733 research outputs found
The role of nursing in multimorbidity care
Background
Multimorbidity (the co-occurrence of two or more chronic conditions in the same person) affects around one in three persons, and it is strongly associated with a range of negative outcomes including worsening physical function, increased health care use, and premature death. Due to the way healthcare is provided to people with multimorbidity, treatment can become burdensome, fragmented and inefficient. In people with palliative conditions, multimorbidity is increasingly common. Better models of care are needed.
Methods
A mixed-methods programme of research designed to inform the development of a nurse-led intervention for people with multimorbidity and palliative conditions. A mixed-methods systematic review explored nurse-led interventions for multimorbidity and their effects on outcomes. A cross-sectional study of 63,328 emergency department attenders explored the association between multimorbidity, complex multimorbidity (≥3 conditions affecting ≥3 body systems), and disease-burden on healthcare use and inpatient mortality. A focussed ethnographic study of people with multimorbidity and life-limiting conditions and their carers (n=12) explored the concept of treatment burden.
Findings
Nurse-led interventions for people with multimorbidity generally focus on care coordination (i.e., case management or transitional care); patients view them positively, but they do not reliably reduce health care use or costs. Multimorbidity and complex multimorbidity were significantly associated with admission from the emergency department and reattendance within 30 and 90 days. The association was greater in those with more conditions. There was no association with inpatient mortality. People with multimorbidity and palliative conditions experienced treatment burden in a manner consistent with existing theoretical models. This thesis also noted the effect of uncertainty on the balance between capacity and workload and proposes a model of how these concepts relate to one another.
Discussion
This thesis addresses a gap in what is known about the role of nurses in providing care to the growing number of people with multimorbidity. A theory-based nurse-led intervention is proposed which prioritises managing treatment burden and uncertainty.
Conclusions
Nursing in an age of multimorbidity necessitates a perspective shift which conceptualises chronic conditions as multiple overlapping phenomena situated within an individual. The role of the nurse should be to help patients navigate the complexity of living with multiple chronic conditions
'Aquà se ve la fuerza del SME': a political economy analysis of the Mexican Electrical Workers Union's path towards self-management
This research engages with and contributes to political economy scholarship and broader
academic research on the energy sector in the Global South. It uses anthropological
methods to contribute to the social science scholarship on International Development,
Labour, and neoliberalism in the Global South, specifically in the Latin American context.
The thesis examines how the reconfiguration of national political economy has modified the
Mexican state, structuring particular possibilities in the electricity sector. It argues that
energy resources have been used to give coherence to the Mexican state and that the
sector’s modification has affected how sovereignty is imagined, understood, and defined.
The thesis analyses how a neoliberal logic condemned the performance of a parastatal
entity, the Central Light and Force Company [CompañÃa de Luz y Fuerza del Centro, CLFC],
ordering its closure to transform electricity from a public service to a commodity ruled by
the open market and managed as a private enterprise. It also modified and shaped the
processes and practices of collective subject formation, power relations, notions of
sovereignty, and coherence within the Mexican state.
The thesis uses an ethnographic approach and methodologies to provide an in-depth
analysis of the impacts of this modification by focusing on the case study of the labour force
of the CLFC, the Mexican Electrical Workers Union’s [Sindicato Mexicano de Electricistas,
SME]. The closure of CLFC diminished SME’s leverage over a critical public service,
decimating its political power and impacting its possibilities for survival. It uses SME
members’ experiences and narrations to explore how the changing structural
configurations, under which SME is now transformed from a parastatal organisation into a
self-managing enterprise, have modified its members’ social world and outlook. The
examination is possible because SME acts as a complete social institution that shapes every
aspect of its members’ public and private spheres of interaction. This thesis reviews the
tools that have supported SME’s survival and reinsertion into the energy sector. It provides
the ground to understand the centrality of the union’s infrastructures for the movement of
resistance and the preservation of the workers’ identity. This research argues that the
workers’ development of skills and expertise and their interaction with technology,
machinery and infrastructure allowed the union to construct a particular type of politics and
political power that enabled it to craft a way back into the liberalised and privatised energy
sector through self-management practices.
