Ethel Carnie Holdsworth: General Belinda, co-operation and the servant problem

In July 1920, ‘Belinda: The Story of a Domestic Servant’ first appeared in the co-operative periodical, the Wheatsheaf. It was penned by one of its regular short story writers, Lancashire mill-woman Ethel Carnie Holdsworth (1886-1962). Encouraged by Percy Redfern, the Wheatsheaf’s editor, Carnie Holdsworth returned to the character of Belinda over the next couple of years, and in 1924, General Belinda became her sixth published novel. General Belinda is an episodic adventure about the trials and tribulations of domestic service. Belinda is a maid-of-all work who, like P. G. Wodehouse’s Jeeves, puts her employers’ lives and affairs to right. Comedy is the striking note, but Carnie Holdsworth was adept at putting popular fiction to work for feminist-Marxist politics. This article explores the novel as a radical feminist critique of early twentieth-century domestic service and the devastation of World War One, written from the rare perspective of a working-class woman. General Belinda is also an important example of co-operative ideals. Redfern was a key proponent of consumer socialism between the wars, and Belinda shows her employers the power of consumerism as a rational force for good, preaching against debt and fiscal irresponsibility. The article illustrates how Carnie Holdsworth’s plot intersects with wider debates in interwar women’s print culture on how British women shoppers were encouraged to be good home-making citizens. Belinda shows readers how to practise domestic economy and shop for co-operative good. In doing so, she suggests a new way of conceiving of the labour of domestic service and of positive social relations post-war, based on a co-operative understanding of dignity, mutual association and self-help

Improving the development, monitoring and reporting of stroke rehabilitation research: consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable (SRRR)

Recent reviews have demonstrated that the quality of stroke rehabilitation research has continued to improve over the last four decades but despite this progress there are still many barriers in moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. An international partnership of stroke rehabilitation experts committed to develop consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions. Work exploring each of the three areas took place via multiple teleconferences and a two-day meeting in Philadelphia in May 2016. A total of 15 recommendations were made. To validate the need for the recommendations the group reviewed all stroke rehabilitation trials published in 2015 (n=182 papers). Our review highlighted that the majority of publications did not clearly describe how interventions were developed or monitored during the trial. In particular, under-reporting of the theoretical rationale for the intervention and the components of the intervention calls into question many interventions that have been evaluated for efficacy. More trials were found to have addressed the reporting of interventions recommendations than those related to development or monitoring. Nonetheless the majority of reporting recommendations were still not adequately described. To progress the field of stroke rehabilitation research and to ensure stroke patients receive optimal evidence based clinical care we urge the research community to endorse and adopt our recommendations

What a girl’s gotta do: the labour of the biopolitical celebrity in austerity Britain

This article debunks the wide-spread view that young female celebrities, especially those who rise to fame through reality shows and other forms of media-orchestrated self-exposure, dodge ‘real’ work out of laziness, fatalism and a misguided sense of entitlement. Instead, we argue that becoming a celebrity in a neoliberal economy such as that of the United Kingdom, where austerity measures disproportionately disadvantage the young, women and the poor is not as irregular or exceptional a choice as previously thought, especially since the precariousness of celebrity earning power adheres to the current demands of the neoliberal economy on its workforce. What is more, becoming a celebrity involves different forms of labour that are best described as biopolitical, since such labour fully involves and consumes the human body and its capacities as a living organism. Weight gain and weight loss, pregnancy, physical transformation through plastic surgery, physical symptoms of emotional distress and even illness and death are all photographically documented and supplemented by extended textual commentary, usually with direct input from the celebrity, reinforcing and expanding on the visual content. As well as casting celebrity work as labour, we also maintain that the workings of celebrity should always be examined in the context of wider cultural and real economies

Parenting for lifelong health:A pragmatic cluster randomised controlled trial of a non-commercialised parenting programme for adolescents and their families in South Africa

