Curation

<p>Today we see a simplification in our landscapes; a globalisation of culture and landscape that has forced people into a state of disconnection with place. It has divided our world into culturally rich, and culturally absent worlds. Worlds where natural ecologies are seen as separate entities to the human cultures that live on the land. Our landscapes need to reconnect and adapt; not only to the ever increasingly culturally diverse world, but also to the site specific social and natural ecologies that exist. Wainuiomata is no exemption to this condition. Its suburban landscape is divided from the natural ecologies that lay dormant on its peripheries. It is an austere environment, but one with a colourful and culturally diverse community that is unable to express itself. This piece of research argues that landscape architecture has the ability to enable disadvantaged communities to rekindle a sense of connection with, and custodianship over their landscapes. It discusses ways of designing that can reform lost relationships between communities and the common ground they live upon. The work brings forward how landscapes can be designed in ways that provide opportunities not only for communities to self build their landscape, but also how the architect can create frameworks that facilitate a process of engagement at different scales. It further explores how a respect for ecological environments can be instilled into the community through building relationships between ecological and social environments, as opposed to their current segregation. Lastly, the thesis looks at how a landscape architect may design in a way that pushes beyond the final drawings. Doing this with an understanding that it is a curation of a process (one where communities can become a part of the making of a landscape) that will bring a sense of custodianship to its dwellers.</p>

Curation

<p>Today we see a simplification in our landscapes; a globalisation of culture and landscape that has forced people into a state of disconnection with place. It has divided our world into culturally rich, and culturally absent worlds. Worlds where natural ecologies are seen as separate entities to the human cultures that live on the land. Our landscapes need to reconnect and adapt; not only to the ever increasingly culturally diverse world, but also to the site specific social and natural ecologies that exist. Wainuiomata is no exemption to this condition. Its suburban landscape is divided from the natural ecologies that lay dormant on its peripheries. It is an austere environment, but one with a colourful and culturally diverse community that is unable to express itself. This piece of research argues that landscape architecture has the ability to enable disadvantaged communities to rekindle a sense of connection with, and custodianship over their landscapes. It discusses ways of designing that can reform lost relationships between communities and the common ground they live upon. The work brings forward how landscapes can be designed in ways that provide opportunities not only for communities to self build their landscape, but also how the architect can create frameworks that facilitate a process of engagement at different scales. It further explores how a respect for ecological environments can be instilled into the community through building relationships between ecological and social environments, as opposed to their current segregation. Lastly, the thesis looks at how a landscape architect may design in a way that pushes beyond the final drawings. Doing this with an understanding that it is a curation of a process (one where communities can become a part of the making of a landscape) that will bring a sense of custodianship to its dwellers.</p>

A Case Report of External Cardiac Pads Used for Internal Cardiac Defibrillation During Resuscitative Thoracotomy

ABSTRACT This is a case report regarding the use of non-conventional methods to perform internal cardiac defibrillation on a trauma patient in an austere environment. The patient was a polytrauma causality of an improvised explosive device who arrived to a far forward resuscitative surgical team during a recent armed conflict. After arrival, the patient lost pulses. An emergency resuscitative thoracotomy was performed, and the patient was noted to have ventricular fibrillation on direct cardiac visualization. In the absence of standard surgical defibrillation paddles, the team applied external defibrillator stickers directly to the patient’s myocardium to deliver an electrical shock. The procedure successfully led to the return of spontaneous circulation. This report highlights a novel approach to resuscitation in resource-limited environments by a military surgical team.

Yesterday Meets Tomorrow in Sahelian Intellectual Currents

This chapter offers a review of Sahelian thought across the centuries from the griots and clerics of the past to contemporary intelligentsias. The review is paired with a reflection on how the Sahel shaped the work and consciousness of its thinkers—through its history as well as through more intangible but no less potent factors such as the aesthetics deriving from its austere environment. Given this focus, thinkers are not reviewed here just because they were born in the Sahel, but as participants in the particular intellectual consciousness attached to the region. Thus, some prominent Sahel-born thinkers—Senghor, Cheikh Anta Diop—are not included, but the discussion extends to film, Islam, and religious preaching in addition to the more conventional categories of novelists and theorists.

