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Collecting fashion : nostalgia, passion, obsession
An indispensable survey of the most important archival collections assembled by fashion's key players. In order for fashion to march forward, it must possess the ability to look back. For the fashion obsessed, one's archive is surely a testament to the act of preservation and, of course, a sophisticated symbol of taste. Archives take time to build, wardrobes or storage units packed to the brim with rare, archival shoes, dresses, and handbags, some never worn, are only perfected after countless hours spent on Ebay and in the depths of obscured vintage sales. The results end up being remarkable representations of fashion history. This book gathers the preeminent collections of archival obsessives, capturing the closets of an impressive list of fashion and design talent. Readers will get an in-depth look at Michèle Lamy's extensive Comme des Garçon archive, Sarah Andelman's covetable (and colorful) sneaker and t-shirt collection, ENDYMA's growing Helmut Lang archive, Zaha Hadid's fabulous footwear assemblage, and more. This tome, over 300 pages long, painstakingly showcases the subject's archive while showing off top-tier labels and hard-to-obtain seasons: Issey Miyake, Maison Martin Margiela, Thierry Mugler, John Galliano, and Alexander McQueen, among others, and serves as an indispensable reference for those interested in fashion history and building their own archive. Essays throughout by leading thinkers and writers provide insightful commentary alongside each collection featured in this new, enlightening fashion bible.-- Amazon.
Book
G480 Paediatric consultant review of admissions within 12 h- an audit of a quality standard
Background In Northwest London, CQUIN (Commissioning for quality and Innovation) standards on consultant assessments of paediatric admissions replaced previous RCPCH standards. The CQUIN requirement was that 75% (year 1) and 90% (year 2) of paediatric admissions to be assessed by a consultant within 12 h between Monday and Friday (50% for weekends). RCPCH standards deemed that consultants should review admissions within 24 h. Aim To audit Compliance of above CQUIN standards before and after implementation of in a large district general hospital and Whether this review alters patient management. Method Retrospective case note review of 50 random general paediatric admissions in May 2012 followed by a similar 4week prospective review ending in January 2013. CQUIN standards were implemented in July- August 2012 with an awareness campaign amongst the attending medical team. Data was collected on diagnosis, senior review details and whether consultant review altered clinical management. Results A total of 98 paediatric admissions were studied (49 in each period – 2 cases excluded for wrong speciality). Prior to introduction of CQUIN standards, only 16.3% and 51% of admissions to the wards were reviewed by a consultant within 12 and 24 h respectively. In the post-CQUIN period, the figures were significantly higher at 44.9 and 96% respectively. However, 12 h consultant review changed management only in 18.2% of the cases compared to 75% in the pre-CQUIN period. There was an increased tendency for children with less morbidity (eg: Viral induced wheeze) to get a 12 h consultant review in the post-CQUIN period. Conclusion This audit demonstrates that with the introduction of CQUIN standards, there was a significant improvement (2–3 fold) in consultant contact for paediatric inpatients, with no injection of additional resources. However, the 12 h reviews seem to alter management in a smaller proportion of cases in the post CQUIN period, possibly implying that consultants are reviewing less sick children. Whilst this CQUIN standard will improve consultant contact and patient care it raises the question whether resources and expertise are being appropriately deployed in already overburdened paediatric units.
Journal Article
IT'S NOT ALL ABOUT NUMBERS: IS THE SUPPLY OF LEARNING ENCOUNTERS SUFFICIENT TO GENERATE COMPETENCE IN TRAUMA TEAM LEADERSHIP DURING HIGHER SPECIALITY TRAINING?
Objectives & BackgroundHigher Speciality Trainees (HSTs) are expected to gain competence required for autonomous practice as a consultant. Whether EM HSTs have adequate exposure to achieve competence in the trauma team leader (TTL) role is unclear.Our primary aim was to investigate whether the supply of learning encounters is sufficient to generate competence in the TTL role during HST. Secondary aims were to explore HSTs' participation in trauma calls, roles undertaken, confidence and competence within the TTL role, supervision, opinions on training and the number of TTL encounters required to attain competence.MethodsHSTs in the West Midlands completed a survey exploring the study objectives including confidence in the TTL role. Consultants completed a separate survey assessing HST competence in the TTL role, reasons for lack of competence, and the desired number of supervised encounters required for HSTs to attain competence.To estimate the supply of TTL encounters available, the number of trauma calls was derived from regional and TARN data. This number was proportionally reduced to represent a 48 hour week, divided by the number of HSTs. To assess demand, the supply estimate was compared to the mean number of supervised TTL encounters specified by consultants.Results27/27 eligible HSTs responded. HSTs reported attending 67% of activations during working hours, frequently in the TTL (67%) or Primary Survey roles (29%) but rarely in the airway role (3.2%). 39% of TTL encounters were supervised. 70% reported being confident in the TTL role.35/37 eligible consultants responded. 42% felt that their HSTs were competent in the TTL role. Common deficiencies were lack of exposure and leadership ability.100% of HSTs and 88.5% of consultants reported that a dedicated trauma placement would be desirable (median duration=6 months).Analysis estimates that the number of actual supervised TTL encounters during HST (n=33) is in keeping with the number desired by consultants (n=36) (figure 1).ConclusionThe quantity of TTL encounters during HST broadly matches the demand for exposure specified by consultants. Despite this, there is a disparity between trainee confidence and consultant assessment of competence. Exploration of reasons underlying this difference and the desire for dedicated training may identify areas where HSTs development can be enhanced.Figure 1Flow diagram demonstrating methodology to estimate supply of supervised TTL encounters and average number of supervised TTL encounters desired by consultants.
Journal Article
Gurus, hired guns, and warm bodies
Over the last several decades, employers have increasingly replaced permanent employees with temporary workers and independent contractors to cut labor costs and enhance flexibility. Although commentators have focused largely on low-wage temporary work, the use of skilled contractors has also grown exponentially, especially in high-technology areas. Yet almost nothing is known about contracting or about the people who do it. This book seeks to break the silence.
eBook