Journal articles on the topic 'Compensatory family care'

For several years, demographic trends and changing ideas about responsibilities for elder care in Japan have contributed to the desire, or need, for families to seek out new care approaches. This article focuses on one alternative to traditional approaches to caring for elder family members—the home-helper program that is available through the Japanese long-term care insurance program. Using ethnographic data collected in northern Japan, it will be argued that the home-helper program forms a compensatory elder care system that is intended to augment family-provided care and social support, rather than to promote independent living. This compensatory approach to elder care is based upon an intergenerational social contract in which it is assumed that some degree of dependence on family members is both an expected and preferred outcome of growing old.

BackgroundOperational failures, defined as inadequacies or errors in the information, supplies, or equipment needed for patient care, are known to be highly consequential in hospital environments. Despite their likely relevance for GPs’ experiences of work, they remain under-explored in primary care.AimTo identify operational failures in the primary care work environment and to examine how they influence GPs’ work.Design and settingQualitative interview study in the East of England.MethodSemi-structured interviews were conducted with GPs (n = 21). Data analysis was based on the constant comparison method.ResultsGPs reported a large burden of operational failures, many of them related to information transfer with external healthcare providers, practice technology, and organisation of work within practices. Faced with operational failures, GPs undertook ‘compensatory labour’ to fulfil their duties of coordinating and safeguarding patients’ care. Dealing with operational failures imposed significant additional strain in the context of already stretched daily schedules, but this work remained largely invisible. In part, this was because GPs acted to fix problems in the here-and-now rather than referring them to source, and they characteristically did not report operational failures at system level. They also identified challenges in making process improvements at practice level, including medicolegal uncertainties about delegation.ConclusionOperational failures in primary care matter for GPs and their experience of work. Compensatory labour is burdensome with an unintended consequence of rendering these failures largely invisible. Recognition of the significance of operational failures should stimulate efforts to make the primary care work environment more attractive.

On the basis of family carers’ perspectives, this article sets out to understand the logics of structuring care arrangements for older people over time, as well as to capture the roots of these logics. The data analyzed was gathered through qualitative research carried out in the Lisbon area. We found that elder care arrangements have been structured over time according to a logic designated by ‘family primacy’, in which family care has precedence over other modes of care provision. However, this logic is put into practice in different forms, associated with different social classes: ‘restrictively’ by family carers belonging to middle classes (they want to have a restricted involvement in care provision) and ‘extensively’ by family carers belonging to working classes (they are willing to have an extensive involvement in care provision). The results also reveal that the logic of ‘family primacy’ is rooted not only on ‘familistic’ values and norms but also on the negative impression family carers have of the quality of other modes of care provision. Lastly, it was also found that some elders agree with the logic of ‘family primacy’, whilst others idealize a slightly different logic (‘conditional family primacy’) which is compatible with the logic of ‘family primacy’, and still others who idealize a very different logic (‘family exclusivity’) which is not compatible with the logic of ‘family primacy’ and consequently could produce serious tensions between the elders and their family carers. It is believed that questioning the ‘hierarchical compensatory model’ proposed by Cantor is one of the contributions of this article.

Abstract Increased life expectancy in China implies that adults increasingly survive long enough to see their grandchildren reach adulthood and take on elevated importance—even as smaller family size reduces the number of children and grandchildren available. This article examined the prevalence with which older adults received support and care from grandchildren and the family conditions under which the likelihood of this assistance is enhanced. The data for our analysis derived from the 2014 wave of the Chinese Longitudinal Aging Social Survey, limited to 13.4% of respondents (n = 1,551) who reported requiring personal assistance to perform daily activities. Logistic regression revealed that grandparents were more likely to receive assistance from grandchildren when they had no son available or had daughters who did not provide assistance. Results were consistent across urban and rural regions. These findings support the compensatory or substitution role of grandchildren as sources of support and care for their grandparents within a gendered family system. Implications for policies and services serving older people in China are discussed.

The material for the article was created as part of the project "Education, levelling developmental and educational deficits of charges of family-run children’s houses and care and educational institutions (based on the example of Biała Podlaska poviat)" implemented by the Department of Pedagogy of Higher State School in Biała Podlaska. Two methods: diagnostic survey and study of individual cases were used in the research, using proprietary questionnaires for charges, interview questionnaires with educators of care and educational centres and family facilities, an observation sheet and talks with coordinators and directors of the examined institutions. The research was carried out in Biała Podlaska poviat in three care and educational centres and three family-run children's homes. The subject of the article was to implement the educational needs of foster care children, including the issue of levelling educational gaps. The aim of the study was to determine whether educational deficiencies are noticeable there, what is the compensation of these deficiencies in family and institutional settings, if any of these forms is more favourable, what factors affect the proper satisfaction of educational needs? The analysis of the results made it possible to conclude that educational needs are realized in both care and educational centres and in family-run children’s homes, the beneficiaries of both forms exhibit numerous educational deficiencies conditioned by previous educational negligence. Compensation of educational deficiencies is more beneficial in family care. The basic forms of compensating for gaps include: tutoring, compensatory classes, individual caregiver work with a child, colleague self-help, voluntary activities.

This paper considers the processes and circumstances that create vulnerability among older people, specifically to a very poor quality of life or an untimely or degrading death. Models of ageing processes are used to define vulnerable older people as those whose reserve capacity falls below the threshold needed to cope successfully with the challenges they face. Compensatory supports may intervene to mitigate the effects of challenges and to rebuild reserve. The dimensions of reserve, challenges and compensation are discussed, with emphasis on demographic and other influences on the availability of family and social support. Policy initiatives to reduce vulnerability can focus on each part of the dynamic process that creates vulnerability, namely, ensuring that people reach later life with ‘reserve’, reducing the challenges they face in later life, and providing adequate compensatory supports. The promotion through the lifecourse of healthy lifestyles and the acquisition of coping skills, strong family and social ties, active interests, and savings and assets, will develop reserves and ensure that they are strong in later life. Some of the physical and psychological challenges that people may face as they age cannot be modified, but others can. Interventions to develop compensatory supports include access to good acute care and rehabilitation when needed, substitute professional social and psychological help in times of crisis, long-term help and income support. Our knowledge of which interventions are most effective is however limited by the paucity of rigorous evaluation studies.

Family first response in patients with heart attacks is very important in increasing patient safety. Friedman's familiy theory views that the family has a major role and function indecide the prompt and appropriate course of action. Orem's Wholly Compensatory System Theory looked at that familymust provide partial assistance when a family member is sick. Theory Cultural care Leininger looked at that family tend to maintain their culture when doing help. Indonesia, especially in Banjarmasin, has different social and cultural conditions so that the experience of making its first response will of course also be different. This study aims to explore the family experience of the first response to patients with heart attacks. This study used a qualitative method with a phenomenological study approach to 8 participants from Banjar community in South Kalimantan with purposive sampling technique. Collecting data using in-depth interviews with a tape recorder and field notes. The method of analysis uses Creswell. There are 6 themes found namely (1) The initial understanding of a family about heart attack is in the form of menyamak or angin duduk, (2) The family's first action in a patient with an attackheart in the form of cabut angin, (3) family onset in doing his first response against attacks in the form of estimated time (4) Family delay factors in doing the first response in the form of a cause(5) The emotional response of the family in facing a heart attack such as neutral response, anxiety and shock. (6) Meaning as a helper for family members such as pride, relief and pleasure. Nurses need to rectify the culture that is in conflict with health by changing the family mindset of their understanding of diseases, especially heart attacks.

AbstractMaternal depression negatively impacts children's development, yet few studies have focused on fathering and the family process in cases of maternal depression. A community cohort of married/cohabitating women was recruited on the second postbirth day (N = 1,983) and maternal depression repeatedly assessed across the first year and again at 6 years to form two cohorts: mothers chronically depressed from birth to 6 (N = 46) and nondepressed controls (N = 103). At 6 years, mother–child, father–child, and family interactions were observed. In families of depressed mothers, both mother and father exhibited lower sensitivity and higher intrusiveness, and children displayed lower social engagement during interactions with mother and father. Fathering moderated the effects of maternal depression on the family process. When fathers showed low sensitivity, high intrusiveness, and provided little opportunities for child social engagement, the family process was less cohesive, implying a decrease in the family's harmonious, warm, and collaborative style. However, in cases of high father sensitivity, low intrusiveness, and increased child engagement, the family process was unaffected by maternal depression. Findings describe both comparability and compensatory mechanisms in the effects of fathering on family life when maternal care is deficient, highlight the buffering role of fathers, and underscore the importance of father-focused interventions when mothers are depressed.

Marzena Buchnat, Aneta Wojciechowska, Early childhood education and care of children with normal and abnormal development in Poland – its importanceand barriers. Interdisciplinary Contexts of Special Pedagogy, no. 24, Poznań 2019.Pp. 67-81. Adam Mickiewicz University Press. ISSN 2300-391X. DOI: https://doi.org/10.14746/ikps.2019.24.04 The article presents a discussion on the importance of early therapeutic interactions for the development of a child at risk of disability or with a disability and his/her family. It indicates the importance of the time of taking action in relation to a child with developmental disorder for the period from birth to the age of three years. The article pays special attention to the place of early intervention and early support in the development process, its preventive, compensatory and corrective role. It describes barriers to the development of this system in Poland and points to potential solutions to these difficulties.

Psychological Considerations of the Behavior of Children Causing a Damage and Parents’ Liability for SupervisionSummaryThe study concerns the problem of parents’ compensatory liability for a damage caused by their children in a psychological perspective.The author presents basic issues being the subject of the studies on children’s psychology and refers them to the problem of parents’ civil liability for damages caused by their children. First the paper discusses results of the selected researches concerning the relation between the development of a child and his experiences from the early childhood. Then the author introduces scientific typology of so called parental attitudes, parental styles and systems of family upbringing. and afterwards analyses the reasons for children’s aggressive attitudes.The performed analysis enabled the author to draw conclusions related to the application of the law. They concern wide range of liability for child complying not only care but also children’s upbringing.

Introduction: Determine whether socio-demographic, habits and risk factors are associated with a better tensional control in type 2 diabetes in primary care patients in order to identify a specific target population for compensatory interventions improving diabetes control and reducing its morbi-mortality.Material and Methods: Cross-sectional study in primary care. Randomized type 2 diabetes patient data collection by their volunteer family doctors, proportionally stratified from the 5 Portuguese continental regions. Variables: blood pressure, age, gender, education, diabetes duration, HbA1c, smoking habits, weight, waist circumference, physical activity and adherence to medication. Bivariate and logistic regression analysis to evaluate each measured variable’s independent association with uncontrolled blood pressure (≥ 140/90).Results: 709 patients were included in the study, 60.2% men, mean age 66.12 ± 10.47 years. In logistic regression analysis, the factors independently associated to uncontrolled BP were lower education (p = 0.014), shorter diabetes duration (p = 0.002), higher waist circumference (p < 0.001), higher pulse pressure (p < 0.001), higher physical activity level (p = 0.043) and being a smoker (p < 0.001).Discussion: The main limitations are the fact that the sample was not totaly random and included only primary care patients, a possible inter-observer bias and being a cross-sectional study, thus not providing information on temporal relation or causality.Conclusion: The sub-group of people with diabetes identified to have worse tensional control should have a different and more intensive approach in primary care. We recommend further longitudinal and population based confirmatory research.

