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The 11-Year Itch: Exploitation as Sublimation in \u3cem\u3eBlonde\u3c/em\u3e (Joyce Carol Oates, 2000; Andrew Dominik, 2022)
Get PDFThe goal of this article is to discuss Andrew Dominik’s much-criticized adaptation of Oates’ novel Blonde (2000), released on the Netflix streaming platform in September 2022. It aims at re-assessing the movie in the light of its literary hypotext, which appears to have been rather unfairly left out of much of the debate surrounding the release and critical reception of the film. In a first part, this article briefly addresses the stakes of Dominik’s adaptation, which are more complex than they might seem, notably on account of the extreme iconicity of its subject, even more so than its subject matter. This will then lead to approach the thorny issue of femininity and feminism as found in Oates’ book and transposed in Dominik’s film. Then, a close transsemiotic reading of one specific particular sequence from the movie Blonde will be undertaken; i.e., the famous “Subway Grate” scene – or rather photograph – initially thought of as a publicity stunt for Billy Wilder’s 1954 romantic comedy The Seven-Year Itch, very probably one of the least memorable films of the director, but whose “silly little dress” as well as the body it both covers and reveals, have left a burning impress on the collective memories of viewers and non-viewers alik
Educational Joy, Queer Despair: Freirean Perspectives on Digital Queer HRE Initiatives in Russia
Get PDFThis study examines the contribution of recent digital queer educational projects aimed at a Russian-speaking audience, such as Queerorama and Lesbian Lobby, to the development of critical consciousness and transformative action within the queer communities in contemporary Russia. Analyzing the online discussion of the projects through the lens of Freirean critical pedagogy, the research reveals that while the projects educate their audiences on queer cultural history and highlight the contradictions within the current homophobic societal and legislative environment, they cannot be qualified as praxis, as they often fall short of translating said awareness into action. Users conceptualize the projects as digital safe spaces and value seeing authentic representation but express feelings of hopelessness, entrapment and inability to challenge their oppressive conditions. The findings underscore the complexities of queer human rights education in repressive contexts and point to the need for further research on whether digital conscientization can effectively drive social and political change
A Set of Axioms Providing a Basis for Understanding and Analyzing Work Systems in Organizational Settings
No full textThis paper proposes 24 axioms that form a basis for understanding and analyzing sociotechnical and totally automated work systems in organizational settings. The introduction identifies reasons for trying to develop axioms of that type. Two background sections compare axioms with other types of “knowledge objects”, illustrate the minimal presence of axioms in the IS discipline, define the domain of relevance for the axioms discussed here, and explain the process of developing those axioms. The axioms are organized in five categories: 1) system in context, 2) system operation, 3) system goals and goal attainment, 4) system uncertainties, and 5) system-related change. The axioms potentially address two challenges: helping business and IS/IT professionals understand and collaborate around systems in organization and providing a new starting point for producing and evaluating generalizations such as theories, models, and frameworks in the IS discipline. The Appendix shows the output of a large language model’s application of the axioms to two case studies, thereby illustrating the potential practical value of the axioms
Assessing Older Adults’ Readiness for Adopting Fall Prevention Recommendations Using the Transtheoretical Stages of Change
No full textObjectives: Reducing fall risk requires older adults (age 65+) to adopt effective prevention strategies. This study has three aims: 1) understand Stage of Change (SOC) for three fall prevention strategies; 2) determine strategies older adults’ use; and 3) understand which characteristics relate to readiness to take action.
Methods: A survey of 1063 older adults assessed fall risk, SOC, and use of fall prevention strategies. Data analysis included descriptive statistics and regression analysis.
Results: The most common SOC for older adults by strategy was action for overall fall prevention (61%), contemplation for medication management (45%) and preparation and action for strength/balance (29% each). Believing falls are preventable was most strongly related to being in a Change stage (e.g., action, maintenance) for overall fall prevention (Risk Ratio: 1.4, 95%CI: 1.1, 1.7).
Discussion: Health promotion can focus on increasing knowledge of evidence-based fall prevention strategies to encourage older adults to take action
Seizure monitoring by combined diary and wearable data: A multicenter, longitudinal, observational study
No full textOptimizing Non-member Transfer Process
No full textAbstract
Background: This quality improvement project aims to reduce the process time for transferring non-members from the emergency department to another acute hospital, thereby decreasing the admission day rate.
