Transfigurations: Curatorial and Artistic Research in an Age of Migrations

Within the framework of MeLa Research project "European Museums in an Age of Migrations", the fieldwork developed by researchers Victoria Walsh (RCA) and Paul Goodwin (UAL) into curatorial and artistic research culminated in the exhibition “Transfigurations: Curatorial and artistic research in an age of migrations”. How are globalisation, digital media and changing patterns of migration affecting our understanding and experience of the contemporary work of art, and how are contemporary artists engaging with curators to think about the condition of the contemporary through their work, its display and collection? How are curators working with new forms of artistic production, particularly ‘immaterial’ works of art, that fall outside conventional forms of display, collection and archive? This research exhibition brought together a rich group of international artists and curators: MACBA in Barcelona with curator Bartomeu Marí and artist Lawrence Abu-Hamdan Bétonsalon in Paris with curator Mélanie Bouteloup and artist Camille Henrot Whitechapel Gallery in London with curator Sofia Victorino and artist Kader Attia Stedelijk Museum in Amsterdam with curators Jelle Bouwhuis / Kerstin Winking and artist Quinsy Gario Royal College of Art in London with Paul Goodwin and artist Leo Asemota In particular, the research exhibition reflected on the challenges and opportunities of curatorial and artistic research in the 21st century, and the rise of new forms of practice such as performance, sound, and video which are both expanding the range of artists’ interests and challenging conventional ideas of the ‘art object’ in museums and galleries. Following what had been described as ‘the curatorial turn’ and ‘the educational turn’ the exhibition considered how complex the interface is between issues of representation, globalisation, collection and object, curating, programming, audiences, and technology. The exhibition launch took place at MACBA - Capella, Museum of Contemporary Art of Barcelona (Plaça dels Àngels 1, Barcelona 08001, Spain) on Thursday 19 June, and was on display from 20 to 26 June 2014

Vertebral fragility fractures: co-designing solutions to promote independence and quality of life based on the needs of service users

Introduction Vertebral fragility fractures (VFF) affect one in six women and one in twelve men during their lifetime, costing the UK NHS more than £133 million each year (without considering medication). Pain as a result of VFF can last up to 2 years, with up to 20% having another VFF within a year. They impact on ability to do everyday activities, such as getting washed and dressed as well as stopping people going to work, often because people are afraid to move. The aim of this study was to utilise a co-design approach with people living with VFF to identify areas of unmet need and establish whether proof of prototype devices could be co-created that addressed those needs. Methods A participatory and iterative approach was utilised involving ten people with osteoporosis or VFF, plus carers, physiotherapists, industrial designers, design engineers and researchers in a series of workshops. Results In workshop one, we immersed ourselves in the lived experiences of people with VFF, carers and physiotherapists. A series of creative activities captured these experiences visually, physically and emotionally and statements of need were defined. In the second workshop, creative activities were undertaken to generate ideas and concepts, moving from two dimensional to three dimensional visualisations. We are currently in the process of converting these visualisations into concept artefacts. The final workshop (May 2017) will develop ‘brand and marketing material’ for each artefact that will be promoted to a ‘Dragon’s Den’ panel of key stakeholders. Conclusion People with VFF report that services and support (including equipment) do not particularly meet their needs. As a diverse group of patients, carers, designers, engineers and researchers, we were able to develop prototype solutions with supporting materials that could be further developed and tested. We plan to use this this work to underpin the development of a future grant application in 2017

Bridging the second gap in translation:A case study of barriers and facilitators to implementing Patient-initiated Clinics into secondary care

