Women\u27s agency in the development of hybrid social spaces: The trials of Sarah Ballenden and Maria Thomas in Canada\u27s Red River colony, 1850 and 1863 (Manitoba)

In 1850 and 1863, the British Hudson\u27s Bay Company\u27s Red River colony (current day Winnipeg) witnessed two sensationalized lawsuits. These lawsuits focused on two women of mixed First Nations and British extraction, namely Sarah Ballenden and Maria Thomas. Using these legal cases as a backdrop, this study aims to destabilize the notion that British claims to power and authority in the contact zones in the Red River colony were fixed and that women were the passive victims of history. I argue that British women developed defensive strategies based on their situated knowledges of social and spatial relations in that place. They used this knowledge to achieve agency and voice in the patriarchal British fur trade. Operating from within Victorian interpretations of the ideology of the doctrine of separate spheres, British women deployed the spatial expressions of middle class discourses on gender, class, race, and sexuality to influence social and power relations in public and private places. British women\u27s enforcement of socially constructed notions about immoral sexual and spatial behaviours marked certain women of colour as out of place. This research project revealed that Countryborn individuals used similar defensive strategies to reject the imposition of British stereotypes on their identities. Their refusal to accept these identities allowed them to engage in a process of identity formation. Focusing on the testimonies of a variety of witnesses during both trials, I analyzed how narrative accounts of events indicated human behaviour did not always proceed from expected class or racial positions. Incorporating hybridity theory into this study, it became possible to unpack the ways in which certain Countryborn women and some men took advantage of Britons\u27 ambivalent aversion and desire for the other to engage in mimetic behaviour and subvert power relations. Such conscious engagement with British power structures allowed Countryborn men and women to influence, but not internalise, British codes of conduct. Thus, mimicry facilitated resistance and agency for people of colour and suggests that the Red River colony was a hybrid place

Problematizing Prostitution in Law and Policy in the Republic of Ireland: A Case for Reframing

This article attempts to uncover the discursive practices that have framed recent debates on prostitution in the Republic of Ireland. As Ireland prepares to introduce Swedish-style laws, which criminalize the purchase of sexual services, we are particularly interested in interrogating the dominant construction of prostitution in recent policy debates and consultations. Taking these spaces as sites for the reproduction of discursive and material practices, we employ methods of critical discourse analysis through Carole Bacchi's (1999) 'What's the problem represented to be' approach to question: How is prostitution problematized in Irish law and policy? We argue the representation of prostitution in neo-abolitionist discourse in Ireland operates through gendered and racialized assumptions about sex workers and migrant women. The material consequences of this have implications not only for current prostitution law and policy proposals but also for wider feminist spaces in Ireland

Risk Factors for Noninvasive Ventilation Failure in Children Post-Hematopoietic Cell Transplant

Rationale: Little is known on the use of noninvasive ventilation (NIPPV) in pediatric hematopoietic cell transplant (HCT) patients. Objective: We sought to describe the landscape of NIPPV use and to identify risk factors for failure to inform future investigation or quality improvement. Methods: This is a multicenter, retrospective observational cohort of 153 consecutive children post-HCT requiring NIPPV from 2010-2016. Results: 97 (63%) failed NIPPV. Factors associated with failure on univariate analysis included: longer oxygen use prior to NIPPV (p=0.04), vasoactive agent use (p40 at 4 hours [aOR=6.3 9(95% CI: 2.4, 16.4), p<0.001] and vasoactive use [aOR=4.9 (95% CI: 1.9, 13.1), p=0.001]. Of note, 11 patients had a cardiac arrest during intubation (11%) and 3 others arrested prior to intubation. These 14 patients were closer to HCT [14 days (IQR:4, 73) vs 54 (IQR:21,117), p<0.01] and there was a trend toward beginning NIPPV outside of the PICU and arrest during/prior to intubation (p=0.056). Conclusions: In this cohort respiratory rate at 4 hours and vasoactive use are independent risk factors of NIPPV failure. An objective model to predict which children may benefit from a trial of NIPPV, may also inform the timing of both NIPPV initiation and uncomplicated intubation

The Role of Whole Blood Impedance Aggregometry and Its Utilisation in the Diagnosis and Prognosis of Patients with Systemic Inflammatory Response Syndrome and Sepsis in Acute Critical Illness