Problem: The medical center\u27s Emergency Department (ED) has experienced a significant increase in patient visits over the past five years, particularly since the COVID-19 pandemic. This increase includes non-members from other health plans, leading to high demand for specialty beds. The current process of transferring stable non-members to community hospitals is inefficient, taking 5-6 hours, with the goal of reducing this to 4 hours. The quality improvement project focuses on enhancing communication and workflow among healthcare teams to optimize the transfer process and improve patient care and satisfaction.
Interventions: Team members planned the execution of the non-member transfer process, discussing changes and interventions. They aimed to reduce transfer time from 6 to under 4 hours by improving communication and workflow. The average cost of an ED visit is 360,000 if the transfer time is reduced. Training costs 354,230.
Outcome Measures: Manual data from huddles indicated that nurse awareness of non-member identification increased from 20% to 80%. The goal was to reduce the non-member transfer process time from 4-6 hours to 4 hours. The data from December 20204 to June 2025 showed that the average baseline transfer time was 5 hours for all these months.
Results: Post-intervention results showed an increase in nurses’ awareness of the transfer process from 20% to 80%. The transfer process time remains the same as the baseline of 5 hrs. This failure to meet outcome goals was due to the assigned community hospital\u27s inability to accept non-members, influenced by new leadership decisions, and the lack of other contracted hospitals for non-member transfers.
Conclusion: Optimizing the non-member transfer process was unsuccessful due to unforeseen obstacles arising from the new leadership of the accepting facility. The next step is to hand off to the inpatient care coordinator to continue looking for appropriate community beds and transfer non-members from inpatient units.
Keywords: Transfer patients from the ED, Interfacility transfer, and intrahospital transfer
Red Room Redesign: Improving Operating Room Workflow for Urgent and Emergency Procedures
No full textProblem: Limited operating room (OR) availability is a significant challenge in many healthcare facilities. Overbooked or understaffed ORs can lead to delays in surgical procedures, which are particularly detrimental in urgent and emergency situations (Cholewa et al., 2024). The OR is among the costliest areas in a hospital; it is essential to improve efficiency in surgical throughput to deliver timely care for urgent and emergent cases, enhance patient outcomes, and manage healthcare costs effectively.
Context: The microsystem for this project is a Northern California OR that handles a high volume of surgical procedures. There is a dedicated red room for urgent and emergent cases, with a target turnover time (TOT) of 45 minutes.
Intervention: Three Plan, Do, Study, Act cycles were introduced, focusing on streamlining communication using alpha text,environmental services (EVS) to use OR tape barrier during room turnover, and daily huddles between OR, post-anesthesia care unit, and supply chain at 9:00 a.m. and 4:00 p.m. to review the day’s schedule and to address potential issues that could cause delays.
Measures: TOT is defined as the interval from one patient exiting the OR to the next patient entering, with a target of 57 minutes; any arrival after this time is recorded as a delay. The causes and durations of these delays are monitored using Health Connect. Process measures include the use of OR tape barriers by EVS during room turnover, alpha text messaging to facilitate communication with surgeons and anesthesia, and daily huddles involving the OR, PACU, and supply chain teams.
Results: Data were collected from January 2025 to June 2025. In January, the baseline average of TOT was 71 minutes. After implementing interventions, we observed rapid improvement in February, an average of 63 minutes. In March, there was a continuous improvement to 57 minutes. April saw an increase to 63 minutes, but there was a rapid decrease to 49 minutes in May, and by June we are sustaining the improvement with an average TOT of 52 minutes.
Conclusions: In conclusion, we decreased the TOT in the red room from 65 minutes to 57 minutes over 5 months. Although there were increases in TOT in February and April, it has recovered in the last 2 months, and the progress is significant
Optimizing Processes to Improve Relative Value Units for Healthcare Providers
No full textProblem: An outpatient epilepsy clinic receives reimbursement for services rendered based on three relative value units (RVUs). Nurse practitioners (NPs) in the clinic are not meeting their expected RVUs based on current productivity limitations.
