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A clear distinction between art and other exhibitions characterised the growth of large exhibitions in the nineteenth century. While art exhibitions were staged within a narrowly defined context of European painting and sculpture, all else was displayed within two broader contexts: specific academic disciplines (natural history, history, anthropology, design and industry, book fairs), and/or trade exhibitions. Since at least the mid-twentieth century, this distinction between art and other exhibitions has become blurred. References to the natural sciences, history, theatre, music, dance or literature have been incorporated into art exhibitions, while historical museums have exhibited art works, commissioned art interventions and utilised contemporary curatorial practices. The British museum, for example, hosts ‘permanent’ exhibits of contemporary art works in its collection, as do many other museums. The frequently asked question ‘what is art?’ invites the response: ‘art is…’. Since so far no definitive answer has proved to be possible, it is common to hear the question put in the context of a specific work asking: ‘but is this art?’. Philosophical discourse acknowledges the plurality of arts, at least since Plato. However, until the twentieth century the plurality of the arts was presented hierarchically with poetry at the top. Modernity saw a rethinking of this hierarchical order of the arts. For example, Adorno argues that ‘art’ is not a generic concept; if the arts were governed by a single concept they would be hierarchically placed under philosophy, establishing a hierarchical chain. The value of the plurality of the arts is precisely in its capacity to circumvent the above hierarchy. Jean-Luc Nancy further develops the thought and asks: ‘Why Are There Several Arts [not just one]?’, in his essay of the same title. At issue is how might we understand the relationships between the plurality of arts disciplines without imposing a hierarchy? The art critic Clement Greenberg argued in his radio essay ‘Modernist Painting’ (1961), that Modernism was ‘the intensification, almost the exacerbation’ of the self-critical tendency that he identified in the approach taken by the philosopher Immanuel Kant, in the discipline of philosophy. Greenberg contended that the essence of Modernism was in the capacity of each arts discipline to focus on what was specific to itself in order to escape the traditional hierarchy in which paintings were expected to ‘illustrate’ literary narratives in order to establish their value. Greenberg’s argument focused on the formal qualities of each art form; for him, painting’s essential characteristic was in its two-dimensionality. In modernity, he thus argued, artists insisted on the non-referentiality of art and focused on the medium itself. Hence, artists titled their works ‘composition’ or ‘untitled’ to emphasise that their art works should be interpreted on their own terms and not on their ability to illustrate ‘higher’ art forms. Shortly after the publication of Greenberg’s essay, his claim that each arts discipline sought to ‘purify’ itself through its formal means was challenged. However, his argument that in modernity art performs a self-critical role was taken up by many artists. This performative process does not take place through the ‘purification’ of each arts discipline but precisely through the ‘poetic translations’ across arts disciplines: some paintings in the 1960’s were translated into performance acts, dance and music performances were translated into visual art works (Fluxus), film and video were translated into visual art installations, visual artists presented performance works, artists translated curatorial practices to present art installations and curators translated both visual and performance work (including music, dance, theatre), as well as literature, film and video into art exhibitions. The curator Harald Szeemann sought to revive Richard Wagner’s approach to Gesamtkunstwerk (total work of art) which made use of most arts disciplines including design, as can be seen in his post-1969 exhibitions. Since literature (poetry) was historically the highest form of art, much of the twentieth century avant-garde art shunned references to literary narratives. However, recently some exhibitions have been using literary material to organise visual art exhibitions. For example, Tate St Ives’ Virginia Woolf: An Exhibition Inspired by her Writing (2018), exhibited works by women artists who addressed issues arising from Woolf’s writing. London’s Gagosian Gallery exhibited Crash: Homage to J. G. Ballard, bringing together art works that resonated strongly with Ballard’s harsh, dystopian literary visions. Most notably, Mieke Bal’s Emma & Edward: Love in the time of Loneliness, Oslo (2016-17), established ‘associative connections’ across time and arts disciplines (Literature and visual arts) between characters in Flaubert and the works of Munch and others. The rationale of the conference is to explore how the different arts translate across disciplines and to establish exchanges that will allow arts disciplines to engage with contemporary debates and concerns in a non-hierarchical way. In this context the term ‘translation’ is taken from Walter Benjamin through Jacques Derrida’s interpretation, which can be read as yet another translation in a long line of poetic translations. Translation, as Derrida points out, implies a hierarchy: the translation is generally perceived as secondary to the translated material. The translator is thus always indebted to the text/material which is translated, and to its author. And yet, the translator also transforms the translated material and makes it relevant for a different context. The act of translation involves a level of betrayal analogous to the betrayal of the ‘creative act’ it translates (each creative work betrays a tradition through the creative moment). Hence this conference’s use of the term ‘poetic translation’ with reference to the hierarchical tradition and the way it is being transformed through translations to create non-hierarchical structures of exchange. For the ‘creative act’, by definition, introduces an innovative moment. It is this ‘poetic’ innovation, Benjamin insists, in which ‘the unfathomable, the mysterious, the “poetic”, can be reproduced; but only if the translator is also a poet [artist]’. A wide range of contemporary debates and concerns can be addressed from the perspective of non-hierarchical relationships between a plurality of the arts and across cultures, for example: globalisation, migration, environmental concerns, issues of gender/ethnicity identity. Papers are invited to discuss and/or present exhibitions which are not limited to the European tradition and/or works made by marginalised communities often categorised as craft and those associated with ‘design’ rather than ‘the Arts’. Examples of craft might include textile, pottery and folk art, while design might include fashion, everyday objects, popular culture, even web design.