The article entitled "Benefits for an employee due to an occupational disease" presents a catalog of benefits due to an employee who has an occupational disease. This catalog has been divided into one-off, short-term and long-term benefits. One-time benefits include one-off compensation for an employee due to permanent or long-term damage to health or to the family of a worker due to death due to occupational disease and covering medical costs in the field of dentistry and immunization and supply of orthopedic items. Short-term benefits include sickness benefit from accident insurance, rehabilitation benefit and compensatory allowance. On the other hand, long-term benefits are a disability pension, a training pension, a survivor's pension and a care allowance. Guarantees about benefits are wide, but it must be borne in mind that receiving each of the indicated benefits requires a medical certificate confirming the occupational disease. The benefits are awarded only in half of cases, and their amount is usually not sufficient to cover the costs of treatment and rehabilitation.

Following reunification in Germany in 1990 the new states in the Federal Republic faced the task of restructuring and rebuilding the structures of complementary care for the chronically mentally ill. First and foremost, residential facilities had to be established that would correspond to and meet the currently high need for de-hospitalization by making different types of care and care concepts available. Five groups of patients with chronic schizophrenic psychoses (N = 245 patients) who live in different types of psychiatric care facilities (psychiatric nursing home, social therapeutic hostel, sheltered community residence) or at home, either with or without a family network, were studied. In addition to the sociodemographic data, the psychopathology and the extent of social disabilities were also surveyed, as well as data on the living situation and the subjective quality of life with an emphasis on ‘social relationships’, ‘recreation/leisure activities’, and ‘general independence’.The five groups differed with regard to various sociodemographic and disorder-related variables, particularly with regard to the extent of social disabilities. Especially relevant, however, are the differences among the patient groups in the extent of daily social life and recreational/leisure activities that are partially reflected in their statements on the subjective quality of life. Primarily for the two groups of home residents, but also in part for the patients living in sheltered community care, social contacts are more or less limited to the residential situation and patients are more or less otherwise socially isolated. This is due among other things to the fact that patients who have been hospitalized for long periods do not as a rule return to their prior area of residence; thus, the available compensatory mediation of relationships with the social environment does not suffice. Demands for the further development of complementary systems of psychiatric care derive from these findings.

AbstractThe cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal–spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.

This paper investigates the gendered division of labor in different types of domestic work within married couples in contemporary Japan. We analyze routine housework such as cleaning and cooking, non-routine housework such as home repairs, and care work by using the 2016 Survey of Time Use and Leisure Activities (Japan’s national time diary survey). Our core analysis is done using ordinary least squares (OLS) regressions on total domestic work time, routine housework time, non-routine housework time, and care time. We find that women’s domestic work time dwarfs men’s, and there is some variation by day of the week and education. On weekdays domestic work is almost exclusively the domain of women. On weekends we find evidence of compensatory behaviors for both men and women. Men, especially those with university education, catch up on all types of unpaid work while women, especially those with tertiary education, catch up on unpaid work mostly by spending more time caring for children. Looking at the family balance in sharing domestic labor we find that men increase their time on unpaid work on weekends proportionately more than women do. Consequently, within couples, wives’ share of all types of unpaid work is around 10% smaller on weekends compared to weekdays. In couples where wives have tertiary education, there is an additional reduction by several percentage points in their weekend share of domestic work time compared to weekdays. Our findings suggest that Japanese men’s long work hours contribute to gender inequality in domestic work participation. We also find that university education is associated with more equal sharing of domestic workload, indicating that socialization may play a role in bringing about greater egalitarianism in the domestic sphere in the future.

We recently detected the spoligotype patterns of strains ofMycobacterium pinnipedii, a species of theMycobacterium tuberculosiscomplex, in sputum samples from nine cases with pulmonary tuberculosis residing in Porto Alegre, South Brazil. Because this species is rarely encountered in humans, we further characterized these nine isolates by additional genotyping techniques, including 24-locus mycobacterial interspersed repetitive-unit–variable-number tandem-repeat (MIRU-VNTR) typing, verification of the loci TbD1, RD9,pks15/1, RDRio, andfbpC, the insertion of IS6110at a site specific to theM. tuberculosisLatin American Mediterranean (LAM) lineage, and whole-genome sequencing. The combined analysis of these markers revealed that the isolates are in factM. tuberculosisand more specifically belong to the LAM genotype. Most of these isolates (n= 8) were shown to be multidrug resistant (MDR), which prompted us to perform partial sequencing of therpoA,rpoB,rpoC,katG, andinhAgenes. Seven isolates (77.8%) carried the S315T mutation inkatG, and one of these (11%) also presented the C(−17)T single-nucleotide polymorphism (SNP) ininhA. Interestingly, six of the MDR isolates also presented an undescribed insertion of 12 nucleotides (CCA GAA CAA CCC) in codon 516 ofrpoB. No putative compensatory mutation was found in eitherrpoAorrpoC. This is the first report of anM. tuberculosisLAM family strain with a convergentM. pinnipediispoligotype. These spoligotypes are observed in genotype databases at a modest frequency, highlighting that care must be taken when identifying isolates in theM. tuberculosiscomplex on the basis of single genetic markers.

Abstract There is growing popularity and interest in very-low-carbohydrate (VLC) diets for a variety of established and perceived health benefits. While some impacts have been seen in cardiometabolic diseases such as diabetes, hypertension and short-term weight loss (particularly when paired with caloric restriction), other effects such as in energy levels, mood and sense of well-being are variable. In the extreme, these diets suggest restriction of dietary carbohydrates (CHO) to less than 20 grams daily and often encourage a compensatory increase in dietary fat to promote ketogenesis. There has been concern about the long-term effects of these changes, as well as unintended consequences of increased saturated fat intake. A minority of patients, such as in the case below, may experience exaggerated lipid changes, thought to be influenced by underlying metabolic and genetic factors. Meta-analyses have shown conflicting results of the effects of VLC diets on low density lipoprotein cholesterol (LDL-C) levels. A 63-year-old woman presented for outpatient consultation for markedly elevated LDL-C 524 mg/dL. The rest of her lipid panel was as follows: total cholesterol 637 mg/dL, triglycerides 152 mg/dL, HDL-C 83 mg/dL. She was asymptomatic. Record review of annual laboratory testing from her primary care physician revealed baseline LDL-C 114–134 mg/dL between 2012 and 2017. Her lipid panel in 2017 was as follows: total cholesterol 216 mg/dL, triglycerides 82 mg/dL, HDL-C 68 mg/dL, LDL-C 132 mg/dL. She described that in late 2017 she began a VLC diet for perceived metabolic benefits, and in the past year intensified CHO restriction to less than 15 grams daily. In 2018–2019, her LDL-C level increased to 303–316 mg/dL, and in 2020 to 524 mg/dL. She had no history of diabetes, liver or kidney disease, nephrotic syndrome, hypothyroidism or alcohol use. She took no prescribed medications. She reported over-the-counter use of magnesium and potassium. She denied use of any other supplements or herbal remedies. Her past medical history included osteoarthritis. Her family history included hyperlipidemia in her mother, and coronary artery disease in both parents with age of onset in their 70s. She was a lifelong non-smoker and did not drink alcohol. Her BMI was 21.5. On examination, she was normotensive, euthyroid-appearing, and had no stigmata of familial hypercholesterolemia. Other labs were grossly normal, including blood counts, comprehensive metabolic panel, thyroid function tests, hemoglobin A1c and urinalysis. She was counseled extensively regarding her laboratory results and concerns about her cardiovascular safety. This case demonstrates an exaggerated lipid response to a VLC diet, and supports the National Lipid Association scientific statement Class IIa recommendation to obtain baseline and follow-up lipid profiles in patients who follow such diets due to variation in lipid response.

O presente texto é parte de um trabalho de tese desenvolvido no Programa de Pós-Graduação em Educação da Universidade Federal da Paraíba (UFPB) que objetivou analisar em que medida o Fundeb se constituía uma política pública capaz de financiar adequadamente a expansão do atendimento à educação infantil no município de João Pessoa, PB. Trata-se de uma pesquisa qualitativa de cunho bibliográfico com objetivo de problematizar o paradigma do capital humano aplicado à primeira infância e compreendido como desenvolvimento de capacidade que prepara crianças para a vida adulta, para o mercado e para geração de valor econômico dos indivíduos e de um país. Constatou-se que, a atenção, a educação e o desenvolvimento da criança têm sido considerados uma solução para os problemas sociais e para o desenvolvimento econômico sustentável, pois gera significativos retornos econômicos e elimina a desigualdade. Entretanto, os pressupostos, as orientações e os programas direcionados para a infância são desenvolvidos por meio de propostas assistencialistas e compensatórias para países em desenvolvimento e com foco no alívio à pobreza. Por isso, é comum encontrar nesses países, instituições com infraestrutura inadequada, profissionais pouco qualificados e modelos de atendimento focalizado na família. Palavras-chave: Investimento na Infância, Alívio à Pobreza, Direito à Educação, Viés Econômico. Assumptions of the Human Capital paradigm applied to Early Childhood ABSTRACT. The present text is part of a thesis developed in the Graduate Program in Education of the Federal University of Paraíba (UFPB) that aimed to analyze the extent to which the Fundeb constituted a public policy capable of adequately financing the expansion of attendance to education in the municipality of João Pessoa, PB. It is a qualitative bibliographical research aimed at problematizing the human capital paradigm applied to early childhood and understood as capacity development that prepares children for adult life, for the market and for generating economic value of individuals and for a country. It has been found that child care, education and development have been considered as a solution to social problems and to sustainable economic development since it generates significant economic returns and eliminates inequality. However, assumptions, orientations and programs directed towards childhood are developed through assistance and compensatory proposals for developing countries with a focus on alleviating poverty. Therefore, it is common to find in these countries institutions with inadequate infrastructure, low-skilled professionals and family-focused models of care. Keywords: Investment in Childhood, Poverty Alleviation, Right to Education, Economic Bias. Presupuestos del paradigma del Capital Humano aplicados a la Primera Infancia RESUMEN. El presente texto es parte de un trabajo de tesis desarrollado en el Programa de Postgrado en Educación de la Universidad Federal de Paraíba (UFPB) que objetivó analizar en qué medida el Fundeb se constituía una política pública capaz de financiar adecuadamente la expansión de la atención a la educación en el municipio de João Pessoa, PB. Se trata de una investigación cualitativa de cuño bibliográfico con el objetivo de problematizar el paradigma del capital humano aplicado a la primera infancia y comprendido como desarrollo de capacidad que prepara a los niños para la vida adulta, para el mercado y para la generación de valor económico de los individuos y de un país. Se constató que la atención, la educación y el desarrollo del niño han sido considerados una solución a los problemas sociales y al desarrollo económico sostenible pues, genera significativos retornos económicos y elimina la desigualdad. Sin embargo, los presupuestos, las orientaciones y los programas dirigidos a la infancia se desarrollan a través de propuestas asistencialistas y compensatorias para los países en desarrollo y centrándose en el alivio de la pobreza. Por eso, es común encontrar en esos países, instituciones con infraestructura inadecuada, profesionales poco cualificados y modelos de atención enfocados en la familia. Palabras clave: Investimento en la Infancia; Alivio a la Pobreza, Dirección a la Educación, Economía Económica.

