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Review of: Barang-Barang, Erika Tan Stanley Picker Gallery, Kingston University, London, 17 February–9 April 2022 [ABSTRACT FROM AUTHOR]

An editorial is presented on artist filmmaker Jasmina Cibic reflecting on the generative role of archive research in the filmmaking. Topics include archival transcripts of diplomatic speeches, cultural papers and letters, particularly relating to the governmental operations of the Balkans and former Yugoslavia; and filmmakers counter official histories and their archives, unravelling the reifications to provide a more discursive and dynamic reading of history.

Aims: Antimicrobial resistance is an evolving phenomenon with alarming public health consequences. Antibiotic cycling is a widely known antimicrobial stewardship initiative that encompasses periodical shifts in empirical treatment protocols with the aim of limiting selective pressures on bacterial populations. We present a review of the evidence regarding the actual impact of antimicrobial cycling on bacterial resistance control within hospitals. Methods: A systematic literature review was conducted using the PubMed/MedLine, Embase, CINAHL Plus and Global Health databases. Results: A systematic search process retrieved a sole randomised study, and so we broadened inclusion criteria to encompass quasi‐experimental designs. Fifteen studies formed our dataset including seven prospective trials and eight before‐and‐after studies. Nine studies evaluated cycling vs. a control group and produced conflicting results whilst three studies compared cycling with antibiotic mixing, with none of the strategies appearing superior. The rest evaluated resistance dynamics of each of the on‐cycle antibiotics with contradictory findings. Research protocols differed in parameters such as the cycle length, the choice of antibiotics, the opportunity to de‐escalate to narrow‐spectrum agents and the measurement of indicators of collateral damage. This limited our ability to evaluate the replicability of findings and the overall policy effects. Conclusion: Dearth of robust designs and standardised protocols limits our ability to reach safe conclusions. Nonetheless, in view of the available data we find no reason to believe that cycling should be expected to improve antibiotic resistance rates within hospitals. [ABSTRACT FROM AUTHOR]

Antimicrobial stewardship constitutes an essential element of any concerted effort to tackle bacterial resistance, a rising public health threat both in community as well as hospital settings. The term comprises variable strategies which aim to optimise prescribing practices through either antibiotic restrictions or prospective audits of prescriptions with subsequent feedback to clinicians. Although highly debated, the actual effects of the latter on the antimicrobial susceptibility patterns of hospital flora are uncertain. The present study aims to review and evaluate the literature concerning the impact of persuasive stewardship strategies on antimicrobial resistance within hospitals. A literature review covering the period to 1st April 2020 was conducted using the PubMed/Medline, Embase, Global Health and CINAHL Plus databases. Fifteen studies were retrieved, including twelve simple before-and-after, and three interrupted time-series studies. Audit frequency and compliance rates varied broadly. The rationale of treatment optimisation is not clear in most cases. Overall, surveillance of sentinel microorganisms through antibiograms indicates ambiguous results, with uncertainty as to whether the few successes are due to a causal effect, random incidence fluctuations, or confounding. The most informative approach targeted solely fluoroquinolones, reporting improvements in relevant Pseudomonas susceptibilities and MRSA, but without sufficient data on other effects of the strategy to assess its overall utility in clinical practice. Higher standard research is needed to address the actual effects of persuasive stewardship strategies on antimicrobial susceptibility patterns. At present, they seem inadequate to play a decisive role in bacterial resistance control within hospitals. [ABSTRACT FROM AUTHOR]

Abstract This paper reviews the healthcare issues facing nations which have a substantial caseload of chronic HIV cases. It considers the challenges of extending antiretroviral coverage to an expanding caseload as supplier price rises and international trade agreements come into force to reduce the availability of affordable antiretrovirals just as the economic downturn restricts donor funding. It goes on to review the importance in this context of supporting adherence to drug regimens in order to preserve access to affordable antiretrovirals for those already on treatment, and of removing key barriers such as patient fees and supply interruptions. The demands of those with chronic HIV for health services other than antiretroviral therapy are considered in the light of the fearful or discriminatory attitudes of non-specialist healthcare staff due to HIV-related stigma, which is linked with the weakness of infection control measures in many health facilities. The implications for prevention strategies including those involving criminalisation of HIV transmission or exposure are briefly summarised for the current context, in which the caseload of those whose chronic HIV infection must be controlled with antiretrovirals will continue to rise for the foreseeable future.