Articular cartilage is prone to degradation as a result of aging, disease and injury, which can lead to the onset of osteoarthritis (OA). The avascular nature of the tissue renders its endogenous repair capacity notoriously poor and its aneural nature means that disease progression is often quite advanced before symptoms present. OA places a huge burden on the NHS and UK economy and there is an urgent need for alternative therapies, which offer patients a one-off durable treatment and mitigate or significantly delay the need for joint replacement. Tissue engineering offers a possible solution, wherein replacement cartilage is developed in vitro from undifferentiated cells.\ud Human embryonic stem cells (hESC) are readily available, pluripotent and demonstrate huge expansion capacity in vitro; all of which makes them an appealing cell source for tissue engineered constructs. This work sought to enhance the maturity of hESC-derived chondroprogenitors with the application of a range of 2D and 3D culture techniques and regimes of mechanical stimulation.\ud hESC were subjected to a directed differentiation protocol (DDP), described previously (Oldershaw et al. 2010), with the addition of an immobilised Wnt base and an acellular fibrin hydrogel to enable migration into a 3D environment. Addition of the hydrogel to differentiating monolayer hESC, always resulted in improved chondrogenic gene expression and the application of a Wnt platform significantly increased the migration of cells into the gel.\ud Hydrostatic pressure was applied to fibrin-encapsulated progenitors and was found to increase chondrogenic matrix deposition and gene expression. In addition, the application of low level compressive forces to monolayer progenitors resulted in increased chondrogenic gene expression at low cell seeding densities.\ud Taken together, results suggest that both a 3D environment and the application of mechanical stimuli can significantly enhance the chondrogenic potential of hESC-derived chondroprogenitors. We believe that the work described here holds great potential for the development of a cell-based therapy for cartilage damage and degeneration.

