Design Construction Networks

This visual essay diagrams a global design construction network that connects architects to migrant construction workers in a direct line. A hypothetical stadium construction site lies in the center; one side maps the movement of a steel truss from design to fabrication to a building site; the other side charts the path of migrant workers as they travel from villages to this construction site. Detailed scenarios outline the work of different actors on both sides, and additionally highlight challenges faced by migrant construction workers and where solutions might intervene. By connecting architects and workers the essay points to visible as well as sometimes hidden economies of architecture, and asks: What are the architects’ ethical responsibilities towards those who erect their buildings around the world? The essay further opens up a theoretical trajectory that seeks to understand the underlying and often unequal systems that structure today’s architecture and construction

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Building Advocacy ‐ Who Builds Your Architecture?

Presented on March 2, 2016 at 2:00 p.m-4:00 p.m. in the Reinsch-Pierce Family Auditorium, College of Architecture at Georgia Tech.Mabel 0. Wilson received a doctorate in American Studies from NYU in 2007 and an M. Arch from Columbia University in 1991. As the Nancy and George E. Rupp Professor at Columbia University Graduate School of Architecture, Planning and Preservation, she directs the program for Advanced Architectural Research, co-directs the Global Africa Lab, and is a Senior Fellow at the Institute for Research in African American Studies in the Graduate School of Arts and Sciences. Wilson is an award winning designer and scholar. Her collaborative design practices (KW: a and Studio &) have worked on speculative and built projects. The (a)way station, in the collection of SFMoMA, received a design award from ID Magazine and has been exhibited widely. Her practice has been a competition finalist for several important cultural institutions including lower Manhattan's African Burial Ground Memorial (with Dean Wolfe Architects) and the Smithsonian's National Museum for African American History and Culture (with Diller Scofidio + Renfro.) The Wexner Center for the Arts, the Cooper Hewitt National Design Museum's Triennial, the Storefront for Art and Architecture, and SF Cameraworks have exhibited her installations. She is currently compiling the rich photographic archive from her book Negro Building into an experimental exhibit and database as part of the Becoming History Project. Her research on African Cities and modern architecture appeared in the video and photography exhibition Listening There: Stories from Ghana.Runtime: 96:03 minutesAs an ongoing advocacy project, Who Builds Your Architecture? (WBYA?) asks architects and allied fields to better understand how the production of buildings connects their practices to migrant construction workers who build their designs. WBYA?, a group of designers, scholars, and activists based in New York City, has extensively researched the networks, modes representations, and processes of the global construction industry. Through exhibitions, publications, workshops and public forums, WBYA? seeks to inform the design disciplines and professions of the importance of developing an ethical response to critical matters of human sustainability

Experiences of a Novel Integrated Service for Older Adults at Risk of Frailty: A Qualitative Study

The UK has a significant and growing population of older adults with frailty and complex healthcare needs, necessitating innovative care solutions. This study aimed to explore patients’ and carers’ experiences of a novel integrated service that was set up to address the increasing healthcare needs of older people living with frailty. A qualitative study that combined free-text survey questions with in-depth interviews. This study is part of a larger non-randomized trial of the service, with evaluation of wellbeing and quality of life at baseline, 2 to 4 weeks, and 10 to 14 weeks. Patients (aged 65 and above) with an electronic Frailty Index in the severe range and their informal family carers participated in this study. Data were collected between April 2019 and March 2020. Free text survey responses and interview data were subjected to reflexive thematic analyses. Four themes were generated: the overall experience of the service; interactions within the service; treatment and interventions; and outcomes due to the service. Most participants wanted further follow-up and more extensive integration with other services. Most participants described their overall experience positively, especially the available time to address their full range of concerns, but opportunities to integrate the service more fully and to extend follow-up remain

Theaster Gates : How to Build a House Museum

"Chicago-based artist Theaster Gates, whose projects range from small-scale sculptures to ambitious urban interventions, investigates the transformative powers of art in this provocative book. As the force behind the much-acclaimed Stony Island Arts Bank, Gates responds creatively to the challenges of space, whether working in museums or in communities. In this instance, he explores notions of blackness, freedom, and the history of house music. Featuring works by the artist himself as well as objects drawn from the Exhibit of American Negros at the 1900 Paris Exposition, the Ed Williams collection of negrobilia, and Frankie Knuckles's vinyl collections, How to Build a Museum proposes new ways of honouring and remembering Black experience, exploring the potential of symbolic structures and their associated objects. " -- Publisher's website

Money

The discussion of architecture, with all the visibility of its objects, tends to downplay the invisible flows of money that sustain its production. It is as if the dependency on economic forces is too much to face up to; better then to celebrate the catalytic genius of the architectural hero and then the glorious outputs, and try to ignore everything else that goes on in between. This issue intends to probe the in-between space of the operations of architecture, examining the intersection of the projects of architecture with economies, and with it their associated social and political contexts and implications. It is only through a better understanding of the way that contemporary economics cut across architectural operations that one can learn to deal with these dominant forces in a resistive and transformational manner