Objective To assess the impact of ‘Parenting for Lifelong Health: Sinovuyo Teen’, a parenting programme for adolescents in low- and middle-income countries, on abuse and parenting practices. Design Pragmatic cluster randomised control trial. Setting 40 villages/urban sites (clusters) in the Eastern Cape province, South Africa. Participants 552 families reporting conflict with their adolescents (aged 10-18). Intervention Intervention clusters (n=20) received a 14-session parent and adolescent programme delivered by trained community members. Control clusters (n=20) received a hygiene and hand-washing promotion programme. Main outcome measures Primary outcomes: abuse and parenting practices at one and 5-9 months post-intervention. Secondary outcomes: Caregiver and adolescent mental health and substance use, adolescent behavioural problems, social support, exposure to community violence, and family financial wellbeing at 5-9 months post-intervention. Blinding was not possible. Results At 5-9 months post-intervention, the intervention was associated with lower abuse (caregiver report incidence rate ratio (IRR) 0.55 (95% CI 0.40 to 0.75, p Conclusions This parenting programme shows promise for reducing violence, improving parenting and family functioning in low-resource settings.</p

Post mortem magnetic resonance imaging in the fetus, infant and child: A comparative study with conventional autopsy (MaRIAS Protocol)

<p>Abstract</p> <p>Background</p> <p>Minimally invasive autopsy by post mortem magnetic resonance (MR) imaging has been suggested as an alternative for conventional autopsy in view of the declining consented autopsy rates. However, large prospective studies rigorously evaluating the accuracy of such an approach are lacking. We intend to compare the accuracy of a minimally invasive autopsy approach using post mortem MR imaging with that of conventional autopsy in fetuses, newborns and children for detection of the major pathological abnormalities and/or determination of the cause of death.</p> <p>Methods/Design</p> <p>We recruited 400 consecutive fetuses, newborns and children referred for conventional autopsy to one of the two participating hospitals over a three-year period. We acquired whole body post mortem MR imaging using a 1.5 T MR scanner (Avanto, Siemens Medical Solutions, Enlargen, Germany) prior to autopsy. The total scan time varied between 90 to 120 minutes. Each MR image was reported by a team of four specialist radiologists (paediatric neuroradiology, paediatric cardiology, paediatric chest & abdominal imaging and musculoskeletal imaging), blinded to the autopsy data. Conventional autopsy was performed according to the guidelines set down by the Royal College of Pathologists (UK) by experienced paediatric or perinatal pathologists, blinded to the MR data. The MR and autopsy data were recorded using predefined categorical variables by an independent person.</p> <p>Discussion</p> <p>Using conventional post mortem as the gold standard comparator, the MR images will be assessed for accuracy of the anatomical morphology, associated lesions, clinical usefulness of information and determination of the cause of death. The sensitivities, specificities and predictive values of post mortem MR alone and MR imaging along with other minimally invasive post mortem investigations will be presented for the final diagnosis, broad diagnostic categories and for specific diagnosis of each system.</p> <p>Clinical Trial Registration</p> <p><a href="http://www.clinicaltrials.gov/ct2/show/NCT01417962">NCT01417962</a></p> <p><b>NIHR Portfolio Number: </b>6794</p

Automated recording of home cage activity and temperature of individual rats housed in social groups: The Rodent Big Brother project

Measuring the activity and temperature of rats is commonly required in biomedical research. Conventional approaches necessitate single housing, which affects their behavior and wellbeing. We have used a subcutaneous radiofrequency identification (RFID) transponder to measure ambulatory activity and temperature of individual rats when group-housed in conventional, rack-mounted home cages. The transponder location and temperature is detected by a matrix of antennae in a baseplate under the cage. An infrared high-definition camera acquires side-view video of the cage and also enables automated detection of vertical activity. Validation studies showed that baseplate-derived ambulatory activity correlated well with manual tracking and with side-view whole-cage video pixel movement. This technology enables individual behavioral and temperature data to be acquired continuously from group-housed rats in their familiar, home cage environment. We demonstrate its ability to reliably detect naturally occurring behavioral effects, extending beyond the capabilities of routine observational tests and conventional monitoring equipment. It has numerous potential applications including safety pharmacology, toxicology, circadian biology, disease models and drug discovery

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

A parenting programme to prevent abuse of adolescents in South Africa:Study protocol for a randomised controlled trial

