Search

'Jaws: The Sharkspoitation Edit' (The Man Behind The Mask, 2009) raises a variety of fascinating questions regarding the integrity of canonised film texts. In particular, it focuses attention upon the ways in which the contemporary ransacking of film history might affect judgments regarding the intersection of ‘official’ and ‘alternative’ film histories. First appearing in the wake of 'Grindhouse' (Robert Rodriguez & Quentin Tarantino, 2007), the film is steeped in an attitude which privileges not only a retro-fitted nostalgia for the new Hollywood renaissance of the 1970s, but also a range of assumptions regarding exploitation film practice in both the past and present. The film is an unauthorised cut of 'Jaws' (Steven Spielberg, 1975), which serves as the basis for an irreverent, but respectful interpretation of a narrative familiar to audiences around the globe, removing iconic moments, adding footage from other films (including its official 1978 sequel), manipulating the soundtrack (including the insertion of several songs and alternative music sources in place of John Williams venerated score) and even re-inserting sequences discarded by Spielberg at the original editing stage. This results in a parallel version of the film which often alters its characterisations, tone, rhythm and structure, but which alerts the viewer to issues of authorship, control, artistry and quality which might apply to a discussion of mainstream and exploitation film practice alike. Of course, the film is also the symptom of the digital age, in which fan participation and interaction with particular texts has been enabled in ways unimaginable at the time of Jaws’ original production, and which now extends to the alterations and manipulations of particular narratives which suit a consensus that is led by aficionados rather than critics. The chapter considers the film as playful homage and critique alike, asking how such creative interventions can enhance and perhaps even illuminate the place of Jaws within broader discourses and debates regarding its varied cultural meanings.

Aim: Analyse the effects of professional flash glucose monitoring system (FreeStyle Libre Pro™) on glycaemic control in insulin-treated type 2 diabetes. Methods: Primary (n = 17) and secondary care centres (n = 5) randomised 148 type 2 diabetes patients into three groups: (A) self-monitoring of blood glucose (n = 52), (B) self-monitoring of blood glucose and two Libre Pro sensor wears (n = 46) or (C) self-monitoring of blood glucose and four sensor wears (n = 50). Primary endpoint was time in range (glucose 3.9–10 mmol/L) within group C comparing baseline with days 172–187. Predefined secondary endpoints included HbA1c, hypoglycaemia and quality of life measures analysed within and between groups (clinicaltrials.gov, NCT02434315). Results: In group C, time in range in the first 14 days (baseline) and days 172–187 was similar at 15.0 ± 5.0 and 14.1 ± 4.7 h/day (mean ± SD), respectively, (p = 0.1589). In contrast, HbA1c reduced from baseline to study end within group C by 4.9 ± 8.8 mmol/mol (0.44% ± 0.81%; p = 0.0003). HbA1c was also lower in group C compared with A at study end by 5.4 ± 1.79 mmol/mol (0.48% ± 0.16%; p = 0.0041, adjusted mean ± SE), without increased time in hypoglycaemia ( p = 0.1795). Treatment satisfaction scores improved in group C compared with A ( p = 0.0225) and no device-related serious adverse events were reported. Conclusions: Libre Pro can improve HbA1c and treatment satisfaction without increasing hypoglycaemic exposure in insulin-treated type 2 diabetes individuals managed in primary/secondary care centres.

Released in 1973 amidst the moral and political turmoil of US withdrawal from Vietnam, Forced Entry is a seemingly indefensible pornographic text. The tale of a psychologically disturbed Vietnam war veteran who embarks upon a rape and murder spree in New York, its opportunism, deliberate provocation and extreme hardcore sexual violence are all seemingly designed to titillate at the basest, most prurient level imaginable. Playing directly into the hands of feminist intellectuals and campaigners intent on proving pornography’s inherently harmful or dangerous effects, the film’s surfaces would appear to offer scant material for the critic intent on articulating its varied levels of historical or cultural interest. This article address not only the film’s textual, structural and narrative modes, but also its relationship to the sexploitation ‘roughie’ cycle of the 1960s, its incongruity amidst the so called ‘porno chic’ phenomenon of the early 1970s, its status in relationship to other examples of both feature-length and ‘loop’ violent pornography in the period and its early evocation of the psychotic, sexually dysfunctional Vietnam veteran, a cinematic icon that would establish a niche in both mainstream and exploitation cinema as the decade progressed. Directed by Shaun Costello, and featuring a lead performance by Harry Reems, the film also serves as an early feature length showcase for hardcore industry veterans who would each contribute significantly to the notoriety of the burgeoning adult film industry. Academic appraisals of feature film pornography have tended to favour examples which might be re-claimed as radical incursions or counter-textual responses to the prevailing conventions or ideological project of films which are produced for male audiences beyond mainstream dictates of taste and propriety. The article addresses the critical possibilities of one of those texts which is perhaps 'irredeemable' from any political or ethical position, considering how such works are often the purest expression of an untrammelled and wilfully obnoxious counter-sensibility, assuring their canonical importance regardless (or, perhaps, because) of their ideological provocations.