AbstractThe first part of the paper describes the process of weaning in domestic cats. The subjects were seven families of cats living under laboratory conditions-each family consisting of a mother and her two kittens, living in their own large indoor pen. Observations were carried out at regular intervals from the third week after birth until the kittens were 10 weeks old. Weaning is viewed as the period during which the rate of milk transfer from mother to offspring drops most sharply. According to this definition, weaning commenced when the kittens were four weeks old and was largely completed by the time they were seven weeks old. During the weaning period mothers made suckling progressively more difficult for their kittens by increasingly adopting body postures that blocked access to their nipples. The amount of suckling declined sharply from four weeks after birth and seldom occurred after seven weeks. Kittens were first seen to eat solid food during the fifth week, and this was associated with a large increase in the variability of their daily weight gain. Prior to the start of weaning, mothers' food intake was approximately double that of non-lactating females. Male kittens grew more rapidly than their sisters and were significantly heavier. However, there was no evidence that males suckled more than females prior to the start of weaning. In general, weaning was characterised by a gradual reduction in the ease with which kittens could suckle, rather than by any overt rejection or aggression by the mother. The absence of any obvious weaning conflict is thought to be related to the favourable housing conditions (small litter size, ad libitum food, freedom from disturbances, etc.) used in this study. The second half of the paper describes the results of an experiment in which maternal lactation was interrupted during the first week of weaning. Seven Experimental (E) mothers were injected with the lactation-blocking drug bromocriptine on days 28, 30 and 33 post partum, each injection being sufficient to interrupt lactation for about 18-24 h. In the period immediately following the injections (days 29-46), E mothers and their kittens were more active than the controls, and E mothers washed their kittens more. Later on (days 47-70), E kittens suckled more than the controls-notably in the eighth week after birth, at a time when suckling would normally be rare. E mothers appeared to be more willing to let their kittens suckle during this period, as they adopted a fully accessible posture more often, and a blocking posture less often, than controls. The overall pattern of results is interpreted in terms of an initial withdrawal from the kittens in the period immediately after lactation was interrupted, followed by a later resumption of maternal care and a postponement of the end of weaning. Perhaps as a result of this continuation of suckling, the experimental treatment had no overall effect on the kittens' growth, although the Experimental kittens did grow more slowly in the week of the injections. One tentative hypothesis is that the apparent postponement of weaning represents a compensatory response to the earlier reduction in the rate of parental investment.

Acute myeloid leukemia (AML) cells highly depend on oxidative phosphorylation (OxPhos) to satisfy their heightened demands for energy, and the complex I OxPhos inhibitor IACS-010759 (Molina, Nat. Med. 2018) is currently in Phase 1 clinical trial in AML. In this study, we investigated how the bone marrow (BM) microenvironment affects the response to OxPhos inhibition in AML. To characterize the molecular mechanisms of sensitivity to OxPhos inhibition, we performed Cap Analysis of Gene Expression analysis (CAGE) on 31 genetically diverse primary AML samples (20 were defined as sensitive and 11 as resistant to IACS-010759; cut off &gt;3.0 fold annexin V(+) by 100 nM IACS-010759/DMSO at 72 hours). CAGE identified higher expression of transcription start sites (TSS) for 17 genes in IACS-010759 resistant AML samples compared to sensitive (fold change &gt;2.0, FDR &lt; 0.05, EdgeR), which were related to cell adhesion, integrin and/or Rho GTPase family genes that modulate intracellular actin dynamics. We next investigated the interactions between IACS-010759 sensitive OCI-AML3 cells and BM-derived mesenchymal stem cells (MSC). Under conditions mimicking the BM microenvironment, IACS-010759 upregulated the pathways of focal adhesion and ECM-receptor interaction in OCI-AML3 cells (KEGG analysis based on CAGE). In turn, MSC co-culture increased oxygen consumption by AML, induced generation of mitochondrial ROS (control 4.4% vs IACS 44.4%), increased mtDNA (2-fold by q-PCR) and upregulation of mitochondrial proteins VDAC and cytochrome C, translating into dampened growth-inhibitory effects of IACS-010759. We further demonstrated that OCI-AML3 cells adhering to MSCs were fully protected from IACS-010759 induced apoptosis (IACS-induced specific apoptosis: non-adherent cells 16.2% ± 1.6% vs adherent cells 1.6% ± 0.7%, p=0.008, 30nM, 72hours). Similarly, adherent cells were fully protected from apoptosis induced by combination of IACS and AraC. These findings indicate that direct interactions with MSC trigger compensatory activation of mitochondrial respiration, increase in mitochondrial mass and resistance to OxPhos inhibition in AML. We next hypothesized that the trafficking of mitochondria from BM stroma cells to AML cells could represent a putative mechanism of an acquired resistance to OxPhos inhibition. To visualize mitochondria, OCI-AML3 and MSC were stably transfected with mitochondria-targeted PDHA1-GFP and -dsRed, respectively. We discovered that IACS-010759 induced transfer of MSC-derived mitochondria to OCI-AML3 cells (% of GFP/dsRed double-positive OCI-AML, control 4.1 ± 1.7 vs IACS 26.2 ± 13.4, p=0.002) via tunneling nanotubes (TNTs) detected by confocal and electron microscopy (Fig.1). Mitochondria transfer was only observed in the direct contact but not in the transwell co-cultures, and was abrogated by ICAM-1 neutralizing antibody and TNT blockade with Cytochalasin B. Likewise, combination of IACS with AraC increased mitochondrial transfer. We further found that IACS-010759 induced autophagy in OCI-AML3 cells co-cultured with MSC, as noted by increased conversion of LC3-I to LC3-II, which was further enhanced by the lysosome inhibitor Bafilomycin. Additionally, we observed autophagosome formation enwrapping MSC-derived mitochondria (Fig.1F), along with the degradation of an outer mitochondrial membrane protein Tom20. Finally, IACS-010759-induced transfer of mtDNA in BM-resident AML cells was confirmed in vivo in humanized AML PDX models (n=2). Daily oral treatment of mice harboring human AML with IACS-010759 (5.0 mg/kg/day, 21 days) increased the ratio of murine/human mtDNA in human AML cells isolated from BM, in 5 days on/2 days off PDX models tested (2.1 ± 0.3 fold, n=2). In conclusion, the findings of this study indicate an important role of mitochondria trafficking from BM stromal cells to AML cells in a compensatory adaptation to OxPhos inhibition in BM microenvironment. We propose that blocking of mitochondrial transfer could enhance the anti-AML efficacy of OxPhos targeting agents. Disclosures Zhang: The University of Texas M.D.Anderson Cancer Center: Employment. Kuruvilla:The University of Texas M.D.Anderson Cancer Center: Employment. Andreeff:BiolineRx: Membership on an entity's Board of Directors or advisory committees; Breast Cancer Research Foundation: Research Funding; Oncolyze: Equity Ownership; Oncoceutics: Equity Ownership; Senti Bio: Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Eutropics: Equity Ownership; Reata: Equity Ownership; Aptose: Equity Ownership; 6 Dimensions Capital: Consultancy; Daiichi Sankyo, Inc.: Consultancy, Patents & Royalties: Patents licensed, royalty bearing, Research Funding; Jazz Pharmaceuticals: Consultancy; Celgene: Consultancy; Amgen: Consultancy; AstaZeneca: Consultancy; CPRIT: Research Funding; NIH/NCI: Research Funding; Center for Drug Research & Development: Membership on an entity's Board of Directors or advisory committees; Cancer UK: Membership on an entity's Board of Directors or advisory committees; NCI-CTEP: Membership on an entity's Board of Directors or advisory committees; German Research Council: Membership on an entity's Board of Directors or advisory committees; Leukemia Lymphoma Society: Membership on an entity's Board of Directors or advisory committees; NCI-RDCRN (Rare Disease Cliln Network): Membership on an entity's Board of Directors or advisory committees; CLL Foundation: Membership on an entity's Board of Directors or advisory committees. Konopleva:Astra Zeneca: Research Funding; Agios: Research Funding; Eli Lilly: Research Funding; AbbVie: Consultancy, Honoraria, Research Funding; Cellectis: Research Funding; Amgen: Consultancy, Honoraria; F. Hoffman La-Roche: Consultancy, Honoraria, Research Funding; Genentech: Honoraria, Research Funding; Ascentage: Research Funding; Kisoji: Consultancy, Honoraria; Reata Pharmaceuticals: Equity Ownership, Patents & Royalties; Ablynx: Research Funding; Forty-Seven: Consultancy, Honoraria; Calithera: Research Funding; Stemline Therapeutics: Consultancy, Honoraria, Research Funding.