Context: The clinic assessment revealed workflow gaps limiting NPs’ ability to increase productivity. The clinic is high-performing, and the staff worked collaboratively to improve the work RVUs. However, dissatisfaction can occur in other microsystems if collaboration breaks down.
Intervention: A microsystem assessment, NP interviews, and clinic template revisions were discussed with leadership and implemented.
Measures: Monthly productivity reports and pre- and post-intervention visit templates were collected and evaluated over one month.
Results: Visit volume improved 10% to 30% over one month, and NP satisfaction improved.
Conclusion: Improving the work RVUs requires a collaborative effort between clinical and administrative staff to coordinate effective care that impacts the financial aspect of the clinic. Future efforts are needed to address the identified gaps in the RVUs template.
Keywords: improving work relative value units (RVUs), productivity, performance, Medicare reimbursement, Medi-Cal reimbursement, healthcare providers, optimization, proces
Illuminating Leadership Excellence: An Evidence-Based QI Intervention Reigniting Nurse Leaders from Burnout to Brilliance Using Caring Science and Reflective Practice
No full textAbstract
Problem: A 2024 assessment at a 250‑bed Northern California medical center revealed that 76% of 16 inpatient nurse leaders met high‑burnout criteria on the Maslach Burnout Inventory, and leader turnover had climbed to 25%, more than triple national benchmarks, threatening patient care quality, financial stability, and alignment with Magnet® and employee engagement goals.
Context: Root causes included pandemic‑era promotions without development support, a task‑oriented leadership culture, and eroding psychological safety (Press Ganey engagement ≈ 30%). An integrative logic model positioned Watson\u27s Caring Science as the theoretical base, Schön\u27s Reflective Model for adaptive learning, and the Prosci ADKAR change framework to sequence individual behavior change, all consistent with IHI Joy-in-Work principles.
Interventions: Two targeted interventions delivered over 12 weeks: (1) a 120-minute Guided Meditation session embodying Watson\u27s Caritas Processes 1 & 5, and (2) Reflective Modalities centered on Caritas Processes 2 & 4. Five discrete changes to test targeted centering, empathic communication, inclusive decision‑making, protected reflection, and leadership sustainability. Direct cost: US 933,200 in first‑year savings, yielding a 51:1 ROI.
Conclusion: A low-cost, theory-aligned program integrating Caring Science, mindfulness-based reflection, and ADKAR structured change rapidly reduced nurse leader burnout while safeguarding patient safety and delivering exceptional financial value. The curriculum framework and strong ROI support sustainability and scale‑up across service lines to advance the Quadruple Aim and leadership effectiveness.
Keywords: Nurse burnout, leadership effectiveness, healthy work environment, Magnet, Caring Science, mindfulness, reflective practic
Implementation of endometriosis toolkit: A quality improvement project to enhance nurse practitioners’ knowledge and management
No full textAbstract
Background: Endometriosis, characterized by the ectopic growth of endometrial-like tissue, affects approximately 11% of reproductive-aged women in the United States. Diagnosing endometriosis is challenging due to its diverse clinical presentations, reliance on laparoscopic procedures, absence of biomarkers, and limited awareness among healthcare providers and patients.
Local Problem: The diagnostic complexity of endometriosis, compounded by reduced provider awareness and a lack of comprehensive resources, leads to delayed and suboptimal care for affected women.
Methods: This Doctor of Nursing Practice quality improvement project aimed to enhance nurse practitioners’ (NPs) knowledge and management of endometriosis through a 1-hour educational session at the California Association for Nurse Practitioners conference. The session employed a case study to introduce the Endometriosis Toolkit for Practitioners (ETP). Investigator-developed eight-item pre-test and nine-item post-test surveys were administered to evaluate knowledge and toolkit use.
Interventions: The project involved delivering an evidence-based, 1-hour podium presentation that introduced the ETP, complemented by a case study illustrating its clinical application.
Results: Nineteen NPs completed the pre-test, and seventeen completed the post-test surveys. The intervention resulted in a 60% increase in endometriosis knowledge and an 88% agreement to implement the toolkit in practice, thereby achieving the project’s objectives.
Conclusion: This project significantly enhanced NPs’ understanding of endometriosis. The findings highlight the crucial role of targeted education and practical resources in improving clinicians’ ability to provide timely and effective care for women with endometriosis