. It exemplifies the value of enabling service providers and other stakeholders to work together to agree the intended impacts of a service and how these will be measured. The logic model itself provides a clear graphic to illustrate how service activities lead to outputs, outcomes and impacts. This approach could be used more widely in health libraries and information services

Sheepdog or watchdog? The role of statutory public involvement institutions in political management of the NHS, 1974-2010

Since 1974, governments have created a series of statutory public involvement institutions in the English NHS: Community Health Councils; Patient and Public Involvement Forums; Local Involvement Networks; and, from 2013, local Healthwatch. This study presents the role of these institutions as a puzzle, given the growth of alternative forms of public involvement. Public involvement in the NHS tends to be studied for its contribution to democratising the NHS or for its role in a choice-led consumer market, but these analyses generally focus on involvement led by NHS personnel or by independent patient organisations. This dissertation uses a different body of political science theory to assess roles that statutory public involvement institutions may play in Ministers’ political management of the NHS. One approach is to see these institutions as ‘sheepdogs’, rounding up and organising diverse groups, thus providing a form of corporatist interest intermediation. Alternatively, they could be ‘watchdogs’, raising the alarm when standards slip critically and thereby helping to safeguard the NHS against disasters. The explanatory value of these two interpretations is reviewed over the period 1974-2010, using policy documents and archive material, including the records of these organisations and the archives of public inquiries into problems in hospitals. The findings suggest that at various times national political actors have used statutory public involvement institutions to manage the representation and mobilisation of interests and to alert them to problems in local health services. There is more recent evidence for the watchdog than for the sheepdog role. The watchdog role has been reappraised following the failure of statistical monitoring and regulatory police patrols to prevent disasters in the NHS. The discussion also shows how the sheepdog powers of these institutions mean that they can round up opposition, rather than moderating it, resulting in Ministerial reforms to statutory public involvement institutions

Balancing long-term health literacy skills development with immediate action to facilitate use of reliable health information on COVID-19 in England

High-quality healthcare information exists for patients and the public, but a high proportion of individuals do not have the skills to access, assess and use this information. Health Education England leads the strategic development of knowledge and library services in the National Health Service (NHS) in England. One of the goals of the Knowledge for Healthcare strategy is that staff, learners, patients and the public are better equipped to use evidence-based patient, health and wellbeing information for shared decision-making and self-care. This paper outlines a partnership approach to raising awareness of health literacy, and improving the health literacy awareness and skills of NHS staff and citizens, whilst meeting immediate needs to access trustworthy information on COVID-19

On the Dialectics of Charisma in Marina Abramović’s The Artist is Present

While ‘charisma’ can be found in dramatic and theatrical parlance, the term enjoys only minimal critical attention in theatre and performance studies, with scholarly work on presence and actor training methods taking the lead in defining charisma’s supposed ‘undefinable’ quality. Within this context, the article examines the appearance of the term ‘charismatic space’ in relation to Marina Abramovic’s retrospective The Artist is Present at New York’s Museum of Modern Art in 2010. Here Abramovic uses this term to describe the shared space in which performer and spectator connect bodily, psychically, and spiritually through a shared sense of presence and energy in the moment of performance. Yet this is a space arguably constituted through a number of dialectical tensions and contradictions which, in dialogue with existing theatre scholarship on charisma, can be further understood by drawing on insights into charismatic leaders and charismatic authority in leadership studies. By examining the performance and its documentary traces in terms of dialectics we consider the political and ethical implications for how we think about power relations between artist/spectator in a neoliberal, market-driven art context. Here an alternative approach to conceiving of and facilitating a charismatic space is proposed which instead foregrounds what Bracha L. Ettinger calls a ‘matrixial encounter-event’: A relation of coexistence and compassion rather than dominance of self over other; performer over spectator; leader over follower. By illustrating the dialectical tensions in The Artist is Present, we consider the potential of the charismatic space not as generated through the seductive power or charm of an individual whose authority is tied to his/her ‘presence’, but as something co-produced within an ethical and relational space of trans-subjectivity

Functional immune responses against SARS-CoV-2 variants of concern after fourth COVID-19 vaccine dose or infection in patients with blood cancer

Summary Patients with blood cancer continue to have a greater risk of inadequate immune responses following three COVID-19 vaccine doses and risk of severe COVID-19 disease. In the context of the CAPTURE study (NCT03226886) we report immune responses in 80 patients with blood cancer who received a fourth dose of BNT162b2. We measured neutralising antibody titres (NAbT) using a live virus microneutralization assay against wild-type (WT), Delta, Omicron BA.1 and BA.2 and T cell responses against WT and Omicron BA.1 using an activation-induced marker (AIM) assay. The proportion of patients with detectable NAb titres and T cell responses after the fourth vaccine dose increases compared to those after the third vaccine dose. Patients who received B cell-depleting therapies within 12 months before vaccination have the greatest risk of not having detectable NAbT. In addition, we report immune responses in 57 patients with breakthrough infections after vaccination

Functional antibody and T-cell immunity following SARS-CoV-2 infection, including by variants of concern, in patients with cancer: the CAPTURE study

Patients with cancer have higher COVID-19 morbidity and mortality. Here we present the prospective CAPTURE study (NCT03226886) integrating longitudinal immune profiling with clinical annotation. Of 357 patients with cancer, 118 were SARS-CoV-2-positive, 94 were symptomatic and 2 patients died of COVID-19. In this cohort, 83% patients had S1-reactive antibodies, 82% had neutralizing antibodies against WT, whereas neutralizing antibody titers (NAbT) against the Alpha, Beta, and Delta variants were substantially reduced. Whereas S1-reactive antibody levels decreased in 13% of patients, NAbT remained stable up to 329 days. Patients also had detectable SARS-CoV-2-specific T cells and CD4+ responses correlating with S1-reactive antibody levels, although patients with hematological malignancies had impaired immune responses that were disease and treatment-specific, but presented compensatory cellular responses, further supported by clinical. Overall, these findings advance the understanding of the nature and duration of immune response to SARS-CoV-2 in patients with cancer

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

The effects of burning on the invertebrate fauna of the tussock grasslands of the east Otago plateau

Fire is an important feature of pastoral farming in the tussock grasslands of Otago. Over many years data have been collected on the effects of fire on the tussocks themselves, and to an extent, the intertussock vegetation, most notably by Prof. Alan Mark and associates at the Botany Department of Otago University, but almost no data exist on the other main part of the biota in these habitats, the invertebrates. One of the many reasons for this has been the taxonomic impediment, the vast number of different species, most of them poorly known, that face the investigator. However, this problem has recently been greatly alleviated through the work of Dr Barbara Barrett (MAFTech, Invermay) who in the course of a long term trial to investigate the problem of seed loss in oversown tussock grasslands has established the identity of many of the invertebrate inhabitats of the East Otago Plateau. In fact it was largely through the encouragement and persistence of Dr Barbara Barrett that this research programme was initiated. She also made the preliminary approaches to the Hellaby Trust for financial support and resampled the experimental sites after the discontinuation of the project to provide a whole year data