Acute myeloid leukemia (AML) cells are highly dependent on oxidative phosphorylation (OxPhos) for survival and continually adapt to the bone marrow (BM) microenvironment. We investigated how the BM microenvironment impacts the response to energy-depriving OxPhos inhibition in AML using a novel complex I OxPhos inhibitor (OxPhosi), IACS-010759. We have reported that OxPhosi-resistant primary AML samples demonstrated higher baseline transcription of genes related to cell adhesion, integrin and/or Rho GTPase family genes that modulate intracellular actin dynamics. (Yang et al. ASH 2019) In this study, we performed Cap Analysis of Gene Expression (CAGE) transcriptome analyses using IACS-010759-sensitive and -resistant AML PDXs. CAGE identifies and quantifies the 5' ends of capped mRNA transcripts (= transcription start sites) and allows investigating promoter structures necessary for gene expression. Primary AML cells from 9 AML PDXs were injected into irradiated NSG mice, which were randomized upon documented engraftment to receive IACS-010759 or vehicle (n = 3/group). The antileukemia efficacy of the treatment was monitored by serial measurements of circulating AML cells. Of the 9 models tested, we defined 4 PDXs as sensitive and 5 as resistant to OxPhos inhibitor therapy. In the resistant models, CAGE analysis of OxPhosi-induced changes (comparing pretreatment with posttreatment) identified upregulation of 77 promoters and downregulation of 207 promoters (log 2-fold change &gt; 3.0, FDR &lt; 0.05, EdgeR), including increased promoter expression (&gt;3.0 fold) of genes associated with adhesion (CCR8,ADGRB2, LAG3, BMF, ATN1, PLXDC1), migration (CCR8, NKX3-2, TMEM123, IGLV7-43, FAM171A1, LBX2, TRAV21, PPP2R5C, BMF, PLXDC1), and actin cytoskeleton dynamics (FAM171A1, BMF, BEST1, PLXDC1). Of note, the 6 adhesion-associated promoters that were upregulated by OxPhosi in 5 of the OxPhosi-resistant mouse models were unchanged or downregulated in the 4 OxPhosi-sensitive models. We then used DEGseq, an R package for identifying differentially expressed genes, to identify promoters whose expression was different between OxPhosi-treated and vehicle-treated groups in the OxPhosi-resistant mouse models. DEGseq detected consistent changes of 214 upregulated and 626 downregulated promoters with OxPhosi treatment in all 5 mouse models. KEGG pathway enrichment analysis was performed with these consistently changed genes and revealed that OxPhos inhibitor treatment significantly upregulated the transcripts of cell adhesion pathway. We then confirmed that BM derived mesenchymal stem cells (MSC) protected OxPhosi-sensitive OCI-AML3 cells; the IC50 of IACS-010759 under MSC coculture was 80-fold higher than in monoculture conditions (IC50; 0.04 nM in monoculture vs. 3.25 nM in coculture), and IACS-010759 (10nM) induced 55% reduction of viable cells in coculture condition as compared to 70% reduction in monoculture. We further observed that OCI-AML3 cells adhered to MSCs were more profoundly protected from OxPhosi induced apoptosis than nonadherent cells. These results indicate that BM stromal cells, in particular those in direct contact with leukemia cells, play a key role in the microenvironment-mediated protection of AML cells from metabolic stress caused by OxPhos blockade. We further observed promoter upregulation of ASS1, coding Argininosuccinate Synthase 1 and of LRP1, coding LDL Receptor Related Protein 1. Argininosuccinate Synthase 1 is an epigenetically regulated key enzyme in the biosynthesis of arginine and energy starvation that induces adaptive transcriptional upregulation of ASS1. LDL Receptor Related Protein 1 plays a major role in lipid metabolism and has been reported to be responsible for hemin-induced autophagy in leukemia cells. These might contribute to intrinsic AML resistance to OxPhosi via activation of compensatory metabolic pathways, amino acid metabolism and lipid metabolism. Taken together, our data highlight the importance of direct interaction with BM stromal cells as well as complementally modification of amino acid- and lipid metabolism for the resistance of AML cells to OxPhos inhibition. While the mechanisms of stroma-leukemia interactions are likely complex, reducing the adhesion of AML cells to nurturing stromal cells ameliorates the resistance to the metabolic and energetic consequences of OxPhos inhibition. Disclosures Andreeff: Amgen: Research Funding; Centre for Drug Research & Development; Cancer UK; NCI-CTEP; German Research Council; Leukemia Lymphoma Foundation (LLS); NCI-RDCRN (Rare Disease Clin Network); CLL Founcdation; BioLineRx; SentiBio; Aptose Biosciences, Inc: Membership on an entity's Board of Directors or advisory committees; Daiichi-Sankyo; Jazz Pharmaceuticals; Celgene; Amgen; AstraZeneca; 6 Dimensions Capital: Consultancy; Daiichi-Sankyo; Breast Cancer Research Foundation; CPRIT; NIH/NCI; Amgen; AstraZeneca: Research Funding. Konopleva:Rafael Pharmaceutical: Research Funding; Reata Pharmaceutical Inc.;: Patents & Royalties: patents and royalties with patent US 7,795,305 B2 on CDDO-compounds and combination therapies, licensed to Reata Pharmaceutical; Sanofi: Research Funding; AstraZeneca: Research Funding; Cellectis: Research Funding; AbbVie: Consultancy, Research Funding; Ablynx: Research Funding; Agios: Research Funding; Ascentage: Research Funding; Eli Lilly: Research Funding; Forty-Seven: Consultancy, Research Funding; Stemline Therapeutics: Consultancy, Research Funding; Amgen: Consultancy; F. Hoffmann La-Roche: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; Kisoji: Consultancy; Calithera: Research Funding.

Abstract Background Considering the global refugee crisis, there is an increasing demand on primary care physicians to be able to adequately assess and address the health care needs of individual refugees, including both the somatic and psychiatric spectra. Meanwhile, intercultural consultations are often described as challenging, and studies exploring physician–patient communication focusing on emotional distress are lacking. Therefore, the aim was to explore physician–patient communication, with focus on cultural aspects of emotional distress in intercultural primary care consultations, using a grounded theory approach, considering both the physician’s and the patient’s perspective. Methods The study was set in Region Stockholm, Sweden. In total, 23 individual interviews and 3 focus groups were conducted. Resident physicians in family medicine and patients with refugee backgrounds, originating from Somalia, Syria, Afghanistan and Iraq, were included. Data was analysed using a grounded theory approach. Results Over time, primary care patients with refugee backgrounds seemed to adopt a culturally congruent model of emotional distress. Gradual acceptance of psychiatric diagnoses as explanatory models for distress and suffering was noted, which is in line with current tendencies in Sweden. This acculturation might be influenced by the physician. Three possible approaches used by residents in intercultural consultations were identified: “biomedical”, “didactic” and “compensatory”. They all indicated that diagnoses are culturally valid models to explain various forms of distress and may thus contribute to shifting patient perceptions of psychiatric diagnoses. Conclusions Physicians working in Swedish primary care may influence patients’ acculturation process by inadvertently shifting their perceptions of psychiatric diagnoses. Residents expressed concerns, rather than confidence, in dealing with these issues. Focusing part of their training on how to address emotional distress in an intercultural context would likely be beneficial for all parties concerned.

Abstract Background: Primary health care provision in terms of quality, equity, and costs are different by countries. The Quality and Costs of Primary Care (QUALICOPC) study evaluated these domains and parameters in 35 countries, using uniformized method with validated questionnaires filled out by family physicians/general practitioners (GPs). This paper aims to provide data of the Hungarian-arm of the QUALICOPC study and to give an overview about the recent Hungarian primary care (PC) system. Methods: The questionnaires were completed in 222 Hungarian GP practices, delivered by fieldworkers, in a geographically representative distribution. Descriptive analysis was performed on the data. Findings: Financing is based mostly on capitation, with additional compensatory elements and minor financial incentives. The gate-keeping function is weak. The communication between GPs and specialists is often insufficient. The number of available devices and equipment are appropriate. Single-handed practices are predominant. Appointment instead of queuing is a new option and is becoming more popular, mainly among better-educated and urban patients. GPs are involved in the management of almost all chronic condition of all generations. Despite the burden of administrative tasks, half of the GPs estimate their job as still interesting, burn-out symptoms were rarely found. Among the evaluated process indicators, access, continuity, comprehensiveness, and coordination were rated as satisfactory, together with equity among health outcome indicators. Financing is insufficient; therefore, many GPs are involved in additional income-generating activities. The old age of the GPs and the lack of the younger GPs generation contributes to a shortage in manpower. Cooperation and communication between different levels of health care provision should be improved, focusing better on community orientation and on preventive services. Financing needs continuous improvement and appropriate incentives should be implemented. There is a need for specific PC-oriented guidelines to define properly the tasks and competences of GPs.

Abstract STUDY QUESTION What are the knowledge and views of UK-based women towards egg donation (ED) and egg sharing (ES)? SUMMARY ANSWER Lacking knowledge of the practices of ED and ES could be an influential factor in donor egg shortages, rather than negative perceptions or lack of donor anonymity and financial incentives. WHAT IS KNOWN ALREADY The increasing age of women trying to conceive has led to donor egg shortages, with ED and ES failing to meet demand. Indeed, in recent years in the UK, ES numbers have fallen. This results in long waiting lists, forcing patients abroad for fertility treatment to take up cross border reproductive care. Previous research suggests a lack of knowledge of ED among members of the general public; however, no study has yet assessed knowledge or views of ES in the general public. STUDY DESIGN, SIZE, DURATION Six hundred and thirty-five UK-based women over 18 years were voluntarily recruited from social media community groups by convenience sampling. The recruitment period was from February to April 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants completed a previously validated questionnaire regarding female fertility, ED and ES, including knowledge, perceptions and approval of the practices and relevant legislation. This included ranking key benefits and issues regarding egg sharing. The questionnaire was completed using the online Qualtrics survey software. Statistical analysis was conducted using SPSS. MAIN RESULTS AND THE ROLE OF CHANCE Regarding knowledge of ED and ES, 56.3% and 79.8%, respectively had little or no prior knowledge. Upon explanation, most approved of ED (85.8%) and ES (70.4%). A greater proportion of respondents would donate to a family member/friend (49.75%) than to an anonymous recipient (35.80%). Overall, ES was viewed less favourably than ED, with ethical and practical concerns highlighted. Women aged 18–30 years were significantly more likely to approve of egg donation practice compared to those aged &gt;30 years (P &lt; 0.0001). Those against ES found fears of financial coercion or negative psychological wellbeing the most concerning. About 35.8% and 49.7% would personally consider anonymous and known ED, respectively, whilst 56.7% would consider ES. Those answering in favour of egg sharing were significantly more likely to give higher benefit ratings compared to those against the practice (P &lt; 0.001). Most agreed (55.8%) with and were not deterred to donate (60.1%) by the ‘Disclosure of Donor Identity’ legislation. Only 31.6% agreed with the compensatory cap; however, 52.7% would not be more motivated to donate by an increased cap. LIMITATIONS, REASONS FOR CAUTION There were several limitations of the study, including the use of convenience sampling and the voluntary nature of participation opening the study up to sampling and participation bias. Finally, closed questions were predominantly used to allow the generation of quantitative data and statistical analysis. However, this approach prevented opinion justification and qualitative analysis, limiting the depth of conclusions drawn. WIDER IMPLICATIONS OF THE FINDINGS To our knowledge, this is the first study to survey the general public’s knowledge and views of ED/ES using a previously validated questionnaire. The conclusion that lack of knowledge could be contributing to the current donor shortfall in the UK demonstrates that campaigns to inform women of the practices are necessary to alleviate donor oocyte shortages. STUDY FUNDING/COMPETING INTEREST(S) No external funds were used for this study. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER NA.

