The moral economy of comfortable living: Negotiating individualism and collectivism through housing in Belgrade

The moral economy of comfortable living: Negotiating individualism and collectivism through housing in Belgrade Charlotte E Johnson First Published February 28, 2018 Research Article Download PDFPDF download for The moral economy of comfortable living: Negotiating individualism and collectivism through housing in Belgrade Article information No Access Please click here for full access options Abstract Comfort in the home depends on material and social connections. From pipes and wires to legal and financial contracts, these connections shape expectations of what comfortable living is and how it can be achieved. These connections create a moral economy that is based on the materiality of housing, and that is revealed as individual households pursue comfortable conditions in reference to external criteria and constraints. This paper explores the moral economy of comfort through an ethnography of one apartment block in Belgrade. The building, built in the 1970s, is an archetype of the modern, consumer lifestyle that Yugoslav market socialism promised to deliver to its citizens. Today the memories of a socialist moral economy are still present in the fabric of the building and the values of the residents who struggle to maintain their homes as individual spaces of comfort within a capitalist economy. This case shows the changing legitimacy of the pursuit of comfort and the ongoing tension to manage individual and collective gain

Role of healthcare workers in early epidemic spread of Ebola: policy implications of prophylactic compared to reactive vaccination policy in outbreak prevention and control

Ebola causes severe illness in humans and has epidemic potential. How to deploy vaccines most effectively is a central policy question since different strategies have implications for ideal vaccine profile. More than one vaccine may be needed. A vaccine optimised for prophylactic vaccination in high-risk areas but when the virus is not actively circulating should be safe, well tolerated, and provide long-lasting protection; a two- or three-dose strategy would be realistic. Conversely, a reactive vaccine deployed in an outbreak context for ring-vaccination strategies should have rapid onset of protection with one dose, but longevity of protection is less important. In initial cases, before an outbreak is recognised, healthcare workers (HCWs) are at particular risk of acquiring and transmitting infection, thus potentially augmenting early epidemics. We hypothesise that many early outbreak cases could be averted, or epidemics aborted, by prophylactic vaccination of HCWs. This paper explores the potential impact of prophylactic versus reactive vaccination strategies of HCWs in preventing early epidemic transmissions. To do this, we use the limited data available from Ebola epidemics (current and historic) to reconstruct transmission trees and illustrate the theoretical impact of these vaccination strategies. Our data suggest a substantial potential benefit of prophylactic versus reactive vaccination of HCWs in preventing early transmissions. We estimate that prophylactic vaccination with a coverage >99% and theoretical 100% efficacy could avert nearly two-thirds of cases studied; 75% coverage would still confer clear benefit (40% cases averted), but reactive vaccination would be of less value in the early epidemic. A prophylactic vaccination campaign for front-line HCWs is not a trivial undertaking; whether to prioritise long-lasting vaccines and provide prophylaxis to HCWs is a live policy question. Prophylactic vaccination is likely to have a greater impact on the mitigation of future epidemics than reactive strategies and, in some cases, might prevent them. However, in a confirmed outbreak, reactive vaccination would be an essential humanitarian priority. The value of HCW Ebola vaccination is often only seen in terms of personal protection of the HCW workforce. A prophylactic vaccination strategy is likely to bring substantial additional benefit by preventing early transmission and might abort some epidemics. This has implications both for policy and for the optimum product profile for vaccines currently in development

Mathematical Modelling of Chemical Diffusion through Skin using Grid-based PSEs

A Problem Solving Environment (PSE) with connections to remote distributed Grid processes is developed. The Grid simulation is itself a parallel process and allows steering of individual or multiple runs of the core computation of chemical diffusion through the stratum corneum, the outer layer of the skin. The effectiveness of this Grid-based approach in improving the quality of the simulation is assessed

Features of programmed cell death in intact Xenopus oocytes and early embryos revealed by near-infrared fluorescence and real-time monitoring.