Abstract Rationale: Patient-initiated clinics (PIC) have been found to be safe and have patient and service benefits in terms of satisfaction and cost. This paper reports our experiences of implementing PIC and the practical challenges of translating research into practice. Methods: The Knowledge to Action framework was used to inform the design of implementation plans in three different departments in one secondary health care organisation. A focused ethnographic approach was utilised to collect data on barriers and facilitators to implementation which were analysed using iterative qualitative analytic techniques. The Promoting Action on Research Implementation in Health Services framework was used to develop the analysis and data presentation. Results: The success of implementation was mixed across the three departments. Despite evidence of effectiveness, contextual issues at a department level, such as empowered leadership and team members, trust in colleagues and patients and capacity to make changes, impacted on the progress of implementation. Discussion: Patient Initiated Clinics can offer a useful and feasible alternative for follow-up care of some groups of patients with long-term conditions in secondary care, and can be implemented through strong leadership and teamwork and a positive attitude to change. Although Implementation Science as an emerging field offers useful tools and theoretical support, its complexity may create additional challenges to implementation of specific interventions, and so further contribute to the second gap in translation.This research was funded by the South West Academic Health Science Network (AHSN) and the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The AHSN and the NIHR had no involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication

Voluntary and community organisations in Cumbria: assets for young people’s decision-making?

Hello Future forms part of the Uni Connect programme (previously known as the National Collaborative Outreach Programme until January 2020), funded by the Office for Students. The programme aims to drive rapid progress towards achieving the Government’s goals to double the proportion of young people from disadvantaged backgrounds in Higher Education (HE) by 2020, increase by 20 per cent the number of students in HE from ethnic minority groups and address the under-representation of young men from disadvantaged backgrounds. Hello Future is a partnership of local universities, colleges and employers who are committed to improving access to HE for young people in Cumbria. Previous reports commissioned by Hello Future (see HASKE 2020) have argued that an asset-based approach to widening participation is a key strategy for improving access and participation in higher education in Cumbria. In previous work this has been explored from the perspective of schools and outreach officers. This report seeks to develop the asset-based approach to widening participation and outreach by examining the roles of voluntary organisations – sports, arts, scouting and so on – which often form key assets for young people’s decision-making regarding future careers. Currently, very little resource or training exists for such organisations in this specific context. The aims of this research are, then, to: • Map the organisations available to young people in different areas of Cumbria (building from the work HASKE have already done on what constitutes “the rural” within the Cumbrian context). • Identify how organisations view their own roles in young people’s potential journey to Higher Education; how their roles constitutes assets for outreach programmes to engage with; and in what ways they “gate” these assets to particular groups of young people (building on the work HASKE have done on widening participation, cultural capital and asset-based approaches). The aim of this report is: • To articulate the ways in which VCOs can be seen as assets for FE and HE outreach, by - Demonstrating the variation in VCO types and activities across Cumbria; - Articulating the different ways in which they engage with young people in general, and in discussions about their potential future decisions in particular; • To identify the ways in which these assets are gated, in order to inform any potential interventions from outreach teams

