Critical evaluation and cultural values

This paper offers a critical perspective on the ‘norms’ and ‘forms’ of evaluation in relation to participatory arts in general, and digital storytelling in particular. The evaluation of arts-based community interventions, presents numerous challenges and opportunities. These include balancing the economic and political imperatives of funding bodies with the desire to establish recognition and reputation with a like-minded community of interest, according to shared notions of practice, identity and value. Evaluation is often reduced to monitoring, evidence gathering and advocacy in order to meet the expectations of funders and commissioners. However, evaluation can be a genuine opportunity for critical reflection on the value of a project for all partners and participants. Drawing on examples, this paper will examine the relationship between the values that underpin a project, organization or programme of work and how they are they can be incorporated (or not) into an evaluation of its success. Examining the EU funded projects 'Extending Creative Practice' and 'Silver Stories', the paper will look at how the stories and visual materials produced through these projects interplay within an evaluation context which might reach beyond the commissioned framework. Addressing issues of translation in multipartner projects, the paper also aims to understand the processes involved in unpicking the local, national and transnational contexts of these visual arts projects.info:eu-repo/semantics/publishedVersio

Robotic total and partial adrenalectomy: A step by step approach

Objective: While open adrenalectomy was performed for many years, minimally invasive adrenalectomy has become the gold-standard for surgical resection of adrenal masses owing to superior perioperative outcomes. The objective of this video is to describe our technique of performing robot-assisted total and partial adrenalectomy. Patients and surgical procedure: In this video, we use the case of a left-sided aldosteronoma to demonstrate our technique of a left robot-assisted total adrenalectomy and a large right-sided tumor with solid enhancing component and mass effect compressing the IVC to demonstrate a right robot-assisted total adrenalectomy. Additionally, we briefly highlight nuances of performing a partial adrenalectomy and the utility of ultrasound in this setting. Results: There were no intraoperative or postoperative complications. All patients were discharged per our routine pathway on post-operative day one. Through our step-by-step video, we demonstrate our technical approach and tips to successfully perform a robotic total and partial adrenalectomy. Conclusion: Robot-assisted adrenalectomy is an effective and well-established option for the management of adrenal masses. The added dexterity and improved visualization provided by the robotic approach allows surgeons to provide patients with an effective, efficient, and oncologically appropriate operation with rapid convalescence

Maternal Digital Media Use during Infant Feeding and the Quality of Feeding Interactions

Experimental research with parents of older children suggests parents’ engagement with technological devices (e.g., television, mobile devices) in the presence of their children decreases the quality of parent-child interactions. Many mothers report frequent use of technological devices during infant feeding but, to date, few studies have explored the potential association between maternal technological device use during feeding and the quality of infant feeding interactions. To this end, mothers (n = 25) and their infants (mean age = 19.3 ± 6.4 weeks) participated in a within-subject, experimental study to explore associations between maternal digital media use and feeding interaction quality within a laboratory setting. Dyads were video-recorded while breastfeeding under two counterbalanced conditions: Digital Media Use versus Control. Mothers engaged their infants in significantly less cognitive growth fostering during the Digital Media Use compared to Control condition. Infants of mothers with typically low levels of technology use during feeding showed a significant decrease in their responsiveness to their mother during the Digital Media Use compared to Control condition. These results illustrate maternal digital media use was associated with decreases in some, but not all, aspects of the quality of the feeding interaction, meriting further investigation with larger, more diverse samples