Factors influencing apoptosis of vertebrate eggs and early embryos have been studied in cell-free systems and in intact embryos by analyzing individual apoptotic regulators or caspase activation in static samples. A novel method for monitoring caspase activity in living Xenopus oocytes and early embryos is described here. The approach, using microinjection of a near-infrared caspase substrate that emits fluorescence only after its proteolytic cleavage by active effector caspases, has enabled the elucidation of otherwise cryptic aspects of apoptotic regulation. In particular, we show that brief caspase activity (10 min) is sufficient to cause apoptotic death in this system. We illustrate a cytochrome c dose threshold in the oocyte, which is lowered by Smac, a protein that binds thereby neutralizing the inhibitor of apoptosis proteins. We show that meiotic oocytes develop resistance to cytochrome c, and that the eventual death of oocytes arrested in meiosis is caspase-independent. Finally, data acquired through imaging caspase activity in the Xenopus embryo suggest that apoptosis in very early development is not cell-autonomous. These studies both validate this assay as a useful tool for apoptosis research and reveal subtleties in the cell death program during early development. Moreover, this method offers a potentially valuable screening modality for identifying novel apoptotic regulators

Personality stability from age 14 to age 77 years.

There is evidence for differential stability in personality trait differences, even over decades. The authors used data from a sample of the Scottish Mental Survey, 1947 to study personality stability from childhood to older age. The 6-Day Sample (N = 1,208) were rated on six personality characteristics by their teachers at around age 14. In 2012, the authors traced as many of these participants as possible and invited them to take part in a follow-up study. Those who agreed (N = 174) completed a questionnaire booklet at age 77 years, which included rating themselves and asking someone who knew them well to rate them on the same 6 characteristics on which they were rated in adolescence. Each set of 6 ratings was reduced to the same single underlying factor, denoted dependability, a trait comparable to conscientiousness. Participants' and others' older-age personality characteristic ratings were moderately correlated with each other, and with other measures of personality and wellbeing, but correlations suggested no significant stability of any of the 6 characteristics or their underlying factor, dependability, over the 63-year interval. However, a more complex model, controlling rater effects, indicated significant 63-year stability of 1 personality characteristic, Stability of Moods, and near-significant stability of another, Conscientiousness. Results suggest that lifelong differential stability of personality is generally quite low, but that some aspects of personality in older age may relate to personality in childhood. (PsycINFO Database Recor

District heating as heterotopia: Tracing the social contract through domestic energy infrastructure in Pimlico, London

The Pimlico District Heating Undertaking (PDHU) was London's first attempt at neighborhood heating. Built in the 1950s to supply landmark social housing project Churchill Gardens, the district heating system sent heat from nearby Battersea power station into the radiators of the housing estate. The network is a rare example in the United Kingdom, where, unlike other European states, district heating did not become widespread. Today the heating system supplies more than 3,000 homes in the London Borough of Westminster, having survived the closure of the power station and the privatization of the housing estate it supplies. Therefore, this article argues, the neighborhood can be understood as a heterotopia, a site of an alternative sociotechnical order. This concept is used to understand the layers of economic, political, and technological rationalities that have supported PDHU and to question how it has survived radical changes in housing and energy policy in the United Kingdom. This lens allows us to see the tension between the urban planning and engineering perspective, which celebrates this system as a future-oriented “experiment,” and the reality of managing and using the system on the estate. The article analyzes this technology-enabled standard of living as a social contract between state and citizen, suggesting this is a way to analyze contemporary questions of district energy

Age-related decline in antibiotic prescribing for uncomplicated respiratory tract infections in primary care in England following the introduction of a national financial incentive (the Quality Premium) for health commissioners to reduce use of antibiotics in the community: an interrupted time series analysis

Objectives: To assess the impact of the 2015/16 NHS England Quality Premium (which provided a financial incentive for Clinical Commissioning Groups to reduce antibiotic prescribing in primary care) on antibiotic prescribing by General Practitioners (GPs) for respiratory tract infections (RTIs). Method: Interrupted time series analysis using monthly patient-level consultation and prescribing data obtained from the Clinical Practice Research Datalink (CPRD), between April 2011 and March 2017. The study population comprised patients consulting a GP who were diagnosed with an RTI. We assessed the rate of antibiotic prescribing in patients (both aggregate and stratified by age) with a recorded diagnosis of uncomplicated RTI, before and after the implementation of the Quality Premium. Results: Prescribing rates decreased over the six year study period, with evident seasonality. Notably, there was a 3% drop in the rate of antibiotic prescribing (equating to 14.65 prescriptions per 1,000 RTI consultations) (p<0.05) in April 2015, coinciding with the introduction of the Quality Premium. This reduction was sustained, such that after two years there was a 3% decrease in prescribing relative to that expected had the pre-intervention trend continued. There was also a concurrent 2% relative reduction in the rate of broad-spectrum antibiotic prescribing. Antibiotic prescribing for RTIs diagnosed in children showed the greatest decline with a 6% relative change two years after the intervention. Of the RTI indications studied, the greatest reductions in antibiotic prescribing were seen for patients with sore throats. Conclusions: Community prescribing of antibiotics for RTIs significantly decreased following the introduction of the Quality Premium, with the greatest reduction seen in younger patients