Benjamin's famous argument that the work of art is distinguished by its 'aura' was written when Benjamin was fully aware of the difficulties it raised. These difficulties were not limited to technological developments which made multiple (near) identical works possible. Historically, this was addressed through the distinction between original and copy which were distinguished temporally, thus privileging the 'first' event as 'original'. In the context of a linear progressive narrative which charts canonical works, this seemed unproblematic. However, when dealing with multiple cultures and multiple geo-political spaces this distinction becomes more problematic. The term 'contemporary', means 'being with time' (heterogenous time) rather than in time (linear time) came into use. The 21st century can be characterised by a growing interest in exhibitions and curatorial practices and the recurrence of the re-staging of exhibitions. The paper will take the well known case study of the 1965 installation of the Rent Collection Courtyard and its repeated presentations in China culminating with its inclusion by Harold Szeemann in the dAPERTutto of the 48th Venice Biennale (1999). This case study can highlight the difficulties and potential solutions that can become visible when re-staging exhibitions/installations, especially when at issue are not just one geopolitical space, nor one culture, one ideology or historical narrative. At issue here is a translation which is always already a mistranslation and multiple narratives and histories which forms the need for the con-temporary, the being-with-time(s), rather than 'in-time' be it past, future and/or stable present.

Summary Background The economic burden on households affected by tuberculosis through costs to patients can be catastrophic. WHO's End TB Strategy recognises and aims to eliminate these potentially devastating economic effects. We assessed whether aggressive expansion of tuberculosis services might reduce catastrophic costs. Methods We estimated the reduction in tuberculosis-related catastrophic costs with an aggressive expansion of tuberculosis services in India and South Africa from 2016 to 2035, in line with the End TB Strategy. Using modelled incidence and mortality for tuberculosis and patient-incurred cost estimates, we investigated three intervention scenarios: improved treatment of drug-sensitive tuberculosis; improved treatment of multidrug-resistant tuberculosis; and expansion of access to tuberculosis care through intensified case finding (South Africa only). We defined tuberculosis-related catastrophic costs as the sum of direct medical, direct non-medical, and indirect costs to patients exceeding 20% of total annual household income. Intervention effects were quantified as changes in the number of households incurring catastrophic costs and were assessed by quintiles of household income. Findings In India and South Africa, improvements in treatment for drug-sensitive and multidrug-resistant tuberculosis could reduce the number of households incurring tuberculosis-related catastrophic costs by 6–19%. The benefits would be greatest for the poorest households. In South Africa, expanded access to care could decrease household tuberculosis-related catastrophic costs by 5–20%, but gains would be seen largely after 5–10 years. Interpretation Aggressive expansion of tuberculosis services in India and South Africa could lessen, although not eliminate, the catastrophic financial burden on affected households. Funding Bill & Melinda Gates Foundation.

On 13 June 2012 the Swiss collector Uli Sigg donated his collection of contemporary Chinese art to the new museum of visual art in Hong Kong: M+. In August 2012 Artprice published its report on contemporary art for July 2011 to June 2012 announcing that five out of the ten contemporary artists fetching highest prices at auction, were Chinese. On 29 November 2012 Xi Jinping delivered his first speech after taking office in which he set out his vision for China. This paper argues that in order to understand the Chinese art market and the political context in which it operates it helps to look at three events which took place in 2012 and their context. Art, the art market and politics are closely interconnected here. The case study of M+ and its foundational donation, the Sigg collection of “contemporary Chinese art”, helps to elucidate the relationships and the astonishing developments of the art market in China and Hong Kong during this time., Journal for Art Market Studies, Vol 3, No 1 (2019)

Heidegger opens his famous essay 'The Origin of the Work of Art' by dispelling the claim that the artist is the sole 'origin' of the work. Instead he argues that the 'origin' is relational between artist, art and concept. Since then the concept of 'relationality' was further developed by Bourriaud and others. Though Heidegger begins to develop an argument that could enlarge the relational group to include viewers/audience/participants, this aspect is still underdeveloped in his work. The role of museums, galleries and curators are also there, but not fully and explicitly developed. The recent restaging of the curator Harald Szeemann's exhibitions (Venice 2013, Los Angeles, Bern, Dusseldorf, Turin and New York 2018-9) and the need to reproduce works which did not survive in collaboration with artists, researchers, gallerists, collectors and artist's estates, further highlights the point.The paper will develop Heidegger's discussion from his wider works and in the context of specific art works and exhibitions to argue for a wider articulation of the relational aspect of 'the origin of the artwork'. In so doing, it will introduce the roles of the museum/gallery, the public, the curator(s), the collectors, the art market, public funders and private funders in order to develop a different conservation ethic appropriate to contemporary and 'global' art. It will move away from the ethic of conservation which focuses purely on the materiality of the object and the intentions of the artist as its 'origin', an approach which easily maps on to our existing legal system in terms of property laws be they material or intellectual.