Objective: To assess the prognostic and diagnostic value of whole blood impedance aggregometry in patients with sepsis and SIRS and to compare with whole blood parameters (platelet count, haemoglobin, haematocrit and white cell count). Methods: We performed an observational, prospective study in the acute setting. Platelet function was determined using whole blood impedance aggregometry (multiplate) on admission to the Emergency Department or Intensive Care Unit and at 6 and 24 hours post admission. Platelet count, haemoglobin, haematocrit and white cell count were also determined. Results: 106 adult patients that met SIRS and sepsis criteria were included. Platelet aggregation was significantly reduced in patients with severe sepsis/septic shock when compared to SIRS/uncomplicated sepsis (ADP: 90.7±37.6 vs 61.4±40.6; p<0.001, Arachadonic Acid 99.9±48.3 vs 66.3±50.2; p = 0.001, Collagen 102.6±33.0 vs 79.1±38.8; p = 0.001; SD ± mean)). Furthermore platelet aggregation was significantly reduced in the 28 day mortality group when compared with the survival group (Arachadonic Acid 58.8±47.7 vs 91.1±50.9; p<0.05, Collagen 36.6±36.6 vs 98.0±35.1; p = 0.001; SD ± mean)). However haemoglobin, haematocrit and platelet count were more effective at distinguishing between subgroups and were equally effective indicators of prognosis. Significant positive correlations were observed between whole blood impedance aggregometry and platelet count (ADP 0.588 p<0.0001, Arachadonic Acid 0.611 p<0.0001, Collagen 0.599 p<0.0001 (Pearson correlation)). Conclusions: Reduced platelet aggregometry responses were not only significantly associated with morbidity and mortality in sepsis and SIRS patients, but also correlated with the different pathological groups. Whole blood aggregometry significantly correlated with platelet count, however, when we adjust for the different groups we investigated, the effect of platelet count appears to be non-significant

Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence study

Introduction: Consensus criteria for pediatric severe sepsis have standardized enrollment for research studies. However, the extent to which critically ill children identified by consensus criteria reflect physician diagnosis of severe sepsis, which underlies external validity for pediatric sepsis research, is not known. We sought to determine the agreement between physician diagnosis and consensus criteria to identify pediatric patients with severe sepsis across a network of international pediatric intensive care units (PICUs). Methods: We conducted a point prevalence study involving 128 PICUs in 26 countries across 6 continents. Over the course of 5 study days, 6925 PICU patients &lt;18 years of age were screened, and 706 with severe sepsis defined either by physician diagnosis or on the basis of 2005 International Pediatric Sepsis Consensus Conference consensus criteria were enrolled. The primary endpoint was agreement of pediatric severe sepsis between physician diagnosis and consensus criteria as measured using Cohen's ?. Secondary endpoints included characteristics and clinical outcomes for patients identified using physician diagnosis versus consensus criteria. Results: Of the 706 patients, 301 (42.6 %) met both definitions. The inter-rater agreement (? ± SE) between physician diagnosis and consensus criteria was 0.57 ± 0.02. Of the 438 patients with a physician's diagnosis of severe sepsis, only 69 % (301 of 438) would have been eligible to participate in a clinical trial of pediatric severe sepsis that enrolled patients based on consensus criteria. Patients with physician-diagnosed severe sepsis who did not meet consensus criteria were younger and had lower severity of illness and lower PICU mortality than those meeting consensus criteria or both definitions. After controlling for age, severity of illness, number of comorbid conditions, and treatment in developed versus resource-limited regions, patients identified with severe sepsis by physician diagnosis alone or by consensus criteria alone did not have PICU mortality significantly different from that of patients identified by both physician diagnosis and consensus criteria. Conclusions: Physician diagnosis of pediatric severe sepsis achieved only moderate agreement with consensus criteria, with physicians diagnosing severe sepsis more broadly. Consequently, the results of a research study based on consensus criteria may have limited generalizability to nearly one-third of PICU patients diagnosed with severe sepsis

Why Decriminalise Prostitution? Because Law and Justice Aren’t Always the Same

Leigh Goodmark’s work on domestic violence argues for alternatives to criminal justice to ‘solve’ issues of gendered violence. The criminalisation of sex work and prostitution is rarely discussed in this context—a rather odd omission given the increasing trend towards ‘criminalising demand’ and counter-calls for decriminalisation in this domain. In this article, we bring the two debates into conversation, using Goodmark’s work to bring analytical clarity to the prostitution debate and connect sex work to wider social justice debates in feminist anti-violence circles. We aim to move the conversation beyond retribution and the view that law is justice to outline a vision of justice for sex workers grounded in the principles of rights, recognition and representation. By contextualising the decriminalisation of prostitution within the framework of a wider anti-carceral justice movement, we seek to build alliances for social justice that transcend the current divide