There can be a tendency in art-science projects for science discourses to instrumentalise arts practices, and for arts discourses to instrumentalise science practices, rather than for each to rigorously challenge and inform the other. The Chancellor’s Fund Green-Blue-Grey Campus/Rain Garden project was an attempt to get beyond this limiting instrumentalisation, and to explore new ways of working across the art-science interface in which dialogue can be generated and knowledge produced across diverse discourses, practices, communities and identities. It used innovative art, science and participatory research methodologies to explore, devise and test strategies for successfully integrating green-blue infrastructure in an urban design context, with specific reference to the sustainable design feature of the rain garden in the ongoing University of Glasgow campus redevelopment. This report introduces the Green-Blue-Grey Campus/Rain Garden project, summarises the aims and methods used, and the principle findings generated, before contextualising the work in the broader fields. It then takes a closer look at the art-science methods used, and shares some of the strategies developed. Finally the report outlines some key practical recommendations for the implementation of the rain garden, which emerged from the deployment of these innovative strategies and methods.

Historical background of deaneries as NHS organizations. Organisations involved in postgraduate medical education and training. Training in the new NHS. Teaching the teachers in primary care. Teaching the teachers in secondary care. Induction. Career counseling. Recruitment to training posts. Human rights and equal opportunities in training. E-learning. Higher professional education for new GPs. Attracting doctors into the NHS. Return to medicine. Educational schemes to retain qualified GPs. Managing the trainee doctor in difficulty. Deanery performance work in primary care. Assessment. Mentoring. Life long learning. General practitioners with specialist interest. Medical ethics. The future.

The Japanese House: Architecture and Life after 1945 Barbican Art Gallery, London 23 March–25 June 2017 When reviewing, in these pages, the 2015 exhibition The World of Charles and Ray Eames at the Barbican Art Gallery in London, I observed how the building's heavy, windowless gallery had been imbued with some of the sunlight of Southern California.1 In the recent exhibition The Japanese House: Architecture and Life after 1945 , curated by Florence Ostende and designed by Lucy Styles, the re-creation by Ryue Nishizawa (the N in SANAA) of his Moriyama House in Tokyo (2005) made the defamiliarization of the gallery almost complete. Architecture and life started afresh in Japan after 1945 and the horrors of Hiroshima and Nagasaki. In architecture, this was demonstrated by the rejection of both teikan yōshiki , the Imperial Crown style that recalled the great disaster of the war, and Western modernism, which was the architecture of the conqueror. In their place, Kenzō Tange promoted the zakuri style of the imperial villa at Katsura, while Seiichi Shirai turned to the minka , the vernacular farmhouse architecture that stretched back to the ancient Jōmon period. Both themes reoccurred in photographs, drawings, and the occasional installation throughout the exhibition. More difficult to identify was “life,” a concept characterized at the beginning of the exhibition by the films of Yasujirō Ozu and Mikio Naruse, which …

The Children and Families Act 2014, Section 96, defines a young carer as ‘… a person under 18 (5–17) who provides or intends to provide care for another person. A person is not a young carer if the person provides or intends to provide care under or by virtue of a contract, or as voluntary work.’ 1 With the Care Act 2014, it extended the rights to a needs assessment to all young carers under the age of 18 regardless of who they care for, what type of care they provide, or how often they provide it.2 A survey in 2018 asking 925 children in England to outline if they provide care, and to describe the care provided and to whom, reveals the extent of caring by children is much higher than previous estimates.3 If results of the research reflect the country as a whole, then there are over 800 000 secondary school children (aged 11–16 years) in England caring for an individual at home, and that approximately 7% of young people have a significant caring role in the home for an ill or disabled relative. Of the 200 identified as young carers, 177 responded fully about the care they give. The scores from 56 (32%) of children showed them to being carrying out a high level of caring, with 16 (9%) of children doing a very high level of caring. The results show that most frequently responders cared for their mother (46%, n = 91) and siblings (40%, n = 46). Physical illness was most frequently cited as their reason for caring (35%, n = 70), followed by …

This essay, based upon material held in the Pierre Koenig papers in the Getty Research Institute’s Special Collections, describes the restoration of Case Study House 21 (the Bailey House) by the original architect from 1997 to 1999, forty years after it was built. Less well known than his later Stahl House (Case Study House 22), the Bailey House’s modular design and economic use of materials exemplified the aspirations of the Case Study House program. In the remaking of the building, Koenig demonstrated an extraordinary level of care for his favorite house. Supported by clients who allowed him to have his own way with his own building, this essay describes how Koenig returned the house to a level of perfection that not only attained new rewards and recognition but also allowed it eventually to be commoditized as a collector’s item.