Globally, Tuberculosis remains a devastating disease, despite the availability of treatment. The disease is associated with poverty, and those with the disease incur a high cost of accessing care, while simultaneously experiencing income loss due to a loss in productivity. A key challenge in TB programmes remains the accurate diagnosis of the disease, especially in people who are HIV positive. Diagnosing TB can be very resource intensive and the accuracy of diagnosis is dependent on a range of disease, health service organisation and provider behaviour factors. This thesis seeks to enhance understanding of how the behaviour of healthcare workers mediates the value of TB diagnostic algorithms, and how this may affect the costs, outcomes as well as the economic burden associated with the disease in South Africa. The work presented is based on empirical work done alongside a pragmatic cluster randomized control trial. Empirically, it examines the longitudinal economic burden of TB diagnosis and treatment in South Africa. The discrepancies between the time at which patients incur the greatest cost and income loss, and the available social protection are highlighted. Based on empirical work, a purpose-built state-transition mathematical model of TB diagnosis and treatment was developed to estimate the cost-effectiveness, from the perspective of the health service and the patient, of health systems interventions to strengthen TB diagnosis. Recognising healthcare workers as those who ultimately express policies, the behaviour of healthcare workers was included in the cost-effectiveness analysis by 1) using data from a pragmatic trial reflecting routine practice and clinical decision-making at the time of the study; 2) developing a conceptual framework of the relationship between behaviour at decision points and disease outcomes; and 3) investigating how these interactions may influence the value of the diagnostic algorithm. Possible public policy levers to improve TB diagnosis in healthcare facilities, as well as the potential mediators of costs and effects were explored. The thesis concludes with recommendations for further methodological work to expand on the approach explored in this thesis to improve how heterogeneity in estimates of cost-effectiveness is presented to decision-makers.

Out‐of‐pocket spending is increasingly recognized as an important barrier to accessing health care, particularly in low‐income and middle‐income countries (LMICs) where a large portion of health expenditure comes from out‐of‐pocket payments. Emerging universal healthcare policies prioritize reduction of poverty impact such as catastrophic and impoverishing healthcare expenditure. Poverty impact is therefore increasingly evaluated alongside and within economic evaluations to estimate the impact of specific health interventions on poverty. However, data collection for these metrics can be challenging in intervention‐based contexts in LMICs because of study design and practical limitations. Using a set of case studies, this letter identifies methodological challenges in collecting patient cost data in LMIC contexts. These components are presented in a framework to encourage researchers to consider the implications of differing approaches in data collection and to report their approach in a standardized and transparent way. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

The British museum houses a vast array of artefacts from the early 20th Century and earlier brought to Britain from what at the time were British colonies. These objects are displayed today in the main still as objects belonging to different geographical areas and as such many of the objects were the subject of a debate on 'repatriation'. The narrative behind such calls followed the claim that the objects were 'native' to a different culture and a different people and to the extent that they are held by the British Museum, colonialism continues, albeit in a different format. The narrative that leads to such an argument insists that place of origin equals the identity of the object and the culture from which it derives is authentic and essential. The paper will utilise some of Mignolo's arguments along side narratives which allow for the 'biography' of the object 'to speak' in order to argue that the objects can also be seen very differently. For example, the display of the Benin artefacts can tell a narrative of exchange, war and domination which is not the 'authentic' narrative of Benin, but that of exchanges between Portuguese traders Benin craftsworkers and British colonial power. Chinese porcelain can equally demonstrate trade and exchange which determined the design and production of what is presented as 'authentic' Chinese artefacts. This is even more obvious when such objects are presented in the context of other contemporary ceramics along the silk route. The paper will thus focus on objects and 'allow' such objects to tell the narrative of cultural exchange they hold. Whilst the current display is predominantly colonial, this display and curatorial practice could be overturned and in so doing decolonise the British Museum where the objects will tell the story of exchange in the context of power struggles of which colonisation was one.