This article will look at the use of personal photographs that attempt to convey a sense of social activism as a reaction against global terrorism. Moreover, I argue that the photographs uploaded to the site “We’re Not Afraid”, which began after the London bombings in 2005, presents a forum to promote the pleasures of western cultural values as a defence against the anxiety of terror. What is compelling are the ways in which the Website promotes, seemingly, everyday modalities through what may be deemed as the domestic snapshot. Nevertheless, the aura from the context of these images operates to arouse the collective memory of terrorism and violence. It promotes photography’s spectacular power. To begin it is worthwhile considering the ways in which the spectacle of terrorism is mediated. For example, the bombs activated on the London Underground and at Tavistock Square on the 7th of July 2005 marked the day that London became a victim of ‘global’ terrorism, re-instilling the fear projected by the media to be alarmed and to be suspicious. In the shadow of the terrorist events of September 11, as well as the Madrid Bombings in 2004, the incidents once again drew attention to the point that in the Western world ‘we’ again can be under attack. Furthermore, the news media plays a vital role in mediating the reality and the spectacle of terrorist attacks in the display of visual ‘proof’. After the London bombings of 7 July 2005, the BBC Website encouraged photo submissions of the incidents, under the heading “London Explosions: Your Photos”, thus promoting citizen journalism. Within six hours the BBC site received more that 1000 photographs. According to Richard Sambrook, director of the BBC’s World Service and Global News division, “people were participating in our coverage in way we had never seen before” (13). Other news Websites, such as Reuters and MSNBC also set up a similar call and display of the incidents. The images taken by everyday people and survivors‚ suggest a visceral response to the trauma of terrorism in which they became active participants in the reportage. Leading British newspapers further evoked the sensational terror of the incidents through the captioning of horrific images of destruction. It contextualised them within the realm of fascination and fear with headlines such as “London’s Day of Terror” from the Guardian, “Terror Comes to London” from the Independent and “Al-Qa’eda Brings Terror to the Heart of London” from the Daily Telegraph (“What the Papers Say”). Roland Barthes notes that “even from the perspective of a purely immanent analysis, the structure of the photograph is not an isolated structure; it is in communication with at least one other structure, namely the text – title, caption or article – accompanying every press photograph” (16). He suggested that, with the rise to prominence of ‘the press photograph’ as a mode of visual communication, the traditional relationship between image and text was inverted: “it is not the image which comes to elucidate or ‘realize’ the text, but the latter which comes to sublimate, patheticize or rationalize the image” (25). Frederic Jameson raises a very important point in regards to the role the media plays in terror. He suggests that the Western media is not only affected by a permanent condition of amnesia, but that this has become its primary ‘informational function’ (20). Hence, terror images are constantly repeated for their affect. “When combined with the media, terrorism’s reality-making power is astounding: its capacity to blend the media’s sensational stories, old mythical stereotypes, and a burning sense of moral wrath” (Zulaika and Douglass ix). Susan Sontag, in her 2003 book Regarding the Pain of Others, also discusses the assault of images (116). She argues that “the iconography of suffering has a long pedigree. The sufferings most often deemed worthy of representation are those understood to be the product of wrath, divine or human” (40). Furthermore, globalisation has profoundly changed the rhetoric of terrorism in which the uses of photographs for political means are ubiquitous. Sontag argues that “it seems as if there is a greater quantity of such news than before” (116). Nevertheless, she stresses, “it seems normal to turn away from images that simply make us feel bad” (116). Rather, than the focus on images of despair, the “We’re Not Afraid” Website provides a reaction against visual assaults. The images suggest a turning away from the iconography of terror and suffering to a focus on everyday western middle-class modalities. The images on the site consist of domestic ritual photographic practices, such as family snapshots. The images were disseminated following what has been referred to as the ‘incidents’ by the British press of the attacks on 7 July on the London transport system. Significantly, rather than being described as an event, such as the September 11 terrorist assaults were, the term ‘incidents’ suggests that everyday modalities, the everyday ways of being, may not be affected despite the terror of the attacks. It is, perhaps, a very British approach to the idea of ‘moving on’ despite adversity, which the Website advocates. The Website invites the general public to upload personal photographs captioned with the phrase “We’re not afraid” to “show that terrorists would not change the way people lived their lives” (Clarke).The Website began on 7 July 2005 and during the first week the site received, at times, up to 15 images a minute from across the world (Nikkah). Notably, within days of the Website’s launch it received over 3500 images and 11 million hits (Clarke).The images taken by everyday people and survivors‚ suggest a visceral response to the incidents. These images seem to support Susan Sontag’s argument from On Photography, in which she argues that photography is mainly a social rite, a defence against anxiety, and a tool of power (8). The images present a social activism for the predominantly white middle-class online participants and, as such, is subversive in its move away from the contextualised sensational images of violence that abound in the mainstream press. According to the site’s creator, London Web designer, Alfie Dennen “the idea for this site came from a picture of one of the bombed trains sent from a mobile phone to Dennen’s own weblog. Someone else added the words ‘We’re Not Afraid’ alongside the image” (“‘Not Afraid’ Website Overwhelmed”). Hence, in Dennen’s Weblog the terror and trauma of the train images of the London underground, that were circulated in the main stream press, have been recontextualised by the caption to present defiance and survival. The images uploaded onto the Website range from personal snapshots to manipulated photographs which all bear the declaration: ‘We are not afraid’. Currently, there are 770 galleries with 24 images per gallery amounting to around 18500 images that have been sent to the site. The photographs provide a crack in the projected reality of terrorism and the iconography of suffering as espoused by the mainstream media. The Website claims: We’re not afraid is an outlet for the global community to speak out against the acts of terror that have struck London, Madrid, New York, Baghdad, Basra, Tikrit, Gaza, Tel-Aviv, Afghanistan, Bali, and against the atrocities occurring in cities around the world each and every day. It is a worldwide action for people not willing to be cowed by terrorism and fear mongering. It suggests that: The historical response to these types of attacks has been a show of deadly force; we believe that there is a better way. We refuse to respond to aggression and hatred in kind. Instead, we who are not afraid will continue to live our lives the best way we know how. We will work, we will play, we will laugh, we will live. We will not waste one moment, nor sacrifice one bit of our freedom, because of fear. We are not afraid. (“we’re not afraid.com: Citizens for a secure world, united against terror.”) The images evoke the social memory of our era of global terrorism. Arguably, the events since September 11 have placed the individual in a protection mode. The photographs represent, as Sontag espouses, a tool against the anxiety of our time. This is a turn away from the visual iconography of despair. As such, rather than images of suffering they are images of survival, or life carrying on as usual. Or, more precisely, the images represent depictions of everyday western middle-class existence. The images range from family snaps, touristic photographs, pictures of the London underground and some manipulated images all containing the words ‘We’re Not Afraid’. Dennen “said the site had become a symbol for people to show solidarity with London and say they will not be cowed by the bombings” (“‘Not Afraid’ Website Overwhelmed”). The photographs also serve as a form of protection of western middle-class values and lifestyle that may be threatened by terrorist acts. Of consideration is that “personal photographs not only bind us to our own pasts – they bind us to the pasts of the social groups to which we belong” (Gye 280). The images on the site may be described as a “revocation of social power through visibility” and as such photography is considered a “performance of power” (Frosh 46). Barthes asserts that “formerly, the image illustrated the text (made it clearer); today, the text loads the image, burdening it with a culture, a moral, an imagination” (25). The images loaded onto the Website “We’re Not Afraid’ assumes notions of resilience and defiance which can be closely linked to Anglo-American cultural memory and imagination. Significantly, efforts to influence ‘heart and minds’ through support of touring exhibitions were common in the earlier days of the Cold War. Sontag argues that “photographic collections can be used to substitute a world” (162). The images exalted a universal humanism, similarly to the images on the “We’re Not Afraid” site. Many exhibits were supported throughout the 1950s, often under the auspices of the USIA (United States Information Agency). A famous example is the photography exhibit ‘The Family of Man’ which travelled to 28 countries between 1955-59 and was seen by 9 million people (Kennedy 316). It contained 503 images, 273 photographers from 68 nations “it posited humanity as a universal ideal and human empathy as a compensatory response to the threat of nuclear annihilation” (Kennedy 322). Significantly, Liam Kennedy asserts that, the Cold War rhetoric surrounding the exhibition blurred the boundaries between art, information and propaganda. The exhibition has been critiqued ideologically as an imperialist project, most notably by Allan Sekula in which he states “the worldliness of photography is the outcome, not of any immanent universality of meaning, but of a project of global domination” (96). In more recent times an exhibition, backed by the US State Department titled ‘After September 11: Images from Ground Zero’, by photojournalist/art photographer Joel Meyorowitz travelled to more than 60 countries and assisted in shaping and maintaining a public memory of the attacks of the World Trade Centre and its aftermath (Kennedy 315). Similar, to ‘The Family of Man’, it adds an epic quality to the images. As Kennedy points out that: To be sure this latter exhibit has been more overtly designed as propaganda, yet it also carries the cachet of ‘culture’ (most obviously, via the signature of a renowned photographer) and is intended to transmit a universal message that transcends the politics of difference. (Kennedy 323) The Website “We’re Not Afraid’ maintains the public memory of terrorism, without the horror of suffering. With a ‘universal message’ similar to the aforementioned exhibitions, it attempts to transcends the politics of difference by addressing the ‘we’ as the ‘everyday’ citizen. It serves as a gallery space and similarly evokes western romantic universal ideals conveyed in the exhibition ‘The Family of Man’, whilst its aesthetic forms avoid the stylististically captured scenes of ‘After September 11’. As stated earlier, the site had over 11 million hits in the first few weeks; as such the sheer number of viewers exceeds that of any formal photographic exhibition. Moreover, unlike these highly constructed art exhibitions from leading professional photographers, the Website significantly presents a democratic form of participation in which the ‘personal is political’. It is the citizen journalist. It is the ‘everyday’ person, as evidenced in the predominant snapshot aesthetics and the ordinariness in the images that are employed. Kris Cohen, in his analysis of photoblogging suggests that this aesthetic emphasises the importance in “photoblogging of not thinking too much, of the role that instinct plays in the making of photographs and the photoblog” (890). As discussed, previously, the overwhelming response and contributions to the Website within days of its launch seems to suggest this. The submission of photographs suggests a visceral response to the incidents from the ‘people’ in the celebration of the ‘everyday’ and the mundane. It also should be noted that “there are now well over a million documented blogs and photoblogs in the world”, with most appearing since 2003 (Cohen 886). As Cohen suggests “their newfound popularity has provoked a gentle storm of press, along with a significant number of utopic scenarios in which blogs feature as the next emancipatory mass media product”(886). The world-wide press coverage for the “We’re Not Afraid’ site is one key example that promotes this “utopian vision of transfigured citizens and in Benedict Anderson’s well used term an ‘imagined community” (Goggin xx). Nevertheless, the defiant captioning of the images also returns us historically to the social memory of the London Blitz 1940-41 in which the theme of a transfigured community was employed and in which the London underground and shelters became a signifier for the momentum of “We’re Not Afraid’. Barthes explained in Mythologies about the “the sight of the ‘naturalness’ with which newspapers, art and common sense constantly dress up a reality which, even though it is the one we live in, is undoubtedly determined by history” (11). What I want to argue is that the mythology surrounding the London bombings articulated in the Website “We’re Not Afraid’ is determined by 20th Century history of the media and the cultural imaginary surrounding predominantly British values*.