An evaluation of the Third Sector Referral Coordinator Team

Context: Health and Society Knowledge Exchange (HASKE), at the University of Cumbria, was commissioned by Cumbria Council for Voluntary Services (Cumbria CVS) to evaluate the ICC Third Sector Referral Coordinator Team and its work, including the Health and Welfare Telephone Support Service. The Third Sector Referral Coordinator Team was initially established in June 2019 as a 12-month pilot service, funded by NHS England. The initial aim of the pilot was to embed one coordinator in Eden Integrated Care Community and another in Cockermouth and Maryport Integrated Care Community. The goal was to become familiar with the third sector services in both of these areas and to encourage health colleagues to refer patients to the appropriate services within the communities. In March 2020, as a direct response to the Covid-19 pandemic, the Health and Welfare Telephone Support Service was established to help safeguard and support patients on discharge from hospital, or whenever it was felt that patients might benefit from additional support from third sector services. The Health and Welfare Telephone Support Service was developed by Cumbria CVS in partnership with NCIC NHS Trust and funded by North Cumbria CCG. The Service is delivered by the Third Sector Referral Coordinator Team in partnership with seven third sector organisations: Alzheimer’s Society, Age UK Carlisle and Eden, Age UK West Cumbria, Carlisle Carers, Eden Carers, People First and West Cumbria Carers. The Health and Welfare Telephone Support Service provides support to patients through a series of up to five telephone calls which aim to identify and address health and social concerns; link patients and their carers to ongoing community support; support patients to navigate health and social care services; and keep clinical staff updated about issues and outcomes. During the pandemic, this service expanded its reach to support all eight ICCs across North Cumbria. Methodology: Two online surveys were designed to collect data from the Third Sector Referral Coordinator Team and the ICC staff who have referred into the Team and/or the Health and Welfare Telephone Support Service. In addition, referral data from October 2020 to October 2021 was provided by Cumbria CVS, along with patient case studies. Findings: • The data collected through the surveys and case studies show that the Third Sector Referral Coordinator Team utilise a person-centred approach to provide a holistic assessment of patient needs and refer patients to the most appropriate support services within their local area. This is apparent in evidence from the Team, the ICC staff liaising with them, and the case studies provided. • The Third Sector Referral Coordinators clearly have an extensive knowledge of the third sector services and have developed strong partnerships with a range of organisations across North Cumbria. It is evident that the Third Sector Referral Coordinator Team are now supporting clinical and care staff across the eight ICCs in North Cumbria. • Having an honorary NHS contract has enhanced the Team’s ability to work collaboratively with health colleagues by updating patient records in real time and ensuring that information governance protocols are adhered to. • The findings show that the Third Sector Referral Coordinator Team, and the Health and Welfare Telephone Support Service, are highly valued by ICC clinical and care staff. Key benefits for ICC staff include: a single point of access for patient referrals; a reduction in the time spent making patient referrals; and confidence in the knowledge that their patients will continue to be cared for by those with expertise of the third sector. • The findings highlight the following key benefits for the patients who are referred to the Third Sector Referral Coordinator Team: a holistic assessment of individual needs; access to a wide range of appropriate support and information; the opportunity to build networks within their local community; and improvements to their quality of life through receiving appropriate support. • The Health and Welfare Telephone Support Service was developed as a response to the Covid-19 pandemic to safeguard patients when being discharged from hospital, or when it was felt that they might benefit from support from third sector organisations. Despite the challenges of remote working throughout the pandemic, this service has successfully supported patients across North Cumbria. Referral data indicates that the service has been used consistently throughout the time it has been operating, and across a range of public and third sector organisations. • The evidence collected not only suggests that the project been a success for all those involved, but also provides a clear sense of what else might be achieved with further funding. For example, long-term funding would enable the Third Sector Referral Coordinator Team to grow and expand the scope of their work across the ICCs, and to embed their service in a wider range of patient pathways

Northern Cancer Alliance Vague Symptoms Pathway. Evaluation report.

Context: In 2018, Health and Social Care Evaluations (HASCE) at the University of Cumbria was commissioned by the Northern Cancer Alliance (NCA) to evaluate the delivery of the NCA programme entitled ‘Vague Symptoms Pathway’ (VSP). The aim of this programme was to address a perceived problem for patients who present to their General Practice/Practitioner (GP), unwell, but with vague symptoms which do not neatly fit the two-week wait criteria. This creates a challenge for GPs in identifying an appropriate route forward into secondary care for those patients. The NCA offered a funding pot for some localities to bid into in order to pilot projects with the aim of creating and enabling expedited access to testing, and assessment for these patients, to establish whether further cancer investigations are required. Methodology: This evaluation work, which began in 2019, utilised a mixed-methods approach; using quantitative data collated from project returns and analysed using descriptive statistics, along with semi-structured interviews to collect qualitative data, which was then subjected to template analysis. The data collection was informed by a realist approach to evaluation; this aims to build an understanding about what works for whom, in what context and the mechanisms and outcomes around this. Conclusions: The evidence illustrates that the overall aim of the programme is being met – clearly, the pathways present a highly appropriate and effective option to GPs when faced with a patient with vague symptoms. It is also evidenced via the quantitative and qualitative data that expedited access is generally being achieved, with those who are staffing the pathways and associated activities feeling very positive about their effect and potential. Importantly, that expedited access is reducing the time to diagnosis for patients, thus enabling more rapid care, for cancer, or identifying another condition. Overall, the evaluation team feel that the pathways considered here, at their individual stages, are successful, that the programme has been well implemented and is delivering against its core aims. However, in all programmes, particularly those that are piloting new approaches, lessons can be learned and, with this mind, thirteen recommendations arose from this evaluation report