Marine Protected Areas (MPAs) and networks of MPAs are being implemented globally as a spatial management tool for achieving conservation objectives. There has been considerable progress in reaching the prescribed 10% protected area target for 2020, outlined in the Convention on Biological Diversity Aichi Target 11 and the United Nations Sustainable Development Goal 14.The application of MPA network design principles (e.g. Representative, ecological connectivity), which underpin ecological coherence, is still lacking or insufficient in many regions. Poor ecological coherence hinders the ecological performance of MPA networks, leading to dysfunction in the flow of ecosystem services and reduced ecosystem benefits, with potentially negative consequences for human well‐being.This paper presents four pivotal focus points for future progress that can bridge the gap between ecological and social systems. The aim is to shift the discourse of ‘ecological coherence’ further into the social sphere, and hence support the alignment of the process of designating ecologically coherent MPA networks with the ‘triple bottom line’ of economic development, environmental sustainability, and social inclusion, as described in the Sustainable Development Goals (SDGs), to achieve social–ecological coherence in MPA network design.

The Sigg collection included over 2000 works by over 300 artists mostly from China. It was a collection of works which the Swiss businessman and short time diplomat Uli Sigg has amassed together with his wife Rita Sigg. Together Uli and Rita gathered works from artists they have encountered in China during their stay there between the early 1990's and the early 2010s. As Uli Sigg has repeatedly pointed out, the collection started as a private collection. However, once he amassed a critical volume of works he wanted the collection to be seen as a reflection of the history of China itself. To achieve this he attempted to persuade the Chinese authorities to accept his collection as reflecting the history of China from the Cultural Revolution to the 21st century. Despite many attempts the Chinese authorities refused to accept the collection into a public museum. However, on the 13th of June 2012 the collection was accepted by the new museum of Hong Kong – as yet to be completed – M+. The paper will engage with the collection's journey from a private collection to becoming a public collection, even a founding collection of a public museum. It will engage in the politics that led Beijing to reject it and Hong Kong to accept it. Moreover, it will also engage in how the collection actually has the potential of becoming not only canonical in the West but also in China. The paper will look at the detail of specific art works and how thy became well known outside China, and how they are likely to become equally well known and accepted, in China. It will examine the strategies and approaches used by Uli Sigg to turn the collection into an important canonical collection from it being simply a private collection.

Benjamin's famous argument that the work of art is distinguished by its 'aura' was written when Benjamin was fully aware of the difficulties it raised. These difficulties were not limited to technological developments which made multiple (near) identical works possible. Historically, this was addressed through the distinction between original and copy distinguished temporally, thus privileging the 'first' event as 'original'. In the context of a linear progressive narrative which charts canonical works, this seemed unproblematic. However, when dealing with multiple cultures and multiple geo-political spaces this distinction becomes more problematic. The term 'contemporary', means 'being with time' (heterogenous time) rather than in time (linear time) came into use. The 21st century can be characterised by a growing interest in exhibitions and curatorial practices and the recurrence of the re-staging of exhibitions. The paper will take the well known case study of the 1965 installation of the Rent Collection Courtyard and its repeated presentations in China culminating with its inclusion by Harold Szeemann in the dAPERTutto of the 48th Venice Biennale (1999). This case study can highlight the difficulties and potential solutions that can become visible when re-staging exhibitions/installations, especially when at issue are not just one geopolitical space, nor one culture, one ideology or historical narrative. At issue here is a translation which is always already a mistranslation and multiple narratives and histories which forms the need for the con-temporary, the being-with-time(s), rather than 'in-time' be it past, future and/or stable present.

