Lilliput

Catalog for the exhibition Lilliput held at the Seton Hall University Walsh Gallery, June 8 - July 24, 2009. Curated by Jeanne Brasile and Asha Ganpat. Includes an essay by Jeanne Brasile and Asha Ganpat. Includes color illustrations

Common value: transferring development rights to make room for water

In 2019 floods made up 49 % of disasters and 43 % of disaster related deaths globally. Flooding is also the costliest natural disaster, with yearly estimated losses of $36.3 billion. In order to counter these challenges, the flood risk management (FRM) narrative is evolving towards integration of blue/green infrastructure (BGI), using projects that harness nature and mimic natural processes. However, there is very little research into how BGI-related innovations will be mainstreamed, nor, particularly, how they will be funded. In order to reflect upon this situation, this paper analyses current academic literature and international best practice in BGI and Land Value Capture (LVC) instruments - to form a novel conceptual framework that is designed to act as a staging post for new research into BGI and its practical delivery. Specifically, this analysis focuses on the Transferable Development Rights (TDR) instrument, which has enabled some planning authorities to successfully push forward their environmental agendas, through land conservation, including in flood prone areas. This gap in knowledge has multiple significance. Firstly, land management decisions related to BGI can have deep distributive-justice implications that need to be addressed. Secondly, there is an immediate need to pay for such FRM measures across the world. Thirdly, this financial imperative takes place against an international backdrop of reduced government funding in a time of deep structural change and Covid-19 pressure. Findings in this paper suggest that TDR has the potential to be a successful conduit for managing all three conditions. Yet, the success of TDR is closely linked to the specific legal, market and urban development contexts, which further research should explore within the framework of BGI implementation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Treating patients who strain the research psychotherapy paradigm

BACKGROUND: Clinical trials of psychotherapy require diagnostic homogeneity, which implies a convergence of clinical presentations. Yet research study patients present diversely, and patients who do not fit a treatment paradigm may greatly complicate delivery of the study psychotherapy. The research literature has not addressed this issue. METHODS: The authors use case illustrations of three psychotherapies – Prolonged Exposure, Relaxation Therapy, and Interpersonal Psychotherapy – from an ongoing psychotherapy outcome trial of posttraumatic stress disorder to describe psychotherapeutic responses to complex, “atypical” patients who strain standard treatment paradigms. RESULTS: Therapists required flexibility, and occasionally deviations from strict protocol, in treating heterodox patients. CONCLUSIONS: Such heterogeneity of presentation may have implications for psychotherapy outcome in research trials. Despite lack of discussion in the literature, many trials may face such issues

Time Spent in Lateral Sleep Position and Asymmetry in Glaucoma.

PurposeTo explore sleep position in asymmetric primary open-angle glaucoma (POAG) with a focus on low pressure glaucoma (LPG).MethodsSleep laboratory videos of 54 POAG patients were examined for lateral sleep. Then, 29 LPG patients (intraocular pressure [IOP] < 22 mm Hg) with an intereye visual field index (VFI) asymmetry of more than 5% continuously recorded their sleep position at home for 2 nights by using a portable device. Correlations were sought between sleep position, visual field (VF), and retinal nerve fiber layer (RNFL) symmetry as well as ocular biometric data and positional IOP changes. Finally, an expanded data set of 178 POAG patients (63 LPG and 115 high pressure glaucoma [HPG; IOP ≥ 22 mm Hg]) was used to correlate VF and the RNFL symmetry to the self-assessed sleep position collected in a survey.ResultsIn the video analysis, patients spent 19% ± 2% (mean ± SEM) more time sleeping on one side than on the other. Right-sided sleep was preferred. Right-sided sleep was 1.6 times more common in continuously recorded home data and correlated to an asymmetric VF that was worse in the left eye (b = -0.422, P = 0.002). Pulse amplitude of left eyes was lower in the right decubitus position (P = 0.02). In the expanded survey, 73% of LPG and 58% of HPG patients slept asymmetrically. Right-sided sleepers had a worse RNFL symmetry score.ConclusionsAsymmetric sleep behavior is common. Right-sided sleep was preferred and correlated with a lower VFI on the left