Development of a continuing professional development website to raise awareness of preconception counselling and pre-pregnancy care for Women with Diabetes

Aims: Pre-pregnancy care reduces the risk of adverse pregnancy outcomes in women with diabetes, yet the majority of women receive suboptimal care due to poor preconception counselling rates and a lack of awareness about the importance of specialised pre-pregnancy care. The primary aim was to develop a continuing professional development (CPD) resource for healthcare professionals (HCPs) who work with women with diabetes to facilitate preconception counselling with this group.

Methods: The website was developed under the direction of a multidisciplinary team, adhering to NICE guidelines. The tone, key messages and format are informed by the “Women with Diabetes” preconception counselling website, www.womenwithdiabetes.net, an existing resource which is effective in helping women to be better prepared for pregnancy.Results: This e-learning resource will give HCPs the necessary knowledge and tools to prepare women with diabetes to plan for pregnancy. The website features women with diabetes sharing their views and experiences, alongside an evidence-based commentary and key messages from research papers and clinical guidelines. It comprises two modules: “Planning for Pregnancy”, focusing on contraception, risks and planning; and “Diabetes and Pregnancy”, focusing on support during pregnancy with an overview of each trimester of pregnancy.

Conclusion: This website will be a useful CPD resource for all HCPs working with women with diabetes, providing a certificate on completion. This resource will empower HCPs to engage in preconception counselling with women with diabetes by providing the HCP with a greater understanding of the specific needs of women with diabetes both preconception and during pregnancy.

Efficacy and safety of peri-prostatic local anaesthetic injection in tram-rectal biopsy of the prostrate:A prospective randomised study

Objective: To assess the efficacy and safety of periprostatic lignocaine injection in trans-rectal ultrasound (TRUS) -guided biopsy of the prostate gland.

Methods: Ninety- six men (mean age 65 years, range 47-74) undergoing TRUS biopsy were randomised into the local anaesthetic (LA) or placebo group. Six to twelve biopsy cores were taken, the majority being 10 cores. Patients were asked to fill in the expected pain score on a visual analogue scale (VAS) prior to the procedure. They also completed the actual pain experienced on VAS after the biopsy. The incidence of complications was documented.

Results: The age, mean prostate specific antigen (PSA) were comparable in both groups. The expected pain score was also comparable (5.2 +/- 1.6 in LA, 5.0 +/- 1.4 in Placebo). In the LA group, the mean actual pain score was 3.0 +/- 1.8 and in the placebo group it was 6.5 +/- 2.2 (P = 0.0001). When patients were asked whether they would undergo the procedure again in the same way, 100% of the LA group and only 64% of the placebo group responded 'yes'(P=0.002 using Fisher's test). The complication rates were not significantly different between the two groups.

Conclusion: Peri-prostatic injection of local anaesthetic is safe and reduces discomfort significantly, and should be routinely offered to patients.

Revival: The Aesthetics of Revival Subcultures and Re-enactment Groups Explored Through Fashion Image-making

This research aims, through performance, fashion photography, video making and the theatrical devices that accompany such practice, to explore the style of a contemporary, largely male, subcultural collective. The common term that joins these loosely bound groups is revival as they appear driven by an impulse to simulate and re-enact the dress, rites and rituals of British and American subcultures from a perceived golden era. The similarities with re-enactment societies are also explored and exploited to the end of developing new style- based aesthetics in male fashion image-making formed around an elaborate re- enactment of Spartacus and the Third Servile Wars. Examined through comparative visuals (revivalists / re-enactors) a common thread is found in the wearing of leather as a metaphor for resistance, style and a pupa-like second skin. Subsequent findings of this research suggest that the cuirass of popular culture emerges as the motorcycle jacket of both the sword and sandal epic and the historical re-enactor. Addressing extremes in narcissistic dress and behaviour amongst certain individuals within these older male communities, this study also questions parts of established theory on subcultural development within the field of cultural studies and postulates on a metaphorical dandy gene. Citing two leading practitioners in the field of fashion photography the work of both Richard Prince and Bruce Weber is viewed through the lens of the subcultural aesthete and conclusions drawn as to their role as agents provocateurs in the development of the fashion image with a revival based narrative. In addition the often used term retro is examined, categorised and granted its own genre within fashion image- making and defined as being separate from the practice element of this research. Reflecting a multi-disciplinary approach that engages the researcher as Bricoleur and participant observer this research operates in the reflexive realm and uses simulation as a key method of enquiry. The practice-led outcome of this investigation takes the form of a final research exhibition that takes the form of a substantial installation of photography, video, clothing and textile prints. Key terms: dandy gene, historical re-enactment groups, internal theatre, narcissism, narrative image-making, reflexive practice, revival as theatre, subcultures,