** *The British Prime Minister at the time, Tony Blair, asserted that “qualities of creativity built on tolerance, openness and adaptability, work and self improvement, strong communities and families and fair play, rights and responsibilities and an outward looking approach to the world that all flow from our unique island geography and history.” (“Blair Defines British Values”). These values are suggested in the types of photographs uploaded onto the activist Website, as such notions of the British Empire are evoked. Moreover, in his address following the incident, “Blair harkened back to the ‘Blitz spirit’ that saw Londoners through the dark days of Nazi bombing during World War II — and, by association, to Winston Churchill, the wartime leader whose determined, moving speeches helped steel the national resolve” (“Blair Delivers”). In his Churchillian cadence he paid “tribute to the stoicism and resilience of the people of London who have responded in a way typical of them”. He said Britain would show “by our spirit and dignity” that “our values will long outlast” the terrorists. He further declared that “the purpose of terrorism is just that. It is to terrorize people and we will not be terrorized” (“Blair Delivers”). The mythology of the Blitz and “the interpretive context at the time (and for some years thereafter) can be summarized by the phrase ‘the People’s War’—a populist patriotism that combined criticism of the past with expectations of social change and inclusive messages of shared heritage and values” (Field 31). The image conveyed is of a renewed sense of community. The language of triumph against adversity and the endurance of ordinary citizens are also evoked in the popular press of the London incidents. The Times announced: Revulsion and resolve: Despite the shock, horror and outrage, the calm shown in London was exemplary. Ordinary life may be inconvenienced by the spectre of terror, yet terrorism will not force free societies to abandon their fundamental features. An attack was inevitable. The casualties were dreadful. The terrorists have only strengthened the resolve of Britain and its people. (“What the Papers Say”) Similarly the Daily Express headline was “We Britons Will Never Be Defeated” (“What the Papers Say”). The declaration of “We’re not afraid” alongside images on the Website follows on from this trajectory. The BBC reported that the Website “‘We’re not afraid’ gives Londoners a voice” (“Not Afraid Website Overwhelmed”). The BBC has also made a documentary concerning the mission and the somewhat utopian principles presented. Similarly discussion of the site has been evoked in other Weblogs that overwhelmingly praise it and very rarely question its role. One example is from a discussion of “We’re Not Afraid” on another activist site titled “World Changing: Change Your Thinking”. The contributor states: Well, I live in the UK and I am afraid. I’m also scared that sites like We’re Not Afraid encourage an unhealthy solidarity of superiority, nationalism and xenophobia – perpetuating a “we’re good” and “they’re evil” mentality that avoids the big picture questions of how we got here. Posted by: John Norris at July 8, 2005 03:45 AM Notably, this statement also reiterates the previous argument on cultural diplomacy presented by theorists in regards to the exhibitions of ‘The Family of Man’ and ‘After September 11’ in which the images are viewed as propaganda, promoting western cultural values. This is also supported by the mood of commentary in the British press since the London bombings, in which it is argued that “Britain and the British way of life are under threat, the implication being that the threat is so serious that it may ultimately destroy the nation and its values” (King). The significance of the Website is that it represents a somewhat democratic medium in its call for engagement and self-expression. Furthermore, the emancipatory photography of self and space, presented in the “We’re Not Afraid” site, echoes Blair’s declaration of “we will not be terrorized”. However, it follows similar politically conservative themes that were evoked in the Blitz, such as community, family and social stability, with tacit reference to social fragmentation and multi-ethnicity (Field 41-42). In general, as befitted the theme of “a People’s War,” the Blitz imagery was positive and sympathetic in the way it promoted the endurance of the ordinary citizen. Geoffrey Field suggests “it offered an implicit rejoinder to the earlier furor—focusing especially on brave, caring mothers who made efforts to retain some semblance of family under the most difficult circumstances and fathers who turned up for work no matter how heavy the bombing had been the night before” (24). Images on the Website consist of snapshots of babies, families, pets, sporting groups, people on holiday and at celebrations. It represents a, somewhat, global perspective of middle-class values. The snapshot aesthetic presents, what Liz Kotz refers to as, the “aesthetics of intimacy”. It is a certain kind of photographic work which is quasi-documentary and consists of “colour images of individuals, families, or groupings, presented in an apparently intimate, unposed manner, shot in an off-kilter, snapshot style, often a bit grainy, unfocused, off-colour” (204). These are the types of images that provide the visual gratification of solidarity amongst its contributors and viewers, as it seemingly appears more ‘real’. Yet, Kotz asserts that these type of photographs also involve a structure of power relations “that cannot be easily evaded by the spontaneous performance before the lens” (210). For example, Sarah Boxer importantly points out that “We’re Not Afraid”, set up to show solidarity with London, seems to be turning into a place where the haves of the world can show that they’re not afraid of the have-nots” (1). She argues that “there’s a brutish flaunting of wealth and leisure” (1). The iconography in the images of “We’re not Afraid” certainly promotes a ‘memorialisation’ of the middle-class sphere. The site draws attention to the values of the global neoliberal order in which capital accumulation is paramount. It, nevertheless, also attempts to challenge “the true victory of terrorism”, which Jean Baudrillard circumspectly remarks is in “the regression of the value system, of all the ideology of freedom and free movement etc… that the Western world is so proud of, and that legitimates in its eyes its power over the rest of the world”. Self-confidence is conveyed in the images. Moreover, with the subjects welcoming gaze to the camera there may be a sense of narcissism in publicising what could be considered mundane. However, visibility is power. For example, one of the contributors, Maryland USA resident Darcy Nair, said “she felt a sense of helplessness in the days after 9/11. Posting on the We’re Not Afraid may be a small act, but it does give people like her a sense that they’re doing something” (cited in Weir). Nair states that: It seems that it is the only good answer from someone like me who’s not in the government or military…There are so many other people who are joining in. When bunches of individuals get together – it does make me feel hopeful – there are so many other people who feel the same way. (cited in Weir) Participation in the Website conveys a power which consists of defiantly celebrating western middle-class aesthetics in the form of personal photography. As such, the personal becomes political and the private becomes public. The site offers an opportunity for a shared experience and a sense of community that perhaps is needed in the era of global terrorism. It could be seen as a celebration of survival (Weir). The Website seems inspirational with its defiant message. Moreover, it also has postings from various parts of the world that convey a message of triumph in the ‘everyday’. The site also presents the ubiquitous use of photography in a western cultural tradition in which idealised constructions are manifested in ‘Kodak’ moments and in which the domestic space and leisure times are immortalised and become, significantly, the arena of activism. As previously discussed Sontag argues that photography is mainly a social rite, a defence against anxiety, and a tool of power (8). The Website offers the sense of a global connection. It promotes itself as “citizens for a secure world, united against terror”. It attempts to provide a universal solidarity, which appears uplifting. It is a defence against anxiety in which, in the act of using personal photographs, it becomes part of the collective memory and assists in easing the frustration of not being able to do anything. As Sontag argues “often something looks, or is felt to look ‘better’ in a photograph. Indeed, it is one of the functions of photography to improve the normal appearance of things” (81). Rather than focus on the tragic victim of traditional photojournalism, in which the camera is directed towards the other, the site promotes the sharing and triumph of personal moments. In the spotlight are ‘everyday’ modalities from ‘everyday people’ attempting to confront the rhetoric of terrorism. In their welcoming gaze to the camera the photographic subjects challenge the notion of the sensational image, the spectacle that is on show is that of middle-class modalities and a performance of collective power. Note Themes from this article have been presented at the 2005 Cultural Studies Association of Australasia Conference in Sydney, Australia and at the 2006 Association for Cultural Studies Crossroads Conference in Istanbul, Turkey. References Barthes, Roland. “The Photographic Message.” Image-Music-Text. Trans. Stephen Heath. New York: Noonday Press, 1977 [1961]. 15-31. Barthes, Roland. Mythologies. Trans. Annette Lavers. London: Vintage, 1993 [1972]. Baudrillard, Jean. “The Spirit of Terrorism.” Trans. Rachel Bloul. La Monde 2 (2001). < http://www.egs.edu/faculty/baudrillard/baudrillard-the-spirit-of-terrorism.html >. “Blair Defines British Values.” BBC News 28 Mar. 2000. < http://news.bbc.co.uk/1/hi/uk_politics/693591.stm >. “Blair Delivers a Classically British Rallying Cry.” Associated Press 7 July 2005. < http://www.msnbc.msn.com/id/8502984/ >. Boxter, Sarah. “On the Web, Fearlessness Meets Frivolousness.” The York Times 12 July 2005. < http://www.nytimes.com/2005/07/12/arts/design/12boxe.html?ex= 1278820800&en=e3b207245991aea8&ei=5088&partner=rssnyt&emc=rss >. Clarke, R. “Web Site Shows Defiance to Bombers: Thousands Send Images to Say ‘We Are Not Afraid.’” CNN International 12 July 2005. < http://edition.cnn.com/2005/WORLD/europe/07/11/london.website/ >. “CJ Bombings in London.” MSNBC TV Citizen Journalist. < http://www.msnbc.msn.com/id/8499792/ >. Cohen, Kris R. “What Does the Photoblog Want?” Media, Culture & Society 27.6 (2005): 883-901. Dennen, Alfie. “We’renotafraid.com: Citizens for a Secure World, United Against Terror.” < http://www.werenotafraid.com/ >. Field, Geoffrey. “Nights Underground in Darkest London: The Blitz, 1940–1941.” International Labor and Working-Class History 62 (2002): 11-49. Frosh, Paul. “The Public Eye and the Citizen-Voyeur: Photography as a Performance of Power.” Social Semiotics 11.1 (2001): 43-59. Gye, Lisa. “Picture This: The Impact of Mobile Camera Phones on Personal Photographic Practices.” Continuum: Journal of Media and Cultural Studies 22.2 (2007): 279-288. Jameson, Fredric. “Postmodernism and Consumer Society.” The Cultural Turn: Selected Writings on the Postmodern. New York: Verso, 1998. 1-20. Kennedy, Liam. “Remembering September 11: Photography as Cultural Diplomacy.” International Affairs 79.2 (2003): 315-326. King, Anthony. “What Does It Mean to Be British?” Telegraph 27 May 2005. < http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2005/07/27/ nbrit27.xml >. Kotz, Liz. “The Aesthetics of Intimacy.” In D. Bright (ed.), The Passionate Camera: Photography and Bodies of Desire. London: Routledge, 1998. 204-215. “London Explosions: Your Photos.” BBC News 8 July 2005 < http://news.bbc.co.uk/1/hi/in_pictures/4660563.stm >. Nikkhah, Roya. “We’restillnotafraid.com.” Telegraph co.uk 23 July 2005. < http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2005/07/24/ nseven224.xml >. “‘Not Afraid’ Website Overwhelmed.” BBC News 12 July 2005. < http://news.bbc.co.uk/go/pr/fr/-/1/hi/england/london/4674425.stm >. Norris, John. “We’re Not Afraid”. World Changing: Change Your Thinking. < http://www.worldchanging.com/archives/003069.html >. “Reuters: You Witness News.” < http://www.reuters.com/youwitness >. Sambrook, Richard. “Citizen Journalism and the BBC.” Nieman Reports (Winter 2005): 13-16. Sekula, Allan. “The Traffic in Photographs.” In Photography against the Grain: Essays and Photoworks 1973-1983. Halifax Nova Scotia: Nova Scotia College Press, 1984. Sontag, Susan. Regarding the Pain of Others. New York: Farrar, Strauss & Giroux, 2003. Sontag. Susan. On Photography. New York: Farrar, Strauss & Giroux, 1977. Weir, William. “The Global Community Support and Sends a Defiant Message to Terrorists.” Hartford Courant 14 July 2005. < http://www.uchc.edu/ocomm/newsarchive/news05/jul05/notafraid.html >. We’renot afraid.com: Citizens for a Secure World, United against Terror. < http://www.werenotafraid.com >. “What the Papers Say.” Media Guardian 8 July 2005. < http://www.guardian.co.uk/media/2005/jul/08/pressandpublishing.terrorism1 >. Zulaika, Joseba, and William A. Douglass. Terror and Taboo: The Follies, Fables, and Faces of Terrorism. New York: Routledge, 1996.

