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Implementing a Nurse-Driven Spontaneous Awakening and Breathing Trial Protocol in the Intensive Care Unit
No full textD.N.P.Patients admitted to the Intensive Care Unit are a particularly vulnerable population, especially when they require mechanical ventilation. While patients are intubated, nurse-driven Spontaneous Awakening Trials (SATs) and Spontaneous Breathing Trials (SBTs) protocols, have been shown to be effective methods of assessing a patient’s ability to be liberalized from the ventilator. Optimizing the time of mechanical ventilatory liberalization can reduce ventilator-acquired complications. In a 32-bed mixed medical-surgical ICU, nursing staff lacked knowledge and confidence about which patients were appropriate candidates for SATs and SBTs, requiring the ICU providers to drive these protocols forward. Because of this, a quality improvement project was formed, and an E-learning module was created to educate the nursing staff about nurse-driven SAT and SBT protocols. The primary aim of this project was to decrease ventilator times in hours and the quantity of sedatives administered to ventilated patients through the use of a nurse-driven SAT and SBT protocol. The secondary aims were to increase nursing knowledge of sedation and ventilator weaning and nursing confidence with sedation and ventilator weaning. After the implementation of the E-learning module, the mean ventilator time over three months measured in days of 148 patients was 2.86 days. There was no statistical difference compared to three months’ worth of retrospective data of 172 patients with a mean ventilator time of 3.15 days. When comparing the number of sedative medications dispensed with the retrospective data, there was no statistical difference in the utilization of propofol, midazolam, fentanyl, and dexmedetomidine. In the nursing knowledge and confidence analysis, participants were asked to take a pretest and post-test to measure changes in nursing knowledge and confidence after the E-learning module (n= 66). All participants completed the E-learning module once it was started. Results showed a statistically significant increase in mean test scores about the knowledge and a statistically significant increase in nursing confidence.
Overall, though the implementation of this E-learning module had no statistical difference in the reduction of mechanical ventilation and sedation, it significantly increased nursing knowledge and confidence related to using these protocols
Effect of Media on Tobacco Use by Chinese People
No full textM.P.P.Smoking presents as a serious public health problem in China. Past studies have focused on the relationship between media and tobacco use in countries other than China. This thesis contributes to the existing literature by exploring the impact of three categories of media – health warning labels on cigarette packages, anti-tobacco media, and tobacco advertisements – on Chinese tobacco use. This thesis uses data from the 2018 Global Adult Tobacco Survey in China. We deployed several regression analysis for each category of media to explore the relationship between media and tobacco use in China. We find no relationship between the three forms of media and tobacco use in China. However, we find that people aged 65 and above smoked significantly more manufactured cigarettes than the rest of the age group. Policies targeting people aged 65 and above could effectively reduce the number of cigarettes smoked in China
From Bad Manners in the Spanish and Belgian Sub-Saharan Colonies to a Postcolonial Aesthetic of Disgust
No full textPh.D.My dissertation examines the use of repulsive imagery by artists from former colonies and former colonizing countries. I focus on two artists from Equatorial Guinea and Congo and six artists from Spain and Belgium who reclaim disgust as a political weapon. These artists leverage disgust to sabotage both the Western decorum imposed by colonizers as well as the repression imposed by postcolonial regimes. I trace the origins of their common fixation on disgust back to colonization. Colonizers often label as disgusting any perceived transgression of Western decorum, including traditional indigenous hygiene practices and styles of dressing and speaking.By analyzing film and literature, as well as less canonical genres/media including instruction manuals, archival footage, and graphic novels, I aim to show that the imposition of Western decorum during colonization reinforces the process of racializing and alienating the colonized subjects. Sabotaging this process, artists from former colonies adopt an aesthetic of disgust as a political weapon, locating their repressive, postcolonial leaders outside of common norms of decorum. For instance, the Equatoguinean cartoonist Ramón Esono Ebalé and the Congolese author Sony Labou Tansi