Exploring Correlates of Infant Clarity of Cues During Early Feeding Interactions

Background Recommendations aimed at reducing infants’ risk for rapid weight gain primarily focus on promoting caregivers’ use of responsive feeding practices and styles. These recommendations are grounded in the belief that infants will effectively signal hunger and satiation to their caregivers. To date, few studies have explored how variability in infants’ communication of hunger and satiation may contribute to feeding interactions. Objective Our aim was to explore variability in, and correlates of, infant clarity of cues during feeding interactions. Design This was a cross-sectional study. Participants/setting Mother-infant dyads (n = 86) were video-recorded during a typical feeding interaction within laboratory-based settings in Philadelphia, PA and San Luis Obispo, CA between June 2013 and June 2017. Main outcome measures Trained raters later coded videos using the Nursing Child Assessment Parent-Child Interaction Feeding Scale’s Infant Clarity of Cues and Maternal Sensitivity to Cues subscales. Infant weight was assessed and standardized to sex- and age-specific z scores.Mothers completed questionnaires related to family demographics, infant feeding history, feeding styles, and infant temperament and eating behaviors. Statistical analyses performed Linear models were used to test for associations between clarity of cues and breastfeeding vs formula-feeding, maternal sensitivity and responsiveness, and feeding and weight outcomes. Results Infants were approximately 15.5 weeks of age and 53% were female. Clarity of cues was not associated with infant sex, age, temperament, or eating behaviors. Breastfed and formula-fed infants exhibited similar clarity of cues (P = 0.0636). Greater clarity of cues for infants was associated with greater maternal sensitivity to cues (P = 0.0011) and responsive feeding style (P = 0.0464) for mothers. Lower clarity of cues was associated with greater weight-for-age z score change for formula-fed infants, but not breastfed infants. Conclusions Efforts to promote responsive feeding may need to also consider infant clarity of cues. Further research is needed to understand the implications of associations between infant communication and responsive feeding

The Maine Wabanaki-State Child Welfare Truth and Reconciliation Commission: Perceptions and Understandings

As this chapter demonstrates, the MWTRC represents a unique and creative approach to healing in communities affected by historical trauma. This chapter presents the history and context of the MWTRC. Drawing on interviews with the key participants4 in the MWTRC creation process, we explain the structure, mandate and role of the MWTRC and the accompanying community support structures that have been created. Key themes emerging from the interviews with the participants in the process are then discussed. The chapter shows that, originating in a deep understanding of the complex individual, family and community trauma that Wabanaki people have endured, the MWTRC embodies a collective desire for truth, healing and change. It provides a space for the articulation of a silenced history, and a process within which traumatic experiences and the trauma of memory can be shared in solidarity. The uniqueness of the MWTRC—a grassroots, community-organized, Indigenous community-state collaboration— makes it an important process for scholars and practitioners to follow. Although it faces challenges and tensions and involves difficult dialogues on race, privilege and accountability, this MWTRC is a new kind of truth commission, linking reconciliation with decolonization, and truth with practical policy change, in the process creating an important model of community-based conflict transformation and trauma recovery that has potentially wider implications for other communities—Indigenous, and non-Indigenous—seeking to reconcile, and to heal, after a period of long-term trauma. To see why such healing is truly necessary, this chapter turns to a summary of the historical context of trauma that the MWTRC aims to address

Reduced maximum capacity of glycolysis in brown adipose tissue of genetically obese, diabetic (db/db) mice and its restoration following treatment with a thermogenic β-adrenoceptor agonist

AbstractThe maximal activities of the key glycolytic enzymes hexokinase and 6-phosphofructokinase, were reduced in brown adipose tissue in db/db mice compared to their lean littermates. Treatment of db/db mice with the thermogenic β-adrenoceptor agonist, BRL 26830, restored normoglycaemia. The only significant increase in activity of hexokinase and 6-phosphofructokinase in the BRL 26830-treated db/db mice occurred in brown adipose tissue where the total tissue activity increased 10- and 11-fold respectively. These changes together with increased 2-deoxyglucose uptake in vivo suggest that brown adipose tissue can play a quantitatively important role in the removal of glucose from the blood

Dynamics of bed bug infestations and control under disclosure policies

Bed bugs have reemerged in the United States and worldwide over recent decades, presenting a major challenge to both public health practitioners and housing authorities. A number of municipalities have proposed or initiated policies to stem the bed bug epidemic, but little guidance is available to evaluate them. One contentious policy is disclosure, whereby landlords are obligated to notify potential tenants of current or prior bed bug infestations. Aimed to protect tenants from leasing an infested rental unit, disclosure also creates a kind of quarantine, partially and temporarily removing infested units from the market. Here, we develop a mathematical model for the spread of bed bugs in a generalized rental market, calibrate it to parameters of bed bug dispersion and housing turnover, and use it to evaluate the costs and benefits of disclosure policies to landlords. We find disclosure to be an effective control policy to curb infestation prevalence. Over the short term (within 5 years), disclosure policies result in modest increases in cost to landlords, while over the long term, reductions of infestation prevalence lead, on average, to savings. These results are insensitive to different assumptions regarding the prevalence of infestation, rate of introduction of bed bugs from other municipalities, and the strength of the quarantine effect created by disclosure. Beyond its application to bed bugs, our model offers a framework to evaluate policies to curtail the spread of household pests and is appropriate for systems in which spillover effects result in highly nonlinear cost–benefit relationships