This article will look at the use of personal photographs that attempt to convey a sense of social activism as a reaction against global terrorism. Moreover, I argue that the photographs uploaded to the site “We’re Not Afraid”, which began after the London bombings in 2005, presents a forum to promote the pleasures of western cultural values as a defence against the anxiety of terror. What is compelling are the ways in which the Website promotes, seemingly, everyday modalities through what may be deemed as the domestic snapshot. Nevertheless, the aura from the context of these images operates to arouse the collective memory of terrorism and violence. It promotes photography’s spectacular power. To begin it is worthwhile considering the ways in which the spectacle of terrorism is mediated. For example, the bombs activated on the London Underground and at Tavistock Square on the 7th of July 2005 marked the day that London became a victim of ‘global’ terrorism, re-instilling the fear projected by the media to be alarmed and to be suspicious. In the shadow of the terrorist events of September 11, as well as the Madrid Bombings in 2004, the incidents once again drew attention to the point that in the Western world ‘we’ again can be under attack. Furthermore, the news media plays a vital role in mediating the reality and the spectacle of terrorist attacks in the display of visual ‘proof’. After the London bombings of 7 July 2005, the BBC Website encouraged photo submissions of the incidents, under the heading “London Explosions: Your Photos”, thus promoting citizen journalism. Within six hours the BBC site received more that 1000 photographs. According to Richard Sambrook, director of the BBC’s World Service and Global News division, “people were participating in our coverage in way we had never seen before” (13). Other news Websites, such as Reuters and MSNBC also set up a similar call and display of the incidents. The images taken by everyday people and survivors‚ suggest a visceral response to the trauma of terrorism in which they became active participants in the reportage. Leading British newspapers further evoked the sensational terror of the incidents through the captioning of horrific images of destruction. It contextualised them within the realm of fascination and fear with headlines such as “London’s Day of Terror” from the Guardian, “Terror Comes to London” from the Independent and “Al-Qa’eda Brings Terror to the Heart of London” from the Daily Telegraph (“What the Papers Say”). Roland Barthes notes that “even from the perspective of a purely immanent analysis, the structure of the photograph is not an isolated structure; it is in communication with at least one other structure, namely the text – title, caption or article – accompanying every press photograph” (16). He suggested that, with the rise to prominence of ‘the press photograph’ as a mode of visual communication, the traditional relationship between image and text was inverted: “it is not the image which comes to elucidate or ‘realize’ the text, but the latter which comes to sublimate, patheticize or rationalize the image” (25). Frederic Jameson raises a very important point in regards to the role the media plays in terror. He suggests that the Western media is not only affected by a permanent condition of amnesia, but that this has become its primary ‘informational function’ (20). Hence, terror images are constantly repeated for their affect. “When combined with the media, terrorism’s reality-making power is astounding: its capacity to blend the media’s sensational stories, old mythical stereotypes, and a burning sense of moral wrath” (Zulaika and Douglass ix). Susan Sontag, in her 2003 book Regarding the Pain of Others, also discusses the assault of images (116). She argues that “the iconography of suffering has a long pedigree. The sufferings most often deemed worthy of representation are those understood to be the product of wrath, divine or human” (40). Furthermore, globalisation has profoundly changed the rhetoric of terrorism in which the uses of photographs for political means are ubiquitous. Sontag argues that “it seems as if there is a greater quantity of such news than before” (116). Nevertheless, she stresses, “it seems normal to turn away from images that simply make us feel bad” (116). Rather, than the focus on images of despair, the “We’re Not Afraid” Website provides a reaction against visual assaults. The images suggest a turning away from the iconography of terror and suffering to a focus on everyday western middle-class modalities. The images on the site consist of domestic ritual photographic practices, such as family snapshots. The images were disseminated following what has been referred to as the ‘incidents’ by the British press of the attacks on 7 July on the London transport system. Significantly, rather than being described as an event, such as the September 11 terrorist assaults were, the term ‘incidents’ suggests that everyday modalities, the everyday ways of being, may not be affected despite the terror of the attacks. It is, perhaps, a very British approach to the idea of ‘moving on’ despite adversity, which the Website advocates. The Website invites the general public to upload personal photographs captioned with the phrase “We’re not afraid” to “show that terrorists would not change the way people lived their lives” (Clarke).The Website began on 7 July 2005 and during the first week the site received, at times, up to 15 images a minute from across the world (Nikkah). Notably, within days of the Website’s launch it received over 3500 images and 11 million hits (Clarke).The images taken by everyday people and survivors‚ suggest a visceral response to the incidents. These images seem to support Susan Sontag’s argument from On Photography, in which she argues that photography is mainly a social rite, a defence against anxiety, and a tool of power (8). The images present a social activism for the predominantly white middle-class online participants and, as such, is subversive in its move away from the contextualised sensational images of violence that abound in the mainstream press. According to the site’s creator, London Web designer, Alfie Dennen “the idea for this site came from a picture of one of the bombed trains sent from a mobile phone to Dennen’s own weblog. Someone else added the words ‘We’re Not Afraid’ alongside the image” (“‘Not Afraid’ Website Overwhelmed”). Hence, in Dennen’s Weblog the terror and trauma of the train images of the London underground, that were circulated in the main stream press, have been recontextualised by the caption to present defiance and survival. The images uploaded onto the Website range from personal snapshots to manipulated photographs which all bear the declaration: ‘We are not afraid’. Currently, there are 770 galleries with 24 images per gallery amounting to around 18500 images that have been sent to the site. The photographs provide a crack in the projected reality of terrorism and the iconography of suffering as espoused by the mainstream media. The Website claims: We’re not afraid is an outlet for the global community to speak out against the acts of terror that have struck London, Madrid, New York, Baghdad, Basra, Tikrit, Gaza, Tel-Aviv, Afghanistan, Bali, and against the atrocities occurring in cities around the world each and every day. It is a worldwide action for people not willing to be cowed by terrorism and fear mongering. It suggests that: The historical response to these types of attacks has been a show of deadly force; we believe that there is a better way. We refuse to respond to aggression and hatred in kind. Instead, we who are not afraid will continue to live our lives the best way we know how. We will work, we will play, we will laugh, we will live. We will not waste one moment, nor sacrifice one bit of our freedom, because of fear. We are not afraid. (“we’re not afraid.com: Citizens for a secure world, united against terror.”) The images evoke the social memory of our era of global terrorism. Arguably, the events since September 11 have placed the individual in a protection mode. The photographs represent, as Sontag espouses, a tool against the anxiety of our time. This is a turn away from the visual iconography of despair. As such, rather than images of suffering they are images of survival, or life carrying on as usual. Or, more precisely, the images represent depictions of everyday western middle-class existence. The images range from family snaps, touristic photographs, pictures of the London underground and some manipulated images all containing the words ‘We’re Not Afraid’. Dennen “said the site had become a symbol for people to show solidarity with London and say they will not be cowed by the bombings” (“‘Not Afraid’ Website Overwhelmed”). The photographs also serve as a form of protection of western middle-class values and lifestyle that may be threatened by terrorist acts. Of consideration is that “personal photographs not only bind us to our own pasts – they bind us to the pasts of the social groups to which we belong” (Gye 280). The images on the site may be described as a “revocation of social power through visibility” and as such photography is considered a “performance of power” (Frosh 46). Barthes asserts that “formerly, the image illustrated the text (made it clearer); today, the text loads the image, burdening it with a culture, a moral, an imagination” (25). The images loaded onto the Website “We’re Not Afraid’ assumes notions of resilience and defiance which can be closely linked to Anglo-American cultural memory and imagination. Significantly, efforts to influence ‘heart and minds’ through support of touring exhibitions were common in the earlier days of the Cold War. Sontag argues that “photographic collections can be used to substitute a world” (162). The images exalted a universal humanism, similarly to the images on the “We’re Not Afraid” site. Many exhibits were supported throughout the 1950s, often under the auspices of the USIA (United States Information Agency). A famous example is the photography exhibit ‘The Family of Man’ which travelled to 28 countries between 1955-59 and was seen by 9 million people (Kennedy 316). It contained 503 images, 273 photographers from 68 nations “it posited humanity as a universal ideal and human empathy as a compensatory response to the threat of nuclear annihilation” (Kennedy 322). Significantly, Liam Kennedy asserts that, the Cold War rhetoric surrounding the exhibition blurred the boundaries between art, information and propaganda. The exhibition has been critiqued ideologically as an imperialist project, most notably by Allan Sekula in which he states “the worldliness of photography is the outcome, not of any immanent universality of meaning, but of a project of global domination” (96). In more recent times an exhibition, backed by the US State Department titled ‘After September 11: Images from Ground Zero’, by photojournalist/art photographer Joel Meyorowitz travelled to more than 60 countries and assisted in shaping and maintaining a public memory of the attacks of the World Trade Centre and its aftermath (Kennedy 315). Similar, to ‘The Family of Man’, it adds an epic quality to the images. As Kennedy points out that: To be sure this latter exhibit has been more overtly designed as propaganda, yet it also carries the cachet of ‘culture’ (most obviously, via the signature of a renowned photographer) and is intended to transmit a universal message that transcends the politics of difference. (Kennedy 323) The Website “We’re Not Afraid’ maintains the public memory of terrorism, without the horror of suffering. With a ‘universal message’ similar to the aforementioned exhibitions, it attempts to transcends the politics of difference by addressing the ‘we’ as the ‘everyday’ citizen. It serves as a gallery space and similarly evokes western romantic universal ideals conveyed in the exhibition ‘The Family of Man’, whilst its aesthetic forms avoid the stylististically captured scenes of ‘After September 11’. As stated earlier, the site had over 11 million hits in the first few weeks; as such the sheer number of viewers exceeds that of any formal photographic exhibition. Moreover, unlike these highly constructed art exhibitions from leading professional photographers, the Website significantly presents