depict dictators who ejaculate and defecate in public. Meanwhile, artists from former colonizing countries, such as the Basque author Bernardo Atxaga and the Catalan author Albert Sánchez Piñol, contrast images of purity with the disgusting behavior of European colonizers in their novels about the Belgian Congo. By analyzing these authors together and drawing upon Gayatri Spivak’s concept of “sabotage” and Neetu Khanna’s notion of “bodily rebellion,” I define the stylistic and narrative foundations of what I call a postcolonial aesthetic of disgust. Artists use this aesthetic to engage audiences viscerally. Disgust becomes a scatological puncturing of Western repressive etiquette and the means of a radical new understanding of colonization as behavioral cleansing
Bruce on Benjamin, Race After Technology: Abolitionist Tools for the New Jim Code
No full textReview: Benjamin, R. (2019). Race after technology: Abolitionist tools for the New Jim Code. Polity Press. 198 pages. $19.95. ISBN: 978150952640
Reducing Patient Wait Times in a Primary Care Setting to Improve Patient Satisfaction
No full textD.N.P.Prolonged wait times in the primary care setting can greatly affect patient satisfaction, and ultimately, patient outcomes. The goal of this project was to assess how patient completion of a health history form and a depression screening tool while waiting to see a provider, compared to medical assistants obtaining patient intake, affected patient wait times and patient satisfaction within adults at a family medicine practice. The primary investigator of the project conducted a retrospective review of wait times in the two months prior to the implementation of the practice change. After collecting this data, the practice change was implemented over the course of a 10-week period. The practice change involved the administration of a health history intake form and the Patient Health Questionnaire-9 (PHQ-9), while the participants were waiting to be seen by their provider. For the purposes of this project, wait times were defined as the time from check-in to the time the provider marked the participant as “ready to be seen.” The participants were asked to complete a patient satisfaction survey, modeled after the Patient Satisfaction Questionnaire Short Form (PSQ-18), after being seen by their provider. The sample size was 158 individuals pre-implementation and 68 individuals post-implementation. A total of 47 individuals completed the patient satisfaction survey post-practice change. The mean pre-practice change wait time was 39.206 minutes and the mean post-practice change wait time was 39.250 minutes. The project did not produce statistically significant data (p=.494). Overall, further research is needed to reduce wait times in primary care and to evaluate the relationship between wait time and patient satisfaction
A Minority, Urban, and Cosmopolitan Group From an International Migration in Colonial Context: Spatialities and Identities of the Indians of Antananarivo, Madagascar
No full textThe Indians of Antananarivo, a tiny minority of the urban population of Madagascar’s capital, are an original social group descending from a long-standing migration throughout the Indian Ocean in a colonial context. Although they have been living in the city for several generations and often occupy dominant social positions in terms of standard of living, they are still considered foreigners by local society and are subject to stigmatization. They form a heterogeneous group, connected to the outside world through an asserted Indian identity, as well as local and international links. Thinking in terms of cosmopolitanism allows us to consider both their urban spatial anchorage and their circulations in an open, globalized world. The presence of Indians in Antananarivo, here studied throughout leisure places and cultural venues run by Indians, contributes to the city’s cosmopolitanism, albeit rarely recognized and often devalued. On an international scale, many of them develop multiple identities, ambiguously turned towards contemporary India, and above all towards France--due to the colonial past–-and close islands, in a reticular manner. In their multiple and variable identities, the Indians of Antananarivo, though numerically very marginal, synthesize many conditions of the contemporary world: postcolonial, diasporic, minority, and cosmopolitan all at once.https://doi.org/10.57928/k4sp-ac3
Examining the Impact of Government Civilian Employment on Political Violence: A State-Level Analysis of Felony Cases in the United States over Two Decades