This thesis investigates SME’s social relationships by focusing on three subgroups to
analyse the processes, practices, and contradictory understandings of collective subject
formation inside the organisation. It interrogates how the modification of political economy
has transformed SME’s internal structures and gender ideology allowing women to
participate in leadership roles. The thesis also explores the role and interactions of workers
in resistance with groups of retired and liquidados workers [literally translated as ‘the
liquidated’ it refers to those that took the settlement from the government], whose
relationship to the organisation was modified by a change in their labour conditions, but
that still make claims on and to the union. Both groups provide an entry point to discuss the
transformation of SME’s social world and the resignification of its ideology and identity
under the neoliberal order. It argues that retirees provided the preservation and
legitimation of ideological and historical values crucial to the cohesion of the resistance
movement, which has been transformed and modified to fit the new ideology. Similarly,
liquidados workers provided a decisive point of contrast to how workers in resistance
defined the esmeita identity based on neoliberal moral commitments that prize persona—
and familiar—sacrifice to the resistance movement over the persona itself. Under this logic,
sacrifice is intertwined with the esmeita identity and can define which workers deserve to
participate in the union’s self-managing endeavour. Overall, the thesis shows how the
changes in the political economy allowed SME to transition towards a self-managing
enterprise testing the organisation’s ability to create coherence among its economic
ventures and its identity and values
Fast Raising: Digital Fundraising as Interaction Rituals
Twice a year, GamesDoneQuick hosts events that showcase the Speed Running Community, a sub-set of the Video Game Community. Since its inception in 2014 through 2021 GDQ has raised $25.7 million that has been distributed to the Prevent Cancer Foundation and Médecins Sans Frontiers (Doctors without Borders). This collection of studies analyzes the Awesome Games Done Quick 2020 event utilizing the Interaction Ritual Theory framework of Randall Collins to understand how ritualistic social action of this community has been leveraged by event organizers to promote successful crowd funding efforts that benefits organizations outside of the community. Further it expands on research into New Social Movements and Participatory Culture to frame and explain the motivations behind this communal process. This study provides evidence to show that interaction ritual chains are present, but failed to accurately identify the specific characteristics of the sacred objects present to link them to the success of rituals. Additionally, it failed to find a link between perceived identity markers of ritual performers with the amount of donations received at the event studied. Lastly, it takes steps to categorize parts of the social action present in the form of donation incentives and describes how those specific incentive types perform in relation to one another
Doing Diversity in Museums and Heritage
The museum and heritage sector has been shaken by debates over how to address colonialism, migration, Islamophobia, LGBTI+ and multiple other forms of difference. This major multi-researcher ethnography of museums and heritage in Berlin provides new insight into how ›diversity‹ is understood and put into action in museums and heritage. Exploring new initiatives and approaches, the book shows how these work - or do not - in practice. By doing so, it highlights ways forward - for research and action - for the future. The fieldwork locations on which this book is based include the Humboldt Forum, the Museum of Islamic Art, the Museum für Naturkunde, and the Memorial to the Murdered Jews of Europe, as well as Berlin streets and protests
Moving Through Experience: Disruption, Emergence, and the Aesthetic of Repose
Contemporary aesthetic philosophy engages the notion of aesthetic experience from two conflicting lenses; on one hand are those who support a connection between the aesthetic and political while the other favors a more pragmatic position. An area of aesthetic engagement not yet explored inhabits an intermediary between these opposing poles, a modality of aesthetic experience I term, the aesthetic of repose. This dissertation traces the evolution of ideas regarding aesthetic experience through a survey of several philosophers whose varied perspectives form the foundation for my inquiry. Beginning with an exploration of Immanuel Kant’s Critique of Judgement, proceeding through Friedrich Nietzsche’s Birth of Tragedy, and progressing to John Dewey’s Art as Experience, my aim is first, to situate their individual aesthetic philosophies within the context of 21st century aesthetic experience. Despite their differing viewpoints, these thinkers share in common; 1) the importance of sense and sensation to valuable aesthetic experience and 2) a desire to find value and meaning in aesthetic experience for overcoming the ills of humanity and advancing culture.