Teams managing civilian and military complex trauma: What are the competencies required in austere environments and the potential of simulation technology to address them?

Surgical training in civilian hospitals may not be sufficient for managing complex trauma in a setting where such care is not commonly practiced. Understanding the challenges that civilian teams face when moving to austere environments can inform the competencies that need to be trained. The aim of this study was to explore the competencies required in austere environments for teams managing complex trauma, and how they can be trained with simulation technologies. Ethnographic field observations were conducted, and field notes were synthesized. The field notes were structured with the elements of Activity Theory to generate the teams’ competencies that need to be trained. A literature review was conducted to verify the results and identify examples of relevant simulation modalities. The analysis resulted in a structured list of competencies for civilian teams to manage complex trauma in an austere environment and recommendations which simulation technologies could be used in training of those competencies based on published studies. Our study contributes to understanding the challenges that civilian teams face when operating in an austere environment. A systematized list of competencies with suggested simulation technologies directs future research to improve quality of complex trauma training in civilian and military collaboration.

EP.WE.802Are we over-zealous in our management of acute diverticulitis?

Aims Of the 25% of people with diverticula who develop symptomatic diverticular disease, approximately 75% will have at least one episode of diverticulitis. However according to the latest NICE guidance those with diverticulitis who are not systemically unwell may not require either admission or antibiotics. In the financially austere environment facing the NHS within the COVID 19 pandemic, prudence in such resource allocation is of vital importance. We aim to review management of patients with acute diverticulitis over a 6-month period in a district general hospital against the 2019 NICE guidelines. Methods 29 patients presenting with acute diverticulitis, M:F ratio 12:17, median age 55 (range 24-82), median ASA 2 (range 0-3) were retrospectively reviewed. Biochemical markers, lactate and vital signs were used to assess if attending patients were systemically unwell. Results 23 patients were admitted and 6 managed as outpatients via the surgical ambulatory unit. Of the 29 patient cohort, 9 (31%) were systemically unwell. All 9 unwell patients received antibiotics. Of the 20 patients not considered systemically unwell, 11 (55%) received antibiotics. 16 (80%) that were admitted did not require admission on retrospective review. Conclusion Prompt administration of intravenous antibiotics for septic patients with diverticulitis reduces associated morbidity and mortality and the observed adherence to this principle is encouraging. For systemically well patients, increased clinical discernment is required to consider managing patients in the surgical ambulatory setting, avoiding unnecessary admissions. Similar caution must be used in appropriate use of antimicrobials to avoid unnecessary adverse consequences.

Novel equipment used in the UK Role 2 medical treatment facility as part of Operation TRENTON in South Sudan

The deployment of a UK military Role 2 Medical Treatment Facility (MTF) to South Sudan during Operation TRENTON into an isolated location and austere environment with a prolonged hold produced potential medical planning challenges. The MTF was augmented with both specific personnel and equipment in order to meet these challenges. This paper discusses equipment available in this facility not previously used at Role 2 before and how it could be used to supplement medical operational deployments in future.

Case Report: Scarring Alopecia After Scalp Avulsion

ABSTRACT Scalp avulsion is a rare trauma in the developed world but is a common injury in countries with poorly established infrastructure and safety regulations. This case reports the long-term sequelae of this injury, observed while conducting a humanitarian mission, and discusses immediate actions for management in an acute setting. We aim to increase awareness about this injury, its risk factors, and treatment options to better prepare clinicians in the developed world to provide care for this condition in the austere environment, which may include not only chronic pain, functional, and aesthetic concerns, but also a psychological impact that persists years after the initial injury.