No full textM.P.P.This study investigates the link between the civilian government employment rate and political violence occurrences across U.S. states, seeking to determine if more robust public service delivery through increased government employment could reduce political unrest. Employing state-level panel data and controlling for various economic, socio-political, and demographic variables, the results demonstrate that higher rates of government civilian employment do not correlate with decreased rates of political violence. On the contrary, an unexpected positive association was found, although this connection weakened considerably upon accounting for year-specific variations and other control factors. The findings suggest that 1) the outlier status of 2020 necessitates careful consideration in econometric and policy analyses and 2) a more significant number of government employees alone may not mitigate political violence. However, future research should explore this question more granularly to test if that assumption holds (e.g., law enforcement employment levels)
Post-Soviet Migrant Identity in Germany Through The Eyes of Generation 1.5: Multimodal Systemic Functional Linguistics-based study of Instagram Discourse
No full textPh.D.Post-Soviet migrants, as the largest migrant group in today’s Germany, often face problematic and one-sided portrayals in mainstream German media, primarily being framed as supporters of the right-wing political party Alternative für Deutschland (AfD), Putin’s regime, and as “foreign neighbors”. As “cultural hybrids” (Todorova, 2018), particularly those of “Generation 1.5” (Panagiotidis, 2021) who either were born in Germany to migrant parents or immigrated in the 1990s with their families, these individuals critically respond to these narratives using social media platforms such as Instagram.This dissertation employs an ideological framework of Positive Discourse Analysis (PDA) and a methodological framework of Systemic Functional Linguistics (SFL) to analyze Instagram discourse produced by post-Soviet migrant activists in Germany. PDA focuses on the empowering role of language, examining the discourse of dissent, resistance, and marginalized communities. SFL views language as a social semiotic system, emphasizing the meaning-making aspect of language production. By analyzing all three semiotic genres of an Instagram post—image, written caption, and comments—through PDA and SFL lenses, this study explores how post-Soviet migrant activists use Instagram for identity construction, identity negotiation, and community building, creating alternative narratives to those dominant in mainstream media.
The study first examines the verbal components of Instagram posts — captions and comments – using the SFL-based Attitude framework to identify patterns of stancetaking and evaluative language. It extracts and analyzes popular themes related to identity, integration, and community. Subsequently, the study analyzes visuals using SFL-based visual grammar to understand how visual elements communicate issues concerning post-Soviet migrant experience and identity, supporting and enhancing the textual content.
Considering that discursive identity is performative (Bucholtz & Hall, 2005), and stancetaking (Du Bois, 2007; Jaffe, 2009) is a discursive act allowing positioning and alignment in relation to others, this study provides a comprehensive analysis of the central issues related to the construction of the identity of post-Soviet migrants on Instagram. Focusing on the three semiotic genres (Mapes, 2021) – caption, comment, and image – it demonstrates how social media platforms like Instagram enable post-Soviet migrants to control the discourse about their minority group, assert their identities, align with one another, resist marginalization, and create empowering narratives for their communities
Alfredo Andersen: Transcultural Landscapes of a Cosmopolitan Artist
No full textThis article examines the reception of Norwegian-Brazilian Alfredo Andersen’s art (1860-1935) by focusing on selected paintings showcased at the “Andersen Returns to Norway” exhibit (2001-2002) and writings published in the exhibit catalogue. Through an analysis of Norwegian-Brazilian immigration patterns, Andersen’s coastal paintings of Paraná, and texts that frame Andersen’s oeuvre for a Brazilian and Norwegian public, I argue that Andersen’s artwork emerges as a poignant case study of cultural cosmopolitanism for its ability to mobilize themes of cultural plurality and transnational states of flux through a pictorial rearticulation of regional identity. I signal an analytic focus away from inland paintings that historically have been most studied and toward Andersen’s coastal paintings to interrogate what they reveal about Andersen’s depictions of the region beyond a purely regionalist logic. In doing so, I argue that Andersen’s coastal paintings enrich our understanding of how the artist urged an outward-looking conception of identity that, through his depiction of the shore as a symbol of liminality, suggests the pictorial articulation of a regional cosmopolitanism.https://doi.org/10.57928/km8h-nc3