Abstract This paper considers the public health impacts of the income-generating activities of organised crime. These range from the traditional vice activities of running prostitution and supplying narcotics, to the newer growth areas of human trafficking in its various forms, from international supply of young people and children as sex workers through deceit, coercion or purchase from family, through to smuggling of migrants, forced labour and the theft of human tissues for transplant, and the sale of fake medications, foodstuffs and beverages, cigarettes and other counterfeit manufactures. It looks at the effect of globalisation on integrating supply chains from poorly-regulated and impoverished source regions through to their distant markets, often via disparate groups of organised criminals who have linked across their traditional territories for mutual benefit and enhanced profit, with both traditional and newly-created linkages between production, distribution and retail functions of cooperating criminal networks from different cultures. It discusses the interactions between criminals and the structures of the state which enable illegal and socially undesirable activities to proceed on a massive scale through corruption and subversion of regulatory mechanisms. It argues that conventional approaches to tackling organised crime often have deleterious consequences for public health, and calls for an evidence-based approach with a focus on outcomes rather than ideology.

The article offers information related to "The three ecologies". Topics discussed includes the three interconnected ecologies that are environment, social relations and human subjectivity, arguing that the ecological crisis that threatens our planet and ourselves is the direct result of the boundless expansion of global capitalism.

This companion paper suggests the potential benefits of applying Steven Lukes’ dimensions of power model to the study of corruption in health systems. Lukes’ model sets out three “faces of power” classified by their influence on political discourse, resulting in overt, covert and latent discussion of issues depending on the degree of their alignment with the agenda of dominant power interests. His concept that differential access to public discourse varies according to this alignment implies the potential for identifying more serious forms of corruption by the mismatch between their practical importance and the amount of open debate addressing them. These two variables are in practice inversely related, and do not, as might be expected, correlate, with more important topics receiving more public attention. Lukes’ model would predict and can explain such inversion of public priorities, which tells us that observed suppression of public debate might efficiently direct the interest of researchers and the efforts of those seeking to further the public good on to the key issues needing discussion and resolution. The commentary goes on to examine whether the most serious and dangerous forms of corruption might therefore also be the most invisible, and suggests that whistleblower reports should be considered a key data source for research into high-level corruption in health systems, including redirection of policy decisions away from those which are in the public interest. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including perspectives and research on historical and contemporary practices, dominant discourses in fine art and traditional film theory, and critical discourses of contemporary art.

An introduction is presented in which the editor discusses the various topics within the issue like the retrospective of radical filmmakers like Jean-Marie Straub, the film "Pierre Vallières, and the nature of political conviction.

Background: The human immunodeficiency virus (HIV) continues to be a major cause of maternal and infant mortality and morbidity in sub-Saharan Africa. Prevention of mother-to-child transmission of HIV (PMTCT) strategies have proven effective in decreasing the number of children infected in utero, intrapartum and during the breastfeeding period. This qualitative study explores knowledge and perceptions of HIV amongst pregnant women, healthcare workers' experiences of the national PMTCT services, and barriers to PMTCT, during a period of programme scale-up in urban Guinea-Bissau (2010-11). Methods: In-depth interviews were undertaken amongst 27 women and 19 key informants at local antenatal clinics and the national maternity ward in Bissau, Guinea-Bissau. Results: Amongst women who had been tested for HIV, awareness and knowledge of HIV and PMTCT remained low. Testing without informed consent was reported in some cases, in particular when the test was performed around the time of delivery. Possible drivers of inadequate counselling included lack of confidentiality, suboptimal healthcare worker training, lack of time, and perceived occupational risk. Demand-side barriers to PMTCT included lack of HIV and PMTCT knowledge, customary and cultural beliefs associated with HIV and ill-health, HIV stigma and discrimination, and fear of partnership dissolution. Conclusions: Socio-cultural and operational challenges, including HIV testing without informed consent, present significant barriers to the scale-up of PMTCT services in Bissau. Strengthening local capacity for effective counselling and testing in the antenatal setting is paramount. Further research into local customary beliefs relating to HIV is warranted. [ABSTRACT FROM AUTHOR]

