Through artistic interventions into the computational backbone of maternity services, the artists behind the Body Recovery Unit explore data production and its usages in healthcare governance. Taking their artwork The National Catalogue Of Savings Opportunities. Maternity, Volume 1: London (2017) as a case study, they explore how artists working with ‘live’ computational culture might draw from critical theory, Science and Technology Studies as well as feminist strategies within arts-led enquiry. This paper examines the mechanisms through which maternal bodies are rendered visible or invisible to managerial scrutiny, by exploring the interlocking elements of commissioning structures, nationwide information standards and databases in tandem with everyday maternity healthcare practices on the wards in the UK. The work provides a new context to understand how re-prioritisation of ‘natural’ and ‘normal’ births, breastfeeding, skin-to-skin contact, age of conception and other factors are gaining momentum in sync with cost-reduction initiatives, funding cuts and privatisation of healthcare services.
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A systematic review with meta-analysis was conducted to assess the prevalence of automatically listing (a) senior member(s) of a department as co-author(s) on all submitted articles in health sciences and the prevalence of degrees of support on a 5-point justification scale. Survey research was searched in PubMed, Lens.org, and Dimensions.ai. until January 5 2023. We assessed the methodological quality of studies and conducted quantitative syntheses. We identified 15 eligible surveys, that provided 67 results, all of which were rated as having low quality. A pooled estimate of 20% [95% CI 16–25] (10 surveys, 3619 respondents) of researchers in various health sciences reported that a senior member of their department was automatically listed as an author on all submitted articles. Furthermore, 28% [95% CI 22–34] of researchers (10 surveys, 2180 respondents) felt that this practice was ‘never’, 24% [95% CI 22–27] ‘rarely’, 25% [95% CI 23–28] ‘sometimes’, 13% [95% CI 9–17] ‘most of the time’, and 8% [95% CI 6–9] ‘always justified’. The practice of automatically assigning senior members of departments as co-authors on all submitted manuscripts may be common in the health sciences; with those admitting to this practice finding it unjustified in most cases.Registration of the protocol The protocol was registered in Open Science Framework. Link: https://osf.io/4eywp/.
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Background: Magnetic resonance imaging (MRI) is being used extensively in the search for pathoanatomical factors contributing to low back pain (LBP) such as Modic changes (MC). However, it remains unclear whether clinical findings can identify patients with MC. The purpose of this explorative study was to assess the predictive value of six clinical tests and three questionnaires commonly used with patients with low-back pain (LBP) on the presence of Modic changes (MC).Methods: A retrospective cohort study was performed using data from Dutch military personnel in the period between April 2013 and July 2016. Questionnaires included the Roland Morris Disability Questionnaire, Numeric Pain Rating Scale, and Pain Self-Efficacy Questionnaire. The clinical examination included (i) range of motion, (ii) presence of pain during flexion and extension, (iii) Prone Instability Test, and (iv) straight leg raise. Backward stepwise regression was used to estimate predictive value for the presence of MC and the type of MC. The exploration of clinical tests was performed by univariable logistic regression models.Results: Two hundred eighty-six patients were allocated for the study, and 112 cases with medical records and MRI scans were available; 60 cases with MC and 52 without MC. Age was significantly higher in the MC group. The univariate regression analysis showed a significantly increased odds ratio for pain during flexion movement (2.57 [95% confidence interval (CI): 1.08-6.08]) in the group with MC. Multivariable logistic regression of all clinical symptoms and signs showed no significant association for any of the variables. The diagnostic value of the clinical tests expressed by sensitivity, specificity, positive predictive, and negative predictive values showed, for all the combinations, a low area under the curve (AUC) score, ranging from 0.41 to 0.53. Single-test sensitivity was the highest for pain in flexion: 60% (95% CI: 48.3-70.4).Conclusion: No model to predict the presence of MC, based on clinical tests, could be demonstrated. It is therefore not likely that LBP patients with MC are very different from other LBP patients and that they form a specific subgroup. However, the study only explored a limited number of clinical findings and it is possible that larger samples allowing for more variables would conclude differently.