By the end of the seventeenth century the hierarchical codification of the genres determined all visual representations of 'home' to be relegated to the genre of 'everyday life' and as such to be kept limited to themes of little public importance. The home became a 'private' space, it was typified as intimate and the viewer often made to feel as an intruder. During the 20th century the presentation of 'home' became the foci of visual discourse by the two competing ideologies: communism in the 'East' and liberalism in the 'West'. Whilst in the 'West' the home was perceived as 'private' in the 'East' it was perceived as 'public' and often conflated with the state. Both articulations proved problematic: in the 'East' there was no place to retire from the public realm whilst in the 'West' 'retirement' for men was at the expense of women's exclusion from the public space. The paper will sketch the problematics of both approaches to 'home' looking specifically at China during the Cultural Revolution' (1966-1976) and compared to the USA at the same time. It will proceed to argue that whilst the ideological debate has shifted, elements of the debate are still alive today globally. The 'home' has gained meaning not only as a private and domestic space but also as a 'geo-political' space and the two meanings have become entangled and no less problematic. Hence, the discourse shifted from 'private' on the one hand and 'public' on the other to a concept that brings both together in the context of feminist and migration discourse. It will conclude with the presentation of the 'practice-based' research undertaken by Fran Norton in her exhibition 'The Home I Carry With Me'.

The Venice Biennale was set up to showcase Italian art in the historical context of European communities developing their national identities. This process of nationalism was accompanied by colonialism. It was in this context that Venice decided to promote itself by showcasing Italian art alongside the art of other nations. National pavilions were thus offered to participating nations who wanted to take place and showcase their own art. These nations were given the right to own and manage their national pavilion, almost as they saw fit. However, not all countries were invited or wanted to participate in the first instance. Since then the number of participating countries has been growing steadily, but not all national requests have been granted. China joined in 2005 under the condition that Taiwan will no longer be given the right to hold a national exhibition. However, the collateral events have shown work by artists from China well before China's official pavilion. It was predominantly Europeans working in China who invited well known European curators who in turn invited artists from China to participate in collateral events. What the Venice Biennale has shown was the gap between the art promoted by European curators and that promoted by the official government. The paper will focus on the case study of China and will explore the relationship between participation in collateral events and the official pavilion. It will engage with the very different representations of China the official and unofficial, including the participation of artists from China in other nations' pavilion such as Ai Weiwe in the German. The paper will show the different narratives of art and its role in construction national and collective identities which emerged out of the official participation of China and that of artists participating in the collateral events.

In Europe the practice of writing was separated from the input of content it was meant to communicate, hence, the actual writing was often left to professionals. However, in China the practice of writing was not separated from the input of content and thus the practice of writing itself was considered on par with painting and poetry. The practice of all three was expected of scholars and was perceived as an expression of their character expected of the good scholar. Hence, whilst in Europe artists were not judged on their capacity to form letters nor were poets judged by this criteria, in China they were. By definition the artist and the poets were also expected to excel in calligraphy. However, women were not generally trained to write. With very few exceptions women were trained and allowed to participate in the practice of writing, painting and poetry. And yet, in a small remote rural area in Hunan province women developed a practice of phonetic writing called Nushu (literally, women's writing/book). It is unclear when this practice started since most related artefacts were either buried or burned with the owner. However, Nushu was not limited to writing, it was transmitted though song Nuge (women's song) whilst women were producing a wide range of related artefacts from visual works including embroidery to poetry and other narratives. This was not the practice of the elite urban but the rural peasant women. During the Cultural Revolution the practice was not tolerated and by the end of the 20th century few surviving women still remembered the practice.The paper looks at three 'translations' of the practice of Nusu and Nuge. Each in an attempt to construct new narratives. The work of the Hong Kong choreographer Helen Lai entitled HerStory seeks to reinterpret women's history in a global context by mixing Chinese practices and European and American practices of dance, music and visuality. The work of the Chinese, Hunan born, American based composer Tan Dun seeks to incorporate women's song (Nuge) from the province he comes from into a work which mixes Chinese and European music. The Hong Kong artist Yuenyi Lo uses the practice of Nushu in the context of global discourse in order to construct a narrative which takes Nushu as a practice of writing which will open up the door for women artists to develop and as such circumvent the difficulties of Chinese tradition in accepting women as artists.