Behavior change interventions to increase physical activity in hospitalized patients: A systematic review, meta-analysis and meta-regression

© The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/)Background Low physical activity levels are a major problem for people in hospital and are associated with adverse outcomes. Objective This systematic review, meta-analysis and meta-regression aimed to determine the effect of behaviour change interventions on physical activity levels in hospitalised patients. Methods Randomised controlled trials of behaviour change interventions to increase physical activity in hospitalised patients were selected from a database search, supplemented by reference list checking and citation tracking. Data were synthesised with random-effects meta-analyses and meta-regression analyses, applying Grades of Recommendation, Assessment, Development and Evaluation criteria. The primary outcome was objectively measured physical activity. Secondary measures were patient-related outcomes (e.g. mobility), service level outcomes (e.g. length of stay), adverse events and patient satisfaction. Results Twenty randomised controlled trials of behaviour change interventions involving 2,568 participants (weighted mean age 67 years) included six trials with a high risk of bias. There was moderate-certainty evidence that behaviour change interventions increased physical activity levels (SMD 0.34, 95% CI 0.14–0.55). Findings in relation to mobility and length of stay were inconclusive. Adverse events were poorly reported. Meta-regression found behaviour change techniques of goal setting (SMD 0.29, 95% CI 0.05–0.53) and feedback (excluding high risk of bias trials) (SMD 0.35, 95% CI 0.11–0.60) were independently associated with increased physical activity. Conclusions Targeted behaviour change interventions were associated with increases in physical activity in hospitalised patients. The trials in this review were inconclusive in relation to the patient-related or health service benefits of increasing physical activity in hospital.Peer reviewe

Exploring residents' experiences of mealtimes in care homes:A qualitative interview study

Abstract Background Many interventions aim to alleviate well-documented problems of malnutrition in residential care homes and improve residents’ health and wellbeing. Despite some positive findings, little is known about how and why mealtime interventions might be effective, and in particular, what effects residents’ experiences of mealtimes have on health outcomes. The aim of this study was to gain an insight into these experiences and explore some of the issues that may impact on residents’ enjoyment of meals, and resulting health and wellbeing. Methods Semi-structured interviews were conducted with eleven residents from four care homes in the South West UK. Thematic analysis was used to derive content and meaning from transcribed interviews. Interviews were supplemented by researcher observations of mealtimes. Results The dining experience was a focal point for participants’ broader experiences of residing in a care home. Three themes pertaining to residents’ experiences were identified: (1) Emotional and psychological connections with other residents; (2) managing competing interests with limited resources; and (3) familiarity and routine. Conclusion Mealtimes are a mainstay of life in a care home through which residents’ experiences are characterised, exemplified and magnified. Understanding how residents interact with one another, accommodating their preferences and encouraging autonomy may enhance their mealtime experiences. It may also help to ease the transition from independent-living to life in care, which can be particularly stressful for some residents, and improve health and wellbeing over the long-term

Keratinocyte-specific deletion of SHARPIN induces atopic dermatitis-like inflammation in mice.

Spontaneous mutations in the SHANK-associated RH domain interacting protein (Sharpin) resulted in a severe autoinflammatory type of chronic proliferative dermatitis, inflammation in other organs, and lymphoid organ defects. To determine whether cell-type restricted loss of Sharpin causes similar lesions, a conditional null mutant was created. Ubiquitously expressing cre-recombinase recapitulated the phenotype seen in spontaneous mutant mice. Limiting expression to keratinocytes (using a Krt14-cre) induced a chronic eosinophilic dermatitis, but no inflammation in other organs or lymphoid organ defects. The dermatitis was associated with a markedly increased concentration of serum IgE and IL18. Crosses with S100a4-cre resulted in milder skin lesions and moderate to severe arthritis. This conditional null mutant will enable more detailed studies on the role of SHARPIN in regulating NFkB and inflammation, while the Krt14-Sharpin-/- provides a new model to study atopic dermatitis