Aim: Growth charts for cerebral palsy (CP) have been constructed using data for 24 920 Californian patients, covering ages 2 to 20 years, with separate charts for the five severity levels of the Gross Motor Function Classification System (GMFCS). Our aim was to test how the data for British children with CP fit these charts, compared with conventional local charts.Method: US CP growth reference was reanalysed using the lambda-mu-sigma (LMS) method to allow calculation of standard deviation z-scores. Growth data for 195 children with CP in Glasgow, UK, were retrieved and converted to z-scores using the CP reference as well as the combined World Health Organization and UK 1990 growth reference (UK-WHO).Results: Compared to the UK-WHO reference, measurements diverged progressively with increasing severity, with mean height for GMFCS level V being close to the second UK-WHO centile. Compared with the CP reference, mean height and weight z-scores were between the 50th and 75th centiles for all severity levels, while body mass index was just below the 50th centile.Interpretation: British children with severe CP seem relatively very small when their growth data are plotted on non-CP charts, but their data for weight and body mass index fit well to US CP charts and reasonably well for height. The LMS look-up tables will make it possible to calculate z-scores and produce charts in local formats. [ABSTRACT FROM AUTHOR]

The article offers information on filmmaker Stephen Dwoskin, and his role in development of experimental films in Great Britain. Topics discussed include his popularity due to founding the London Film-Makers' Co-op film-making workshop and writing the book "Film Is ...," his film "Ballet Black" which utilizes the conventions of interview, narration and archival photography, and film theory and criticism, repositioning in works of Dwoskin.

An interview with filmmaker of the film "Estate"Andrea Luka Zimmerman is presented. Topics mentioned in the iterview include the duel between the characters Clarissa and Pamela on the roof of the 'avant-garde' building, moral imperative of the film, and about filming and the actual funding and who funded the film's workshop.

This article examines the part played by four film and video artists as chroniclers as well as participants in the civic struggle against nuclear weapons, providing alternative documents of the women's camp at Greenham Common to those of the official media record. For, as the article will discuss, the model of protest at Greenham was uniquely indebted to, and characterised by, the models of non-violent resistance developed through post-war feminism. As part of this, a strategy of creative resistance had an important role to play: through song and poems, through banners, paintings and drawings; by amateur and professional artists. However, the film and video documents of Greenham Common by Tina Keane, Joanna Davis and Lis Rhodes, and Annabel Nicolson, on which this article will focus, are not concerned solely with advocacy for anti-nuclear and political protest, but rather, Greenham proved inspirational for them on an individual basis, enabling them to meaningfully explore how feminist principles might be folded into their experimental practices. [ABSTRACT FROM AUTHOR]

Background Ambulatory, community-based care for multi-drug resistant tuberculosis (MDR-TB) has been found to be effective in multiple settings with high cure rates. However, little is known about patient preferences around models of MDR-TB care. Médecins Sans Frontières (MSF) has delivered home-based MDR-TB treatment in the rural Kitgum and Lamwo districts of northern Uganda since 2009 in collaboration with the Ministry of Health and the National TB and Leprosy Programme. We conducted a qualitative study examining the experience of patients and key stakeholders of home-based MDR-TB treatment. Methods We used semi-structured interviews and focus-group discussions to examine patients' perceptions, views and experiences of home-based treatment and care for MDR-TB versus their perceptions of care in hospital. We identified how these perceptions interacted with those of their families and other stakeholders involved with TB. Participants were selected purposively following a stakeholder analysis. Sample size was determined by data saturation being reached within each identified homogenous category of respondents: health-care receiving, health-care providing and key informant. Iterative data collection and analysis enabled adaptation of topic guides and testing of emerging themes. The grounded theory method of analysis was applied, with data, codes and categories being continually compared and refined. Results Several key themes emerged: the perceived preference and acceptability of home-based treatment and care as a model of MDR-TB treatment by patients, family, community members and health-care workers; the fear of transmission of other infections within hospital settings; and the identification of MDR-TB developing through poor adherence to and inadequate treatment regimens for DS-TB. Conclusions Home-based treatment and care was acceptable to patients, families, communities and healthcare workers and was seen as preferable to hospital-based care by most respondents. Homebased care was perceived as safe, conducive to recovery, facilitating psychosocial support and allowing more free time and earning potential for patients and caretakers. These findings could contribute to development of an adaptation of treatment approach strategy at national level. [ABSTRACT FROM AUTHOR]