Piñatex, the design development of a new sustainable material

This is a research project by practice, which firstly develops a new material invention derived from natural fibres extracted from waste pineapple leaves; secondly it articulates the contemporary designer’s role in facilitating sustainable solutions through: Insights from my own material invention, PiñatexTM, which integrates the materiality of design with the immateriality of concepts and values Developing a visual model of mapping I began with these questions: ‘What are the challenges in seeking to make a new and sustainable material from the waste products of pineapple agriculture in the Philippines?’ and ‘How can a design practice link elements of materiality (artifacts) with immaterial elements (value systems) in order to improve sustainable social and economic development?’ Significant influences have been the work of Papanek1 (2003), Hawken2 (1999) and Abouleish3 (2008) and in particular the ethical business model initiated by McDonough and Braungart in Cradle to Cradle®4 (2002). My own research project is inspired by the Cradle to Cradle® model. It proposes the development of a new material, PiñatexTM which is derived from natural fibres extracted from waste pineapple leaves and could be used in a wide variety of products that are currently fabricated in leather or petroleum-based materials. The methods have comprised: Contextual reviews; case studies (SEKEM, Cradle to Cradle® and Gawad Kalinga); practical experiments in the field of natural fibres, chemistry, product development, manufacturing and prototyping, leading to an invention and a theoretical model of mapping. In addition, collaboration has taken place across scientific, technological, social, ecological, academic and business fields. The outcome is a new material based on the synchronicity between the pineapple fibres, polymers, resins and coatings specially formulated. The invention of the new material that I developed as a central part of this research by practice has a patent in the national phase (PCT/GB 2011/000802) and is in the first stages of manufacturing, commercial testing and further design input (Summer 2014). The contribution to knowledge is firstly the material, PiñatexTM, which exhibits certain key qualities, namely environmentally non-toxic, biodegradable, income-generating potential and marketability. This is alongside its intrinsic qualities as a textile product: aesthetic potential, durability and stability, which will make it suitable for the accessories, interiors and furnishing markets. The theoretical mapping system Upstream and Downstream forms a secondary contribution.

Digital Debris of Internet Art: An Allegorical and Entropic Resistance to the Epistemology of Search

This Ph.D., by thesis, proposes a speculative lens to read Internet Art via the concept of digital debris. In order to do so, the research explores the idea of digital debris in Internet Art from 1993 to 2011 in a series of nine case studies. Here, digital debris are understood as words typed in search engines and which then disappear; bits of obsolete codes which are lingering on the Internet, abandoned website, broken links or pieces of ephemeral information circulating on the Internet and which are used as a material by practitioners. In this context, the thesis asks what are digital debris? The thesis argues that the digital debris of Internet Art represent an allegorical and entropic resistance to the what Art Historian David Joselit calls the Epistemology of Search. The ambition of the research is to develop a language in-between the agency of the artist and the autonomy of the algorithm, as a way of introducing Internet Art to a pluridisciplinary audience, hence the presence of the comparative studies unfolding throughout the thesis, between Internet Art and pionners in the recycling of waste in art, the use of instructions as a medium and the programming of poetry. While many anthropological and ethnographical studies are concerned with the material object of the computer as debris once it becomes obsolete, very few studies have analysed waste as discarded data. The research shifts the focus from an industrial production of digital debris (such as pieces of hardware) to obsolete pieces of information in art practice. The research demonstrates that illustrations of such considerations can be found, for instance, in Cory Arcangel’s work Data Diaries (2001) where QuickTime files are stolen, disassembled, and then re-used in new displays. The thesis also looks at Jodi’s approach in Jodi.org (1993) and Asdfg (1998), where websites and hyperlinks are detourned, deconstructed, and presented in abstract collages that reveals the architecture of the Internet. The research starts in a typological manner and classifies the pieces of Internet Art according to the structure at play in the work. Indeed if some online works dealing with discarded documents offer a self-contained and closed system, others nurture the idea of openness and unpredictability. The thesis foregrounds the ideas generated through the artworks and interprets how those latter are visually constructed and displayed. Not only does the research questions the status of digital debris once they are incorporated into art practice but it also examine the method according to which they are retrieved, manipulated and displayed to submit that digital debris of Internet Art are the result of both semantic and automated processes, rendering them both an object of discourse and a technical reality. Finally, in order to frame the serendipity and process-based nature of the digital debris, the Ph.D. concludes that digital debris are entropic . In other words that they are items of language to-be, paradoxically locked in a constant state of realisation.

The Structure of Design Processes: ideal and reality in Bruce Archer’s 1968 doctoral thesis

The paper centres on a single document, the 1968 doctoral thesis of L Bruce Archer. It traces the author’s earlier publications and the sources that informed and inspired his thinking, as a way of understanding the trajectory of his ideas and the motivations for his work at the Royal College of Art from 1962. Analysis of the thesis suggests that Archer’s ambition for a rigorous ‘science of design’ inspired by algorithmic approaches was increasingly threatened with disruption by his experience of large, complex design projects. His attempts to deal with this problem are shown to involve a particular interpretation of cybernetics. The paper ends with Archer’s own retrospective view and a brief account of his dramatically changed opinions. Archer is located as both a theorist and someone intensely interested in the commercial world of industrial design.