BACKGROUND: In 2010 a new diagnostic test for tuberculosis, Xpert MTB/RIF, received a conditional programmatic recommendation from WHO. Several model-based economic evaluations predicted that Xpert would be cost-effective across sub-Saharan Africa. We investigated the cost-effectiveness of Xpert in the real world during national roll-out in South Africa. METHODS: For this real-world cost analysis and economic evaluation, we applied extensive primary cost and patient event data from the XTEND study, a pragmatic trial examining Xpert introduction for people investigated for tuberculosis in 40 primary health facilities (20 clusters) in South Africa enrolled between June 8, and Nov 16, 2012, to estimate the costs and cost per disability-adjusted life-year averted of introducing Xpert as the initial diagnostic test for tuberculosis, compared with sputum smear microscopy (the standard of care). FINDINGS: The mean total cost per study participant for tuberculosis investigation and treatment was US$312·58 (95% CI 252·46-372·70) in the Xpert group and $298·58 (246·35-350·82) in the microscopy group. The mean health service (provider) cost per study participant was $168·79 (149·16-188·42) for the Xpert group and $160·46 (143·24-177·68) for the microscopy group of the study. Considering uncertainty in both cost and effect using a wide range of willingness to pay thresholds, we found less than 3% probability that Xpert introduction improved the cost-effectiveness of tuberculosis diagnostics. INTERPRETATION: After analysing extensive primary data collection during roll-out, we found that Xpert introduction in South Africa was cost-neutral, but found no evidence that Xpert improved the cost-effectiveness of tuberculosis diagnosis. Our study highlights the importance of considering implementation constraints, when predicting and evaluating the cost-effectiveness of new tuberculosis diagnostics in South Africa. FUNDING: Bill & Melinda Gates Foundation.

It is often claimed that lack of female patronage was partially to blame for the lack of successful female artists prior to modernity. Recent research has shown that female patronage can be traced as far back as the Renaissance, if not earlier. Moreover, a small number of women spent lavishly on the arts; commissioning the best artists at the time. And yet, until modernity few women artists could support themselves independently. In order to act as patrons of the arts women required access to financial means and until modernity there were legal restrictions on their ability to hold property in their name. Women patronage during the pre-modern period could be seen to fall into four broad categories: daughters, wives, widows or nuns. Whilst today women can have access to funds in their own name this paper will argue that the changes that allow some women artists to flourish today are not in direct relationship to the patronage of women collectors. The paper looks at three case studies of living women who play a role in the patronage of contemporary Chinese art: Judith Neilson, Dominique Levy and Rita Sigg. It will argue that what has changed since the early Renaissance is the professionalism of the art world where artists and collectors are mediated by dealers, curators, academics, auctioneers, media, branding, design and publicity firms and much much more. Moreover, these roles may overlap, collectors may also be dealers, curators and more. It is through these other professionalised roles that women artists can find patronage and support.

