Identifying and prioritizing strategies for comprehensive liver cancer control in Asia

<p>Abstract</p> <p>Background</p> <p>Liver cancer is both common and burdensome in Asia. Effective liver cancer control, however, is hindered by a complex etiology and a lack of coordination across clinical disciplines. We sought to identify strategies for inclusion in a comprehensive liver cancer control for Asia and to compare qualitative and quantitative methods for prioritization.</p> <p>Methods</p> <p>Qualitative interviews (N = 20) with international liver cancer experts were used to identify strategies using Interpretative Phenomenological Analysis and to formulate an initial prioritization through frequency analysis. Conjoint analysis, a quantitative stated-preference method, was then applied among Asian liver cancer experts (N = 20) who completed 12 choice tasks that divided these strategies into two mutually exclusive and exhaustive subsets. Respondents' preferred plan was the primary outcome in a choice model, estimated using ordinary least squares (OLS) and logistic regression. Priorities were then compared using Spearman's Rho.</p> <p>Results</p> <p>Eleven strategies were identified: <it>Access to treatments; Centers of excellence; Clinical education; Measuring social burden; Monitoring of at-risk populations; Multidisciplinary management; National guidelines; Public awareness; Research infrastructure; Risk-assessment and referral</it>; and <it>Transplantation infrastructure</it>. Qualitative frequency analysis indicated that <it>Risk-assessment and referral </it>(85%), <it>National guidelines </it>(80%) and <it>Monitoring of at-risk populations </it>(80%) received the highest priority, while conjoint analysis pointed to <it>Monitoring of at-risk populations </it>(p < 0.001), <it>Centers of excellence </it>(p = 0.002), and <it>Access to treatments </it>(p = 0.004) as priorities, while <it>Risk-assessment and referral </it>was the lowest priority (p = 0.645). We find moderate concordance between the qualitative and quantitative methods (rho = 0.20), albeit insignificant (p = 0.554), and a strong concordance between the OLS and logistic regressions (rho = 0.979; p < 0.0001).</p> <p>Conclusions</p> <p>Identified strategies can be conceptualized as the ABCs of comprehensive liver cancer control as they focus on <it>Antecedents</it>, <it>Better care </it>and <it>Connections </it>within a national strategy. Some concordance was found between the qualitative and quantitative methods (e.g. <it>Monitoring of at-risk populations</it>), but substantial differences were also identified (e.g. qualitative methods gave highest priority to risk-assessment and referral, but it was the lowest for the quantitative methods), which may be attributed to differences between the methods and study populations, and potential framing effects in choice tasks. Continued research will provide more generalizable estimates of priorities and account for variation across stakeholders and countries.</p

Framing the Real: Lefèbvre and NeoRealist Cinematic Space as Practice

In 1945 Roberto Rossellini's Neo-realist Rome, Open City set in motion an approach to cinema and its representation of real life – and by extension real spaces – that was to have international significance in film theory and practice. However, the re-use of the real spaces of the city, and elsewhere, as film sets in Neo-realist film offered (and offers) more than an influential aesthetic and set of cinematic theories. Through Neo-realism, it can be argued that we gain access to a cinematic relational and multidimensional space that is not made from built sets, but by filming the built environment. On the one hand, this space allows us to "notice" the contradictions around us in our cities and, by extension, the societies that have produced those cities, while on the other, allows us to see the spatial practices operative in the production and maintenance of those contradictions. In setting out a template for understanding the spatial practices of Neo-realism through the work of Henri Lefèbvre, this paper opens its films, and those produced today in its wake, to a spatio-political reading of contemporary relevance. We will suggest that the rupturing of divisions between real spaces and the spaces of film locations, as well the blurring of the difference between real life and performed actions for the camera that underlies much of the central importance of Neo-realism, echoes the arguments of Lefèbvre with regard the social production of space. In doing so, we will suggest that film potentially had, and still has, a vital role to play in a critique of contemporary capitalist spatial practices

Populism, inequality and representation: Negotiating ‘the 99%’ with Occupy London

When Occupy London emerged with a global wave of protest movements in October 2011, it embodied and advanced discursive forms that have characterised the unsettling of political consensus following the financial crisis. The central claim that ‘We are the 99%’ staged a fundamental tension, between a populist appeal to the figure of ‘the people’, and a contrary orientation seeking to critique inequality while rejecting forms of representation and identity. This article – which draws on three years of ethnographic fieldwork with Occupy London (October 2011–October 2014) and a critical theorisation of the figure of ‘the people’ in radical movements – follows movement participants’ negotiation of the tension at the heart of the discourse of ‘the 99%’. It offers an account of the conflicting meanings and practices that emerged, arguing that the result was a creative contradiction that sustained the movement for a time, while setting the terms of its ultimate breakdown. Identifying the concept of ‘representation’ as the site of particular controversy, this is unpicked through a number of key figures (Pitkin, Marx, Spivak, Puchner, Deleuze and Guattari) as the basis for an empirical account of Occupy’s practice of assembly, which offered partial, imperfect ‘solutions’ to these tensions. The article concludes with some implications for the limits and possibilities of both a grassroots populism and a politics against representation, in the context of political developments since

Fragments, cityscapes, modernity:Kracauer on the Cannebiere

Written as a small tribute to David Frisby’s inspiring, pioneering work on Critical Theory and the modern cityscape, this essay explores a number of feuilletons and other textual fragments in which the cultural theorist Siegfried Kracauer expresses his enduring fascination with the French port of Marseilles. It is suggested that this city has a two-fold significance for him: firstly, in the vibrancy of its streetlife, Marseilles is an exemplary indeed inspirational instance of the cinematic qualities of modern urban environments. It is to Marseilles that Kracauer’s 1960 Theory of Film is indebted not only for its first formulation but also for its central motif of the quotidian ‘flow of life’ to which the film camera must attend. Secondly, this seedy city constitutes the preeminent site of ‘promiscuous modernity’ understood here in two senses: not only as an environment of explicit sexuality and sexual activity/exchange, but also one that is ‘for mixing,’ that is to say, open and inviting to the most eclectic and outré elements. This notion of promiscuity as the continuous co-presence and curious contiguity of heterogeneous populations and incongruous objects also has its filmic aspect – as Kracauer observes elsewhere, such surreal juxtapositions are also to be found off-set in the costumes and props of the film studio. In its fusion of everyday urban energies and extraordinary eccentricities, the cinematic city of Marseilles takes on a dreamlike quality. Key Words: David Frisby, Siegfried Kracauer, Marseilles, cityscape, promiscuity, modernity, fil