Evaluating the Liverpool Care Pathway for care of the terminally ill in rural Australia

© 2015, Springer-Verlag Berlin Heidelberg. Purpose: This study evaluates a pilot implementation of the Liverpool Care Pathway (LCP), a clinical tool used to guide the care of dying patients in the last days of life, on the end-of-life care for dying patients in three regions in rural Australia. Methods: The LCP was implemented at 13 participating sites: nine hospitals (general wards), one community-based palliative care service, and three in-hospital palliative care units. To evaluate the implementation of the LCP, 415 eligible patient records were examined: 223 pre-implementation and 192 post-implementation (116 on the LCP and 76 receiving usual care). The primary analysis compared all patients pre-implementation of the LCP versus all patients post-implementation. Results: Increases were found post-implementation for communication with other health professionals and with patients or family (pre-69 %, post-87 %; p ≤ 0.000), use of palliative medications (pre-87 %, post-98 %; p ≤ 0.000) and frequency of symptom assessments (pre-66 %, post-82 %; p ≤ 0.000). Fewer blood and radiological investigations were conducted and venous access devices used in the post-implementation groups than in the pre-implementation period. Conclusions: This study suggests that when rigorously implemented, the LCP improves important components of end-of-life care for dying patients and their families

Securing recruitment and obtaining informed consent in minority ethnic groups in the UK

Background: Previous health research has often explicitly excluded individuals from minority ethnic backgrounds due to perceived cultural and communication difficulties, including studies where there might be language/literacy problems in obtaining informed consent. This study addressed these difficulties by developing audio-recorded methods of obtaining informed consent and recording data. This report outlines 1) our experiences with securing recruitment to a qualitative study investigating alternative methods of data collection, and 2) the development of a standardised process for obtaining informed consent from individuals from minority ethnic backgrounds whose main language does not have an agreed written form. Methods: Two researchers from South Asian backgrounds recruited adults with Type 2 diabetes whose main language was spoken and not written, to attend a series of focus groups. A screening tool was used at recruitment in order to assess literacy skills in potential participants. Informed consent was obtained using audio-recordings of the patient information and recording patients' verbal consent. Participants' perceptions of this method of obtaining consent were recorded. Results: Recruitment rates were improved by using telephone compared to face-to-face methods. The screening tool was found to be acceptable by all potential participants. Audio-recorded methods of obtaining informed consent were easy to implement and accepted by all participants. Attrition rates differed according to ethnic group. Snowballing techniques only partly improved participation rates. Conclusion: Audio-recorded methods of obtaining informed consent are an acceptable alternative to written consent in study populations where literacy skills are variable. Further exploration of issues relating to attrition is required, and a range of methods may be necessary in order to maximise response and participation

The effect of time constraint on anticipation, decision making, and option generation in complex and dynamic environments

Researchers interested in performance in complex and dynamic situations have focused on how individuals predict their opponent(s) potential courses of action (i.e., during assessment) and generate potential options about how to respond (i.e., during intervention). When generating predictive options, previous research supports the use of cognitive mechanisms that are consistent with long-term working memory (LTWM) theory (Ericsson and Kintsch in Phychol Rev 102(2):211–245, 1995; Ward et al. in J Cogn Eng Decis Mak 7:231–254, 2013). However, when generating options about how to respond, the extant research supports the use of the take-the-first (TTF) heuristic (Johnson and Raab in Organ Behav Hum Decis Process 91:215–229, 2003). While these models provide possible explanations about how options are generated in situ, often under time pressure, few researchers have tested the claims of these models experimentally by explicitly manipulating time pressure. The current research investigates the effect of time constraint on option-generation behavior during the assessment and intervention phases of decision making by employing a modified version of an established option-generation task in soccer. The results provide additional support for the use of LTWM mechanisms during assessment across both time conditions. During the intervention phase, option-generation behavior appeared consistent with TTF, but only in the non-time-constrained condition. Counter to our expectations, the implementation of time constraint resulted in a shift toward the use of LTWM-type mechanisms during the intervention phase. Modifications to the cognitive-process level descriptions of decision making during intervention are proposed, and implications for training during both phases of decision making are discussed