a democratic form of participation in which the ‘personal is political’. It is the citizen journalist. It is the ‘everyday’ person, as evidenced in the predominant snapshot aesthetics and the ordinariness in the images that are employed. Kris Cohen, in his analysis of photoblogging suggests that this aesthetic emphasises the importance in “photoblogging of not thinking too much, of the role that instinct plays in the making of photographs and the photoblog” (890). As discussed, previously, the overwhelming response and contributions to the Website within days of its launch seems to suggest this. The submission of photographs suggests a visceral response to the incidents from the ‘people’ in the celebration of the ‘everyday’ and the mundane. It also should be noted that “there are now well over a million documented blogs and photoblogs in the world”, with most appearing since 2003 (Cohen 886). As Cohen suggests “their newfound popularity has provoked a gentle storm of press, along with a significant number of utopic scenarios in which blogs feature as the next emancipatory mass media product”(886). The world-wide press coverage for the “We’re Not Afraid’ site is one key example that promotes this “utopian vision of transfigured citizens and in Benedict Anderson’s well used term an ‘imagined community” (Goggin xx). Nevertheless, the defiant captioning of the images also returns us historically to the social memory of the London Blitz 1940-41 in which the theme of a transfigured community was employed and in which the London underground and shelters became a signifier for the momentum of “We’re Not Afraid’. Barthes explained in Mythologies about the “the sight of the ‘naturalness’ with which newspapers, art and common sense constantly dress up a reality which, even though it is the one we live in, is undoubtedly determined by history” (11). What I want to argue is that the mythology surrounding the London bombings articulated in the Website “We’re Not Afraid’ is determined by 20th Century history of the media and the cultural imaginary surrounding predominantly British values*.** *The British Prime Minister at the time, Tony Blair, asserted that “qualities of creativity built on tolerance, openness and adaptability, work and self improvement, strong communities and families and fair play, rights and responsibilities and an outward looking approach to the world that all flow from our unique island geography and history.” (“Blair Defines British Values”). These values are suggested in the types of photographs uploaded onto the activist Website, as such notions of the British Empire are evoked. Moreover, in his address following the incident, “Blair harkened back to the ‘Blitz spirit’ that saw Londoners through the dark days of Nazi bombing during World War II — and, by association, to Winston Churchill, the wartime leader whose determined, moving speeches helped steel the national resolve” (“Blair Delivers”). In his Churchillian cadence he paid “tribute to the stoicism and resilience of the people of London who have responded in a way typical of them”. He said Britain would show “by our spirit and dignity” that “our values will long outlast” the terrorists. He further declared that “the purpose of terrorism is just that. It is to terrorize people and we will not be terrorized” (“Blair Delivers”). The mythology of the Blitz and “the interpretive context at the time (and for some years thereafter) can be summarized by the phrase ‘the People’s War’—a populist patriotism that combined criticism of the past with expectations of social change and inclusive messages of shared heritage and values” (Field 31). The image conveyed is of a renewed sense of community. The language of triumph against adversity and the endurance of ordinary citizens are also evoked in the popular press of the London incidents. The Times announced: Revulsion and resolve: Despite the shock, horror and outrage, the calm shown in London was exemplary. Ordinary life may be inconvenienced by the spectre of terror, yet terrorism will not force free societies to abandon their fundamental features. An attack was inevitable. The casualties were dreadful. The terrorists have only strengthened the resolve of Britain and its people. (“What the Papers Say”) Similarly the Daily Express headline was “We Britons Will Never Be Defeated” (“What the Papers Say”). The declaration of “We’re not afraid” alongside images on the Website follows on from this trajectory. The BBC reported that the Website “‘We’re not afraid’ gives Londoners a voice” (“Not Afraid Website Overwhelmed”). The BBC has also made a documentary concerning the mission and the somewhat utopian principles presented. Similarly discussion of the site has been evoked in other Weblogs that overwhelmingly praise it and very rarely question its role. One example is from a discussion of “We’re Not Afraid” on another activist site titled “World Changing: Change Your Thinking”. The contributor states: Well, I live in the UK and I am afraid. I’m also scared that sites like We’re Not Afraid encourage an unhealthy solidarity of superiority, nationalism and xenophobia – perpetuating a “we’re good” and “they’re evil” mentality that avoids the big picture questions of how we got here. Posted by: John Norris at July 8, 2005 03:45 AM Notably, this statement also reiterates the previous argument on cultural diplomacy presented by theorists in regards to the exhibitions of ‘The Family of Man’ and ‘After September 11’ in which the images are viewed as propaganda, promoting western cultural values. This is also supported by the mood of commentary in the British press since the London bombings, in which it is argued that “Britain and the British way of life are under threat, the implication being that the threat is so serious that it may ultimately destroy the nation and its values” (King). The significance of the Website is that it represents a somewhat democratic medium in its call for engagement and self-expression. Furthermore, the emancipatory photography of self and space, presented in the “We’re Not Afraid” site, echoes Blair’s declaration of “we will not be terrorized”. However, it follows similar politically conservative themes that were evoked in the Blitz, such as community, family and social stability, with tacit reference to social fragmentation and multi-ethnicity (Field 41-42). In general, as befitted the theme of “a People’s War,” the Blitz imagery was positive and sympathetic in the way it promoted the endurance of the ordinary citizen. Geoffrey Field suggests “it offered an implicit rejoinder to the earlier furor—focusing especially on brave, caring mothers who made efforts to retain some semblance of family under the most difficult circumstances and fathers who turned up for work no matter how heavy the bombing had been the night before” (24). Images on the Website consist of snapshots of babies, families, pets, sporting groups, people on holiday and at celebrations. It represents a, somewhat, global perspective of middle-class values. The snapshot aesthetic presents, what Liz Kotz refers to as, the “aesthetics of intimacy”. It is a certain kind of photographic work which is quasi-documentary and consists of “colour images of individuals, families, or groupings, presented in an apparently intimate, unposed manner, shot in an off-kilter, snapshot style, often a bit grainy, unfocused, off-colour” (204). These are the types of images that provide the visual gratification of solidarity amongst its contributors and viewers, as it seemingly appears more ‘real’. Yet, Kotz asserts that these type of photographs also involve a structure of power relations “that cannot be easily evaded by the spontaneous performance before the lens” (210). For example, Sarah Boxer importantly points out that “We’re Not Afraid”, set up to show solidarity with London, seems to be turning into a place where the haves of the world can show that they’re not afraid of the have-nots” (1). She argues that “there’s a brutish flaunting of wealth and leisure” (1). The iconography in the images of “We’re not Afraid” certainly promotes a ‘memorialisation’ of the middle-class sphere. The site draws attention to the values of the global neoliberal order in which capital accumulation is paramount. It, nevertheless, also attempts to challenge “the true victory of terrorism”, which Jean Baudrillard circumspectly remarks is in “the regression of the value system, of all the ideology of freedom and free movement etc… that the Western world is so proud of, and that legitimates in its eyes its power over the rest of the world”. Self-confidence is conveyed in the images. Moreover, with the subjects welcoming gaze to the camera there may be a sense of narcissism in publicising what could be considered mundane. However, visibility is power. For example, one of the contributors, Maryland USA resident Darcy Nair, said “she felt a sense of helplessness in the days after 9/11. Posting on the We’re Not Afraid may be a small act, but it does give people like her a sense that they’re doing something” (cited in Weir). Nair states that: It seems that it is the only good answer from someone like me who’s not in the government or military…There are so many other people who are joining in. When bunches of individuals get together – it does make me feel hopeful – there are so many other people who feel the same way. (cited in Weir) Participation in the Website conveys a power which consists of defiantly celebrating western middle-class aesthetics in the form of personal photography. As such, the personal becomes political and the private becomes public. The site offers an opportunity for a shared experience and a sense of community that perhaps is needed in the era of global terrorism. It could be seen as a celebration of survival (Weir). The Website seems inspirational with its defiant message. Moreover, it also has postings from various parts of the world that convey a message of triumph in the ‘everyday’. The site also presents the ubiquitous use of photography in a western cultural tradition in which idealised constructions are manifested in ‘Kodak’ moments and in which the domestic space and leisure times are immortalised and become, significantly, the arena of activism. As previously discussed Sontag argues that photography is mainly a social rite, a defence against anxiety, and a tool of power (8). The Website offers the sense of a global connection. It promotes itself as “citizens for a secure world, united against terror”. It attempts to provide a universal solidarity, which appears uplifting. It is a defence against anxiety in which, in the act of using personal photographs, it becomes part of the collective memory and assists in easing the frustration of not being able to do anything. As Sontag argues “often something looks, or is felt to look ‘better’ in a photograph. Indeed, it is one of the functions of photography to improve the normal appearance of things” (81). Rather than focus on the tragic victim of traditional photojournalism, in which the camera is directed towards the other, the site promotes the sharing and triumph of personal moments. In the spotlight are ‘everyday’ modalities from ‘everyday people’ attempting to confront the rhetoric of terrorism. In their welcoming gaze to the camera the photographic subjects challenge the notion of the sensational image, the spectacle that is on show is that of middle-class modalities and a performance of collective power. Note Themes from this article have been presented at the 2005 Cultural Studies Association of Australasia Conference in Sydney, Australia and at the 2006 Association for Cultural Studies Crossroads Conference in Istanbul, Turkey. References Barthes, Roland. “The Photographic Message.” Image-Music-Text. Trans. Stephen Heath. New York: Noonday Press, 1977 [1961]. 15-31. Barthes, Roland. Mythologies. Trans. Annette Lavers. London: Vintage, 1993 [1972]. Baudrillard, Jean. “The Spirit of Terrorism.” Trans. Rachel Bloul. La Monde 2 (2001). http://www.egs.edu/faculty/baudrillard/baudrillard-the-spirit-of-terrorism.html>. “Blair Defines British Values.” BBC News 28 Mar. 2000. http://news.bbc.co.uk/1/hi/uk_politics/693591.stm>. “Blair Delivers a Classically British Rallying Cry.” Associated Press 7 July 2005. http://www.msnbc.msn.com/id/8502984/>. 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