“Don’t tell me this isn’t relevant all over again in its brand new same old way”: imagination, agitation, and raging against the machine in Ali Smith’s Spring

This paper explores the third novel in Ali Smith’s seasonal quartet, Spring. Using Achille Mbembe’s Necropolitics as a conceptual frame, I analyze Smith’s rendering of a Britain grappling with Brexit in times of transnational populism. As with Autumn and Winter, Smith’s prose is saturated with intertextual borrowings from pop and “high” culture, also interrogating the links between “nanoracism” and the “immunity and community” knot (Dillet). This paper reads Spring alongside Smith’s contribution to and advocacy of the Refugee Tales project regarding the diverse discourses surrounding migration, xenophobia, and indefinite detention. Smith’s writing traces the darkness of our populist present with its rhetorical and material violence, as well as the possibilities for creative response and resistance. I argue that her seasonal quartet to date and her work with Refugee Tales aesthetically and ethically defend the principle that human dignity, both individual and collective, rests on the ability to tell stories

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Race and processes of racialisation in British international development discourse, 1997-2017

This thesis analyses the role race and processes of racialisation play in British development discourse about India between 1997 and 2017. Using Stuart Hall’s conceptualisation of race, paired with critical race scholarship, decolonial theory, postcolonial theory and Gramscian notions of hegemony, it offers original empirical findings by examining and comparing three key areas: a) government discourse on development; b) development professionals’ views of their work and c) British newspaper reporting on development in India. The processes of racialisation present in each, and how they interact with colonial tropes, gender and class are evaluated qualitatively and comparatively. They are also compared with domestic discourses already established as racialised, that is discourses on race and asylum and immigration. I demonstrate continuities across these different realms, and identify significant similarities between the arguments of ‘pro’ and ‘anti’ development proponents in British politics. It is by looking at these multiple strands of discourse, articulated at times by different actors, that I suggest racialised development discourse is hegemonic. This thesis offers an original contribution in examining how shifting forms of racialisation operate in development discourse and by arguing that dominant development discourse is key to maintaining and is also maintained by representations of Britishness that are synonymous with whiteness. In addition, it not only demonstrates how race is central to ideas of development but also how this can be masked through competing forms of racialisation of the ‘to-be-developed’ and seemingly ‘positive’ forms of racialisation of people in India