There is an increasing focus on trauma within forensic services. This study aimed to investigate exposure to trauma among a high secure male forensic population. Based on the Childhood Trauma Questionnaire (CTQ) and the Trauma History Questionnaire (THQ) data capture sheets were developed. Patients' own offending behaviour was included as a source of potential trauma. Records for all patients placed within the hospital (n = 194) were reviewed. All patients had been exposed to a traumatic event over the lifespan, with 75% having been exposed to trauma during childhood. Sixty-five percent of patients had experienced more than one type of trauma during childhood; the mean number of trauma types experienced during this period being 2.31. In adulthood 63% had been exposed to one trauma type while 29% had been exposed to two or more trauma types. No significant difference was found between those with and those without childhood trauma histories on hospital variables including admission length, seclusion and incidents. The implications of these results in the context of adopting a trauma informed care approach to treatment in forensic settings are discussed, and recommendations for future clinical and research directions are made.

Psychiatric conditions are common among patients with advanced illness who are referred to palliative care services. Psychiatric illness can cause considerable distress to both patients and their families. In order to improve end-of-life care for patients, it is necessary to diagnose psychiatric conditions and treat them appropriately. This brief review considers cognitive impairment, delirium, dementia, depression, anxiety and suicidal ideation, outlining the prevalence, aetiology, diagnosis and management of these conditions.

Digital Light Processing hyperspectral imaging (HsI) produces a highly sensitive, real-time tissue oxygenation map to monitor renal perfusion/oxygenation during partial nephrectomy (PN). Our initial experience with HsI revealed considerable variation in the baseline renal oxygenation, and we sought to correlate these differences with postoperative renal function.Hyperspectral images were collected intraoperatively in patients undergoing PN for cortical tumors. The kidney was illuminated with visible light (520-645 nm), the spectrum corresponding to that of oxyhemoglobin. Reflectance images were captured and digitally processed to determine the percentage of oxyhemoglobin (HbO2) at each image pixel. Images were taken before hilar occlusion; these %HbO2 values were used to categorize patients as high (75% HbO2) or low (75% HbO2) oxygenation, and postoperative eGFR was assessed.There were 26 patients who underwent PN with ice cooling and HsI imaging. Nineteen patients had a "low" preclamp oxygenation (mean 69%) while the other 7 had a "high" HbO2 (mean 77%). There was no difference in tumor size, hematocrit value, clamp time, or preoperative eGFR between the two groups. Patients with a higher baseline %HbO2 had no significant postoperative change in their eGFR (mean 0 mL/min/1.73 m(2), +4%), while those with the lower baseline %HbO2 had a significant acute decline (mean 15 mL/min/1.73 m(2), -20%, P=0.02, 0.006).Baseline renal oxygenation, as measured with HsI, may help predict risk of postoperative renal insufficiency and may distinguish between patients with otherwise similar baseline characteristics, such as eGFR. HsI may provide individualized assessment of renal function to influence intraoperative decision-making to help preserve renal function.

During partial nephrectomy (PN), artery-only (AO) occlusion may mitigate ischemia/reperfusion injury because of retrograde venous flow. Using digital light processing-hyperspectral imaging (DLP(®)-HSI), we compared renal oxygenation during AO vs artery and vein (AV) occlusion in patients undergoing PN.Thirty-seven patients who were undergoing complex open PN (median R.E.N.A.L. nephrometry of 8) at our institution underwent renal oxygenation assessment using DLP-HSI. Percent renal parenchymal oxyhemoglobin (%HbO2) during AO vs AV occlusion was recorded and its correlation with postoperative estimated glomerular filtration rate (eGFR) was investigated using Pearson correlation. AO and AV occlusion was performed in 12 and 25 patients, respectively.Comparing AO vs AV, mean ischemia time was 41 vs 35 minutes (P=0.02). The %HbO2 at baseline was 73.6% vs 71% (P=0.23). After hilar occlusion, %HbO2 quickly reached an "ischemic plateau" in both groups, with mean ischemic %HbO2 measures of 59.7% vs 62.2% (P=0.19). In the AV group, a lower mean ischemic %HbO2 was associated with lower eGFR at the most recent follow-up (r=0.46, P=0.02) and remained significant on multivariable analysis (odds ratio 2.31; 95% confidence interval 0.29-4.32; P=0.03).In this pilot clinical study, renal oxygenation profiles during PN as assessed by DLP-HSI were similar for AO vs AV occlusion. Significant retrograde venous oxygen delivery using an AO occlusion technique could not be demonstrated. There was also no renal functional advantage for AO occlusion in this population of difficult PN where prolonged ischemia times may have mitigated any advantage. Further study in cases with shorter ischemia times is warranted.