Secondly, this dissertation examines a polarity of ideas that challenge the notion of authentic aesthetic experience in our times. Similar to their predecessors, contemporary aesthetic philosophers desire to make aesthetic experience a portal for humanity’s recuperation. There are thinkers such as Jacques Ranciére and Santiago Zabala, who advance an aesthetics of action; others, like Richard Shusterman and Hans Ulrich Gumbrecht advocate for an aesthetics of presence. The aesthetic of repose rests uniquely between action and presence, as an area of slumber, where neither action nor presence is necessary. Rather, the idea is to remain in repose, linger there, where repositioning occurs naturally, as though without perception. One emerges from this seemingly imperceptible experience, having done nothing save moving through it, yet being forever changed by it.https://digitalmaine.com/academic/1046/thumbnail.jp
Machine Learning Algorithm for the Scansion of Old Saxon Poetry
Several scholars designed tools to perform the automatic scansion of poetry in many languages, but none of these tools
deal with Old Saxon or Old English. This project aims to be a first attempt to create a tool for these languages. We
implemented a Bidirectional Long Short-Term Memory (BiLSTM) model to perform the automatic scansion of Old Saxon
and Old English poems. Since this model uses supervised learning, we manually annotated the Heliand manuscript, and
we used the resulting corpus as labeled dataset to train the model. The evaluation of the performance of the algorithm
reached a 97% for the accuracy and a 99% of weighted average for precision, recall and F1 Score. In addition, we tested
the model with some verses from the Old Saxon Genesis and some from The Battle of Brunanburh, and we observed that
the model predicted almost all Old Saxon metrical patterns correctly misclassified the majority of the Old English input
verses
The Caretaker: Bearing Witness in Public Art an Examination of the Role of Contemporary Artists Addressing the Effects of Environmental Injustice within Michigan Communities
This paper examines public art and the role of contemporary artists in context of their relational experience in communities effected by environmental injustice. As a Michigan resident or as an out-of-state guest invited into an urban neighborhood, each of the twelve artists in this study participates within community through a unique cultural lens. Informed by historical and sociopolitical complexities, the public art bears witness for artists that care about the effects of a city’s water crisis, harm resulting from breached oil pipelines, generational loss of Indigenous traditions, and the inability to breathe unconditionally within certain neighborhood Zip Codes. Engaging in public art in the emerging role of ‘caretaker,’ the artist addresses evolving social narratives in such a way that the aesthetic form through its visual dialogue, becomes a catalyst for change. Current discourse on public art and environmental injustice regards a broad range of social contexts whereby the art performs a certain aesthetic or practical function relevant to location, however, the figure of the artist is rarely discussed. This paper focuses on the figure of the artist. In posing the question, How does public art bear witness for the artist in the role of caretaker?, I argue that the artwork reveals the role of caretaker through the artist’s 1) aesthetic practice, 2) gentleness in form, and 3) particular elucidation that personifies ‘caretaker’ as assessed through aspects of Witness, Testimony, Shelter, and Call, whereby the four categories become markers within the art for attributing the artist’s relational experience within community. The public art fosters consideration for the viewer to gain new insight through aesthetic form that bears witness for the artist as caretaker and to reflect on one’s own role in an environmentally just community.https://digitalmaine.com/academic/1045/thumbnail.jp
Changing Priorities. 3rd VIBRArch
In order to warrant a good present and future for people around the planet and to safe the care of the planet itself, research in architecture has to release all its potential. Therefore, the aims of the 3rd Valencia International Biennial of Research in Architecture are:
- To focus on the most relevant needs of humanity and the planet and what architectural research can do for solving them.
- To assess the evolution of architectural research in traditionally matters of interest and the current state of these popular and widespread topics.
- To deepen in the current state and findings of architectural research on subjects akin to post-capitalism and frequently related to equal opportunities and the universal right to personal development and happiness.
- To showcase all kinds of research related to the new and holistic concept of sustainability and to climate emergency.
- To place in the spotlight those ongoing works or available proposals developed by architectural researchers in order to combat the effects of the COVID-19 pandemic.
- To underline the capacity of architectural research to develop resiliency and abilities to adapt itself to changing priorities.
- To highlight architecture's multidisciplinarity as a melting pot of multiple approaches, points of view and expertise.
- To open new perspectives for architectural research by promoting the development of multidisciplinary and inter-university networks and research groups.
For all that, the 3rd Valencia International Biennial of Research in Architecture is open not only to architects, but also for any academic, practitioner, professional or student with a determination to develop research in architecture or neighboring fields.Cabrera Fausto, I. (2023). Changing Priorities. 3rd VIBRArch. Editorial Universitat Politècnica de València. https://doi.org/10.4995/VIBRArch2022.2022.1686
Video Conferencing: Infrastructures, Practices, Aesthetics
The COVID-19 pandemic has reorganized existing methods of exchange, turning comparatively marginal technologies into the new normal. Multipoint videoconferencing in particular has become a favored means for web-based forms of remote communication and collaboration without physical copresence. Taking the recent mainstreaming of videoconferencing as its point of departure, this anthology examines the complex mediality of this new form of social interaction. Connecting theoretical reflection with material case studies, the contributors question practices, politics and aesthetics of videoconferencing and the specific meanings it acquires in different historical, cultural and social contexts
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