Out-of-pocket spending is increasingly recognized as an important barrier to accessing health care, particularly in low-income and middle-income countries (LMICs) where a large portion of health expenditure comes from out-of-pocket payments. Emerging universal healthcare policies prioritize reduction of poverty impact such as catastrophic and impoverishing healthcare expenditure. Poverty impact is therefore increasingly evaluated alongside and within economic evaluations to estimate the impact of specific health interventions on poverty. However, data collection for these metrics can be challenging in intervention-based contexts in LMICs because of study design and practical limitations. Using a set of case studies, this letter identifies methodological challenges in collecting patient cost data in LMIC contexts. These components are presented in a framework to encourage researchers to consider the implications of differing approaches in data collection and to report their approach in a standardized and transparent way.

PURPOSE: Estimating the incremental costs of scaling-up novel technologies in low-income and middle-income countries is a methodologically challenging and substantial empirical undertaking, in the absence of routine cost data collection. We demonstrate a best practice pragmatic approach to estimate the incremental costs of new technologies in low-income and middle-income countries, using the example of costing the scale-up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa. MATERIALS AND METHODS: We estimate costs, by applying two distinct approaches of bottom-up and top-down costing, together with an assessment of processes and capacity. RESULTS: The unit costs measured using the different methods of bottom-up and top-down costing, respectively, are $US16.9 and $US33.5 for Xpert MTB/RIF, and $US6.3 and $US8.5 for microscopy. The incremental cost of Xpert MTB/RIF is estimated to be between $US14.7 and $US17.7. While the average cost of Xpert MTB/RIF was higher than previous studies using standard methods, the incremental cost of Xpert MTB/RIF was found to be lower. CONCLUSION: Costs estimates are highly dependent on the method used, so an approach, which clearly identifies resource-use data collected from a bottom-up or top-down perspective, together with capacity measurement, is recommended as a pragmatic approach to capture true incremental cost where routine cost data are scarce.

The physiological performance of a reef-building coral is a combined outcome of both the coral host and its algal endosymbionts, Symbiodinium. While Orbicella annularis—a dominant reef-building coral in the Wider Caribbean—is known to be a flexible host in terms of the diversity of Symbiodinium types it can associate with, it is uncertain how this diversity varies across the Caribbean, and whether spatial variability in the symbiont community is related to either O. annularis genotype or environment. Here, we target the Symbiodinium-ITS2 gene to characterize and map dominant Symbiodinium hosted by O. annularis at an unprecedented spatial scale. We reveal northwest–southeast partitioning across the Caribbean, both in terms of the dominant symbiont taxa hosted and in assemblage diversity. Multivariate regression analyses incorporating a suite of environmental and genetic factors reveal that observed spatial patterns are predominantly explained by chronic thermal stress (summer temperatures) and are unrelated to host genotype. Furthermore, we were able to associate the presence of specific Symbiodinium types with local environmental drivers (for example, Symbiodinium C7 with areas experiencing cooler summers, B1j with nutrient loading and B17 with turbidity), associations that have not previously been described.

Methodology and Discussion - Table 1(SADIE outputs, describing the indices for evaluating the spatial distribution of each observed SymbiodiniumITS2 type), Table 2(Cluster indices generated by SADIE analysis for symbionts at each site), Table 3(Summary of DISTLM population-scale outputs), Table 4 (Genotype data for the coral host, Orbicella annularis, by site.)

Global guidelines for new technologies are based on cost and efficacy data from a limited number of trial locations. Country-level decision makers need to consider whether cost-effectiveness analysis used to inform global guidelines are sufficient for their situation or whether to use models that adjust cost-effectiveness results taking into account setting-specific epidemiological and cost heterogeneity. However, demand and supply constraints will also impact cost-effectiveness by influencing the standard of care and the use and implementation of any new technology. These constraints may also vary substantially by setting. We present two case studies of economic evaluations of the introduction of new diagnostics for malaria and tuberculosis control. These case studies are used to analyse how the scope of economic evaluations of each technology expanded to account for and then address demand and supply constraints over time. We use these case studies to inform a conceptual framework that can be used to explore the characteristics of intervention complexity and the influence of demand and supply constraints. Finally, we describe a number of feasible steps that researchers who wish to apply our framework in cost-effectiveness analyses.