Expanding the Entamoeba Universe: New Hosts Yield Novel Ribosomal Lineages.

Removing the requirement for cell culture has led to a substantial increase in the number of lineages of Entamoeba recognized as distinct. Surveying the range of potential host species for this parasite genus has barely been started and it is clear that additional sampling of the same host in different locations often identifies additional diversity. In this study, using small subunit ribosomal RNA gene sequencing, we identify four new lineages of Entamoeba, including the first report of Entamoeba from an elephant, and extend the host range of some previously described lineages. In addition, examination of microbiome data from a number of host animals suggests that substantial Entamoeba diversity remains to be uncovered

Joint Assessment of Intended and Unintended Effects of Medications: An Example Using Vascular Endothelial Growth Factor Inhibitors for Neovascular Age-Related Macular Degeneration

Objective. To estimate the net health benefits of pegaptanib and ranibizumab by considering the impact of visual acuity and unintended effects (cardiovascular and hemorrhagic events) on quality-of-life among persons with neovascular age-related macular degeneration. Methods. We designed a probabilistic decision-analytic model using published data. It employed 17 visual health states and three for unintended effects. We calculated incremental net health benefits by subtracting the harms of each medication from the benefit using the quality-adjusted life year (QALY). Results. In a hypothetical cohort of 1,000 75-year olds with new-onset bilateral age-related macular degeneration followed for ten years, the mean QALYs per patient is 3.7 for usual care, 4.2 for pegaptanib, and 4.3 for ranibizumab. Net benefits decline with increasing baseline rates of unintended effects. Interpretation. Net health benefits present a quantitative, potentially useful tool to assist patients and ophthalmologists in balancing the benefits and harms of interventions for age-related macular degeneration

Solving clinical challenges in prostate cancer using the single-port robot system

Objective: Patients who desire or require surgical management for prostate cancer, but are poor candidates for multi-port robotic surgery, can present a clinical challenge. Use of single port (SP) robotic technology may help overcome these challenges. We present our initial experience with robotic-assisted radical prostatectomy (RARP) using the da Vinci SP robot for prostate cancer in patients who would otherwise not be good surgical candidates for conventional multi-port transabdominal robotic surgery. Patients and surgical procedure: Fourteen of 41 patients who underwent SP-RARP from November 2020 to February 2022 for biopsy confirmed, organ-confined prostate adenocarcinoma at a single tertiary care institution qualified for inclusion in our study due to specific considerations posing challenges for conventional multiport transperitoneal RARP. Perioperative metrics, pathologic findings and functional outcomes were collected prospectively. The accompanying video shows two cases demonstrating our transvesical and extraperitoneal approaches to SP-RARP. Results: All patients underwent successful procedures without need to convert to multi-port robotic or open approach. Most patients had prior abdominal surgery (13/14, 93%) including aborted multi-port RARP (2), hernia repairs (5), bowel diversions (3), and peritoneal dialysis catheters (2) among others. Most underwent extraperitoneal (9/14, 64%) followed by transvesical (5/14, 36%) approach. There were no intraoperative complications and one Clavien III post-operative complication. Positive margin rate was 29%, most of which were microscopic (≤3 mm, 3/4, 75%). Eighty-five percent of patients had undetectable nadir PSA. Conclusions: Our initial experience using the SP robot suggests that this technology can facilitate surgery for prostate cancer patients who might otherwise not be considered surgical candidates. Operative outcomes are not compromised despite a smaller incision and working space. We have found the SP system to be a valuable tool for carefully selected patients