An estimated one billion children experience child abuse each year, with the highest rates in low- and middle-income countries. The Sinovuyo Teen programme is part of Parenting for Lifelong Health, a WHO/UNICEF initiative to develop and test violence-prevention programmes for implementation in low-resource contexts. The objectives of this parenting support programme are to prevent the abuse of adolescents, improve parenting and reduce adolescent behavioural problems. This trial aims to evaluate the effectiveness of Sinovuyo Teen compared to an attention-control group of a water hygiene programme.This is a pragmatic cluster randomised controlled trial, with stratified randomisation of 37 settlements (rural and peri-urban) with 40 study clusters in the Eastern Cape of South Africa. Settlements receive either a 14-session parenting support programme or a 1-day water hygiene programme. The primary outcomes are child abuse and parenting practices, and secondary outcomes include adolescent behavioural problems, mental health and social support. Concurrent process evaluation and qualitative research are conducted. Outcomes are reported by both primary caregivers and adolescents. Brief follow-up measures are collected immediately after the intervention, and full follow-up measures collected at 3-8 months post-intervention. A 15-24-month follow-up is planned, but this will depend on the financial and practical feasibility given delays related to high levels of ongoing civil and political violence in the research sites.This is the first known trial of a parenting programme to prevent abuse of adolescents in a low- or middle-income country. The study will also examine potential mediating pathways and moderating factors. Pan-African Clinical Trials Registry PACTR201507001119966

Reducing child abuse amongst adolescents in low- and middle-income countries:A pre-post trial in South Africa

Background: No known studies have tested the effectiveness of child abuse prevention programmes for adolescents in low- or middle-income countries. ‘Parenting for Lifelong Health’ (http://tiny.cc/whoPLH) is a collaborative project to develop and rigorously test abuse-prevention parenting programmes for free use in low-resource contexts. Research aims of this first pre-post trial in South Africa were: i) to identify indicative effects of the programme on child abuse and related outcomes; ii) to investigate programme safety for testing in a future randomised trial, and iii) to identify potential adaptations. Methods: 230 participants (adolescents and their primary caregivers) were recruited from schools, welfare services and community-sampling in rural, high-poverty South Africa (no exclusion criteria). All participated in a 12-week parenting programme, implemented by local NGO childcare workers to ensure real-world external validity. Standardised pre-post measures with adolescents and caregivers were used, and paired t-tests were conducted for primary outcomes: abuse (physical, emotional and neglect), adolescent behaviour problems and parenting (positive and involved parenting, poor monitoring and inconsistent discipline), and secondary outcomes: mental health, social support and substance use. Results: Participants reported high levels of socio-economic deprivation, e.g. 60% of adolescents had either an HIV-positive caregiver or were orphaned by AIDS, and 50% of caregivers experienced intimate partner violence. i) indicative effects: Primary outcomes comparing pre-test and post-test assessments showed reductions reported by adolescents and caregivers in child abuse (adolescent report 63.0% pre-test to 29.5% post-test, caregiver report 75.5% pre-test to 36.5% post-test, both p&lt;0.001) poor monitoring/inconsistent discipline (p&lt;.001), adolescent delinquency/ aggressive behaviour (both p&lt;.001), and improvements in positive/involved parenting (p&lt;.01 adolescent report, p&lt;.001 caregiver report). Secondary outcomes showed improved social support (p&lt;.001 adolescent and caregiver reports), reduced parental and adolescent depression (both p&lt;.001), parenting stress (p&lt;.001 caregiver report) and caregiver substance use (p&lt;.002 caregiver report). There were no changes in adolescent substance use. No negative effects were detected. ii) Programme acceptability and attendance was high. There was unanticipated programme diffusion within some study villages, with families initiating parenting groups in churches, and diffusion through school assemblies and religious sermons. iii) potential adaptations identified included the need to strengthen components on adolescent substance use and to consider how to support spontaneous programme diffusion with fidelity. Conclusions: The programme showed no signs of harm and initial evidence of reductions in child abuse and improved caregiver and adolescent outcomes. It showed high acceptability and unexpected community-level diffusion. Findings indicate needs for adaptations, and suitability for the next research step of more rigorous testing in randomised trials, using cluster randomization to allow for diffusion effects