Background: While the prevalence of multidrug-resistant (MDR) tuberculosis (TB) is high among children in the Western Cape of South Africa, the psychosocial implications of treatment for children with MDR-TB remain poorly understood. We sought to explore how MDR-TB and its treatment impact children on an individual, familial, and social level. Methods: Semi-structured interviews were conducted with 20 children and caregivers purposively sampled from a prospective clinical cohort of children. The sample was stratified by age at the start of treatment (children >10 years, and 5-10 years). Caregiver proxy interviews were conducted with younger children, supplemented with child interviews; older children were interviewed directly, supplemented with caregiver proxy interviews. Data were analysed using grounded theory. Results: Findings revealed pill volume and adverse effects produced significant physical, psychological and academic disturbances in children. Adverse effects related to the medication were important obstacles to treatment adherence. While there appear to be no long-lasting effects in younger children, a few older children showed evidence of persisting internalised stigma. Caregivers suffered important treatment-related financial and psychological costs. Community support, notably through the continued involvement of children in strong social networks, promoted resilience among children and their families. Conclusions: We found that the current treatment regimen for childhood MDR-TB has significant psychological, academic, and financial impacts on children and their families. There is a need for psychosocial support of children and caregivers to mitigate the negative effects of community stigma, and to manage the stressors associated with chronic illness. [ABSTRACT FROM AUTHOR]

The article examines experimental filmmaker Maya Deren's poetic onscreen transformations. According to the author, in a 1946 article "Magic is New," Deren did not hesitate to use the term "magic" pertaining to her practice and proclaimed that what excited her about film is its magic ability to transform even the most imaginative concept seem real.

Objectives: We reviewed the epidemiology of HIV and selected sexually transmitted infections (STIs) among female sex workers (FSWs) in WHO-defined Europe. There were three objectives: (1) to assess the prevalence of HIV and STIs (chlamydia, syphilis and gonorrhoea); (2) to describe structural and individual- level risk factors associated with prevalence and (3) to examine the relationship between structural-level factors and national estimates of HIV prevalence among FSWs. Design: A systematic search of published and unpublished literature measuring HIV/STIs and risk factors among FSWs, identified through electronic databases published since 2005. 'Best' estimates of HIV prevalence were calculated from the systematic review to provide national level estimates of HIV. Associations between HIV prevalence and selected structural-level indicators were assessed using linear regression models. Studies reviewed: Of the 1993 papers identified in the search, 73 peer-reviewed and grey literature documents were identified as meeting our criteria of which 63 papers provided unique estimates of HIV and STI prevalence and nine reported multivariate risk factors for HIV/STI among FSWs. Results: HIV in Europe remains low among FSWs who do not inject drugs (<1%), but STIs are high, particularly syphilis in the East and gonorrhoea. FSWs experience high levels of violence and structural risk factors associated with HIV, including lack of access to services and working on the street. Linear regression models showed HIV among FSWs to link with injecting drug use and imprisonment. Conclusions: Findings show that HIV prevention interventions should be nested inside strategies that address the social welfare of sex workers, highlighting in turn the need to target the social determinants of health and inequality, including regarding access to services, experience of violence and migration. Future epidemiological and intervention studies of HIV among vulnerable populations need to better systematically delineate how microenvironmental and macroenvironmental factors combine to increase or reduce HIV/STI risk. [ABSTRACT FROM AUTHOR]

