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The SPARTAC study (Short Pulse Anti-Retroviral Therapy at HIV Conversion) was a randomised clinical trial of short (12 weeks) or long (48 weeks) pulsed antiretroviral therapy (ART) at primary or recent HIV infection, compared to deferred therapy (standard of care). The trial has shown a significant effect of 48 weeks ART, compared to deferred therapy; 12 weeks ART had no effect. This definitive result from the SPARTAC trial has informed HIV treatment guidelines nationally and internationally; patients identified with primary or recent HIV infection are now recommended to commence ART, based in whole or part on the evidence arising out of SPARTAC. As a consequence of the SPARTAC trial, it is no longer ethical to undertake research amongst individuals with recent HIV infection without offering immediate ART.
In 2011, 34 million people worldwide were living with, and 1.7 million died from, HIV/AIDS. Since 2002, HIV-positive people have benefited from research by the Antiretroviral Therapy Cohort Collaboration (ART-CC) based at University of Bristol (UoB). Research on the timing of ART led to updated international HIV treatment guidelines that recommended starting treatment earlier. Research on life expectancy highlighted the benefits to patients of earlier ART, and was used by policy makers, clinicians and patient groups to promote earlier treatment. Patients are now starting treatment earlier resulting in increased life expectancy. Insurance companies changed their criteria for providing life insurance, influenced by ART-CC.
In order to reduce morbidity and mortality from HIV/AIDS, tuberculosis and other chronic diseases, effective and cost-effective interventions to strengthen primary care through in-service nurse training were put in place as standard practice throughout South Africa (population 50 million), based on our research. This programme has so far trained 1500 trainers in all 8 provinces, who in turn have trained 18,000 primary care professionals in 1900 of all 3500 clinics nationally. South Africa, with 5.8 million HIV+ people, and 500,000 newly infected with tuberculosis each year, based its Nurse Initiation and Monitoring of Antiretroviral Treatment policy on our training package and trials. These were landmark changes in primary health policy and provision in South Africa. The training methods and materials are also being used in Gambia, Malawi, Brazil and Portugal.
Our work with the World Health Organisation (WHO) had a major impact on global HIV treatment priorities at a critical time in the roll-out of anti-retroviral treatment (ART) worldwide. Concern had been expressed that if ART was provided without simultaneous monitoring of HIV viral load to determine switch in treatment, this would lead to an epidemic of drug resistant HIV. It was argued that viral load monitoring should be introduced as a priority, despite the fact that this was expensive and would inevitably divert resources from ART provision. We used a simulation model to predict the impact of lack of viral load monitoring and showed that while development of viral load assays was important, ART should be prioritised. As a result, the roll out of ART continued despite continued lack of viral load monitoring, and there are now over 9 million people on ART.
This case study focuses on three areas in relation to the social impact of art, across the categories of `cultural life' and `public discourse'.
1) Artistic collaborations with non-artistic specialists in order to generate new interdisciplinary pathways
2) Artistic collaborations with non-artists within a given community or non-artistic institutional setting in order to create new forms of artist-audience participation
3) The sharing of knowledge/skills between either non-artistic specialists or a non-specialist audience and artists in the production of a shared task or project.
4) Performance-based practice inside and outside of the gallery
The outward facing nature of this research, then, addresses the way such work tests the prevailing competences, boundaries and identities of artist and audience alike. This means researchers are involved with both artistic and non-artistic funding-bodies and agencies as the basis for work on a range of critical issues affecting the borders between the art institution and non-artistic settings and contexts.
Derek Matravers' research in aesthetics has contributed to the public discourse on art by offering a plausible postmodern definition of `art'. Matravers' definition offers a way of understanding art that places the emphasis on reasons, and thus moves beyond the obscurantism associated with contemporary art. His podcast on the subject, as part of the PhilosophyBites series, has taken the topic into public discourse. His work has also influenced the art world. Matravers participated in a conceptual art piece, where his ideas on the definition of art were incorporated into the art piece, effectively blurring the borders between the philosophy and the object of study.
The impact of Professor Taylor's work in interpreting modern and contemporary art has taken place on two complementary levels: on the one hand the lucid and accessible exposition, for a wide international reading public, of some of the most difficult, intractable, or provocative works of recent and contemporary art; and on the other, more specialist readings, again for an international reading public, of key tendencies in the broader range of modern art, from Cubism to the present day. Wide readership across Asia, Europe, and the United States has secured increased public understanding of art, and has influenced both policy and art practice.
Prior to the change in WHO recommendations which occurred following this study many patients in Africa and other developing countries were receiving an inferior regimen for the management of tuberculosis, a consequence of which meant that many had to be retreated. Since the implementation of the revised WHO Guidelines in 2010 almost all countries have now switched to the gold standard tuberculosis treatment regimen based on 6 months of isoniazid and rifampicin
Dr Antonello's research on the Italian designer and artist Bruno Munari and his relation with Futurism was instrumental for the realization of an exhibition at the Estorick Collection in London, titled `Bruno Munari: My Futurist Past', held on 19 September - 23 December 2012. This was the first exhibition of Munari's work in the UK and the very first exhibition outside Italy since he passed away in 1998. It caught the attention of international media, and prompted the engagement of scholars, teachers, and schools at all levels (from primary to university), as well as discussions among practitioners and graphic designers. The exhibition was organized in collaboration with the Miroslava Hajek Archive, Novara, Luca Zaffarano at munart.org, and the Massimo and Sonia Cirulli Archive, New York.
The developing collaborative strategic relationship between Professor Ben Quash and the National Gallery stemming from Quash's research, in particular his unique exploration of religious art — or specifically `Christian' art along the dual lines of 'Art in Christianity' and 'Christianity in Art' — has impacted on the approach of this world-leading cultural institution in a number of ways. It has been central to the Gallery's decision to make `Art and Religion' one of its four lead research themes. It has been responsible for attracting significant financial support from donors impressed by the theological character of the questions Quash's research explores. It has resulted in the Gallery's commissioning of its most ambitious educational investment to date in a series of online educational resources; and it has influenced the Gallery's staging of its highly successful 2011 summer exhibition `Devotion by Design'. Finally, Quash's research has impacted on how the National Gallery's education department organizes the public study of religion and art.