The World of Charles and Ray Eames Barbican Art Gallery, Barbican Centre, London 21 October 2015–14 February 2016 The Barbican Centre, in the City of London, is an extensive postwar development of 1955–82 by Chamberlin, Powell and Bon comprising high-rise residential towers, low-rise apartments, a major theater, cinemas, and an art gallery, all robustly executed in exposed-aggregate concrete and purple-brown brick and tile. It is very good of its kind, but it is the antithesis of anything one might associate with the delicate, colorful world of Charles and Ray Eames. In the same space where the Barbican Art Gallery's curator Catherine Ince presented the exhibition Bauhaus: Art as Life in 2012, she attempted, for The World of Charles and Ray Eames , to imbue the heavy, windowless gallery with some of the sunlight of Southern California, and she largely succeeded. Much of the concrete structure that penetrates the gallery was hidden behind white or dark-gray wall panels on which exhibits and labels were sparingly displayed and from which a framework of cold-formed galvanized steel studs emerged to provide a sense of lightweight if temporary construction (Figure 1). In the absence of any attempt to re-create all or part of the Eameses’ house in Pacific Palisades, California—as was done in the Case Study Houses …

DLP® hyperspectral imaging is a technology that can be used to construct a highly sensitive, noninvasive, real-time tissue hemoglobin saturation map. This almost video rate technology may be a tool to monitor renal perfusion/oxygenation during hilar occlusion and kidney recovery. We describe our initial experience using hyperspectral imaging to assess renal hemoglobin saturation parameters during open partial nephrectomy for renal cortical tumors in humans.Hyperspectral images were collected intraoperatively during open partial nephrectomy. The kidney was actively illuminated using a hyperspectral imaging camera with visible light consisting of a chemometrically predetermined spectrum (520 to 645 nm) for hemoglobin. Spectroscopic reflectance images were captured by a focal plane array, which were digitally processed to visualize the percent of oxyhemoglobin at each image pixel.Hyperspectral imaging was done in 21 patients with a mean age of 56 years who were undergoing partial nephrectomy. Mean clamp time was 37.0 minutes. Median baseline percent of oxyhemoglobin in all patients was 74.6%. Hyperspectral imaging revealed a median 20.0% decrease from normalized pre-occlusion baseline at a median 10.3 minutes of hilar occlusion, where it plateaued for the duration of kidney ischemia. Upon reperfusion the percent of oxyhemoglobin returned to baseline at a median of 5.8 minutes.Hyperspectral imaging is a real-time noninvasive method to assess renal oxyhemoglobin saturation intraoperatively throughout the kidney. A nadir percent of oxyhemoglobin is attained within 10 minutes of hilar occlusion. This knowledge may allow future surgical or pharmacological interventions that titrate or minimize ischemic injury in real time.

All participants in the Introduction to Clinical Leadership and Management programme were required to carry out a work-based project (WBP). The following is a list of abstracts from the WBPs which have not already been presented in this special issue. The authors’ e-mail addresses are included so that readers can contact them for a copy of the full WBP if they wish.

My earlier article inArchitectural History43, ‘Christ Church, Streatham, and the Rise of Constructional Polychromy’, showed that James Wild’s church of 1840–42 was, in its use of coloured masonry, far ahead of its time (Fig. 1). It preceded, by about a decade, the High Victorian fashion for constructional polychromy usually associated with John Ruskin’s pronouncements on colour, contained inThe Stones of Venice(1851 and 1853) and William Butterfield’s contemporaneous church of All Saints, Margaret Street (1849–59). The article argued that the interest in polychromy had, in fact, started much earlier in the century. The use of colour in ancient Greek architecture had been investigated and debated by the Institute of British Architects, under the guidance of Thomas Leverton Donaldson, in the 1830s while, in the 1840s, Augustus Welby Northmore Pugin gave constructional polychromy a moral quality — an expression of honesty in construction — at the Grange and St Augustine’s Church, at Ramsgate (1845–50).