Conscious of a paucity of evidence, and drawing upon a combination of historical documentary material, research literature and surveillance data, this paper offers a commentary on the social, historical and HIV contexts affecting men who have sex with men in Central Asia. The authors describe the history of men who have sex with men in the five Central Asian republics, before, during and after the Soviet-imposed legal prohibition, which continues in Turkmenistan and Uzbekistan, the only nations in the World Health Organization Europe region where sex between men remains illegal. This historical context frames contemporary responses to men who have sex with men. Despite long-established homoerotic traditions, modern attitudes to men who have sex with men are marked by great hostility, generating stigmatization of sex between men and discrimination against men suspected of it. The losses following public exposure can be severe: loss of employment; limited/lack of health-care access; and safety from physical and sexual assault. Such hostility creates an environment of increased HIV risk, and constrains the production of reliable HIV evidence. The authors argue that the generation of HIV risk, HIV-prevention responses and HIV evidence are products of their historical and social contexts, and call attention to the urgent need for HIV prevention and structural reforms to protect the health of men who have sex with men in Central Asia. [ABSTRACT FROM PUBLISHER]

July 2011 marked the 40th anniversary of social marketing. However, while the previous Labour administration dedicated sustained resources and support to developing the field of social marketing, this was followed by a time of uncertainty during the Coalition Government’s ascent to power. This paper explores the potential future position of social marketing within David Cameron’s evolving public health landscape, outlining areas of synergy between social marketing’s key features, and the coalition’s emergent public health architecture. The paper concludes with an exploration of the development opportunities nascent within social marketing, suggesting that support for the new commissioners (GP and local authority), and an enhanced emphasis on evaluation of financial and social outcomes, will be required if the evidence base for strong practice is to continue to grow and evolve. [ABSTRACT FROM AUTHOR]

This paper considers the public health impacts of the income-generating activities of organised crime. These range from the traditional vice activities of running prostitution and supplying narcotics, to the newer growth areas of human trafficking in its various forms, from international supply of young people and children as sex workers through deceit, coercion or purchase from family, through to smuggling of migrants, forced labour and the theft of human tissues for transplant, and the sale of fake medications, foodstuffs and beverages, cigarettes and other counterfeit manufactures. It looks at the effect of globalisation on integrating supply chains from poorly-regulated and impoverished source regions through to their distant markets, often via disparate groups of organised criminals who have linked across their traditional territories for mutual benefit and enhanced profit, with both traditional and newly-created linkages between production, distribution and retail functions of cooperating criminal networks from different cultures. It discusses the interactions between criminals and the structures of the state which enable illegal and socially undesirable activities to proceed on a massive scale through corruption and subversion of regulatory mechanisms. It argues that conventional approaches to tackling organised crime often have deleterious consequences for public health, and calls for an evidence-based approach with a focus on outcomes rather than ideology. [ABSTRACT FROM AUTHOR]

Individuals are increasingly being urged to 'do their bit' in the fight against climate change, with governments and pro-environmentalists insisting that the collective impact of small behaviour changes will result in a meaningful reduction in global carbon emissions. The following paper considers this debate, as well as offering personal contributions from two leading environmentalists: Dr Doug McKenzie-Mohr , environmental psychologist and author of Fostering Sustainable Behavior: Community-Based Social Marketing; and Dr Tom Crompton, change strategist for WWF and co-author of Meeting Environmental Challenges: The Role of Human Identity, who argues for the role of intrinsic value systems in achieving sustainable behaviour change. As well as considering the responsibility of the individual in mitigating climate change, the paper introduces the discipline of social marketing as an effective tool for facilitating individual behaviour change, drawing on evidence from the field to recommend the key characteristics of effective behaviour change programmes. [ABSTRACT FROM AUTHOR]

In April 2009, the National Social Marketing Centre launched its new case study resource, ShowCase: a collection of 40 best practice social marketing programmes, predominantly from the UK. The process of collecting and researching these case studies has provided a unique opportunity to look at the current state of 'evaluation' within the field of social marketing. This paper shares some of the observations made during the review, exploring common challenges faced when evaluating social marketing. It also provides recommendations for improving this process to guide future social marketing delivery. [ABSTRACT FROM AUTHOR]

Background: Acupuncture is in widespread use in China, a country where the prevalence of infection with hepatitis B (HBV) is high and that of other bloodborne viruses is growing. Policies to reduce iatrogenic transmission have so far focused on injections, overlooking the risks connected with acupuncture. Objective: To assess knowledge, attitudes, and practice relevant to the potential iatrogenic transmission of bloodborne viruses in Guizhou province, southwest China. Materials and methods: Semi-structured interviews and focus groups were conducted (in 2005) with 80 health care workers, patients, and other key informants in health facilities at provincial, county, and village levels. Results: In village clinics, reusable acupuncture needles were disinfected with alcohol rather than being sterilized, because of concerns that sterilization might blunt the needles. Sterilization of equipment by acupuncturists in the informal sector may be inadequate, but official monitoring of their practice appears not to be taking place. Acupuncturists working in hospitals are not included in formal training on bloodborne diseases and do not routinely receive HBV immunization. Some health workers lack clear understanding of asymptomatic infections. Conclusion: Policy on iatrogenic transmission of bloodborne viruses in China needs to place a greater emphasis on safe acupuncture, taking account of prevailing beliefs that may lead to hazardous practices, while enforcing safe procedures. [ABSTRACT FROM AUTHOR]

The article reports almost all of the British National Health Service (NHS) budget will be spent in a competitive market with competitive tendering by "qualified providers," following the passage of the Health and Social Care Bill. It is noted that to compile successful bids, legal, financial and operational expertise is required. It is mentioned that as part of the austerity programme, many charities have been forced to close after the withdrawal of government funding.

The article presents the authors' view on the impact of the Transatlantic Trade and Investment Partnership (TTIP) on the government agency the National Health Services (NHS). Topics discussed include the authors' assessment of the TTIP trade agreement and an account of the trade dispute between the governments of Austria and Slovakia which shows the important issues that are related to the TTIP trade agreement.

Background: Ambulatory, community-based care for multi-drug resistant tuberculosis (MDR-TB) has been found to be effective in multiple settings with high cure rates. However, little is known about patient preferences around models of MDR-TB care. Médecins Sans Frontières (MSF) has delivered home-based MDR-TB treatment in the rural Kitgum and Lamwo districts of northern Uganda since 2009 in collaboration with the Ministry of Health and the National TB and Leprosy Programme. We conducted a qualitative study examining the experience of patients and key stakeholders of home-based MDR-TB treatment.Methods: We used semi-structured interviews and focus-group discussions to examine patients' perceptions, views and experiences of home-based treatment and care for MDR-TB versus their perceptions of care in hospital. We identified how these perceptions interacted with those of their families and other stakeholders involved with TB. Participants were selected purposively following a stakeholder analysis. Sample size was determined by data saturation being reached within each identified homogenous category of respondents: health-care receiving, health-care providing and key informant. Iterative data collection and analysis enabled adaptation of topic guides and testing of emerging themes. The grounded theory method of analysis was applied, with data, codes and categories being continually compared and refined.Results: Several key themes emerged: the perceived preference and acceptability of home-based treatment and care as a model of MDR-TB treatment by patients, family, community members and health-care workers; the fear of transmission of other infections within hospital settings; and the identification of MDR-TB developing through poor adherence to and inadequate treatment regimens for DS-TB.Conclusions: Home-based treatment and care was acceptable to patients, families, communities and health-care workers and was seen as preferable to hospital-based care by most respondents. Home-based care was perceived as safe, conducive to recovery, facilitating psychosocial support and allowing more free time and earning potential for patients and caretakers. These findings could contribute to development of an adaptation of treatment approach strategy at national level. [ABSTRACT FROM AUTHOR]