“Fugitive Visions”: Cultural Pseudomemory and the Death of the Indigenous Child in the Indian Poems of Duncan Campbell Scott

Whether describing a fictional child’s decease in the Canadian wilds or the painfully real death rates in Indian Residential Schools, poetry and policy entangle in Duncan Campbell Scott’s depictions of Indigenous child mortality. The Confederation Group poet-bureaucrat is perhaps most infamous for his architectural role in the IRS system: it was his 1920 amendment to the Indian Act that legislated mandatory attendance at the chronically underfunded and inherently violent institutions. Yet the relationship between Scott’s responses to consistent reports documenting horrific rates of death and disease in IRS and his insistence that Canadian poets were the stewards of cultural memory for the young colonial nation has largely escaped critique. This paper makes this relationship visible by investigating how Scott’s characterization of Indigenous child mortality participates in the network of “administrative fictions” that governed IRS policy during and beyond Scott’s tenure. Scott’s depictions of dead, dying, and neglected Indigenous children reveal a fiction of neglect that undermines divisions between his so-called “Indian poems” and early-twentieth-century Aboriginal Affairs policy. This fiction implicitly undermines critiques of the IRS system by constructing an historically distant narrative in which the Indigenous child is always already subjected to the physical violence of residential schools within his/her own community. It fabricates a cultural pseudomemory for Anglo audiences in which poetry functions as an administrative technology — a masked violence reverberating at the literary substratum of the bureaucratic fictions which continue to obscure and forestall justice for Indigenous families and communities in Canada

Protocol for the economic evaluation of a complex intervention to improve the mental health of maltreated infants and children in foster care in the UK (The BeST? services trial)

Introduction: Children who have experienced abuse and neglect are at increased risk of mental and physical health problems throughout life. This places an enormous burden on individuals, families and society in terms of health services, education, social care and judiciary sectors. Evidence suggests that early intervention can mitigate the negative consequences of child maltreatment, exerting long-term positive effects on the health of maltreated children entering foster care. However, evidence on cost-effectiveness of such complex interventions is limited. This protocol describes the first economic evaluation of its kind in the UK. Methods and analysis: An economic evaluation alongside the Best Services Trial (BeST?) has been prospectively designed to identify, measure and value key resource and outcome impacts arising from the New Orleans intervention model (NIM) (an infant mental health service) compared with case management (CM) (enhanced social work services as usual). A within-trial economic evaluation and long-term model from a National Health Service/Personal Social Service and a broader societal perspective will be undertaken alongside the National Institute for Health Research (NIHR)–Public Health Research Unit (PHRU)-funded randomised multicentre BeST?. BeST? aims to evaluate NIM compared with CM for maltreated children entering foster care in a UK context. Collection of Paediatric Quality of Life Inventory (PedsQL) and the recent mapping of PedsQL to EuroQol-5-Dimensions (EQ-5D) will facilitate the estimation of quality-adjusted life years specific to the infant population for a cost–utility analysis. Other effectiveness outcomes will be incorporated into a cost-effectiveness analysis (CEA) and cost-consequences analysis (CCA). A long-term economic model and multiple economic evaluation frameworks will provide decision-makers with a comprehensive, multiperspective guide regarding cost-effectiveness of NIM. The long-term population health economic model will be developed to synthesise trial data with routine linked data and key government sector parameters informed by literature. Methods guidance for population health economic evaluation will be adopted (lifetime horizon, 1.5% discount rate for costs and benefits, CCA framework, multisector perspective). Ethics and dissemination: Ethics approval was obtained by the West of Scotland Ethics Committee. Results of the main trial and economic evaluation will be submitted for publication in a peer-reviewed journal as well as published in the peer-reviewed NIHR journals library (Public Health Research Programme). Trial registration number: NCT02653716; Pre-results

Localized cytokine responses to total knee arthroplasty and total knee revision complications

Background The study of localized immune-related factors has proven beneficial for a variety of conditions, and one area of interest in the field of orthopaedics is the impact of implants and localized infections on immune response. Several cytokines have shown increased systemic concentrations (in serum/plasma) in response to implants and infection, but tissue-level cytokines have not been investigated as thoroughly. Methods This exploratory study investigated tissue-level cytokines in a cohort of patients (N = 17) in response to total knee arthroplasty and total knee revision to better understand the immune response to implants and localized infection (e.g., prosthetic joint infection). The overall goal of this study was to provide insight into the localized cytokine response of tissues and identify tissue-level markers specific to inflammation caused by implants vs. inflammation caused by infection. Tissues were collected across several anatomical locations and assayed with a panel of 20 human inflammatory cytokines to understand spatial differences in cytokine levels. Results In this study, six cytokines were elevated in implanted joints, as compared to native joints: IL-10, IL-12p70, IL-13, IL-17A, IL-4, and TNF-α (p \u3c 0.05). Seven cytokines showed infection-dependent increases in localized tissues: IL-1α, IL-1β, IL-6, IL-8, MCP-1, MIP-1α, and MIP-1β (p \u3c 0.05). Conclusions This study demonstrated that differences exist in tissue-level cytokines in response to presence of implant, and some cytokines were specifically elevated for infection; these responses may be informative of overall tissue health. These results highlight the utility of investigating localized cytokine concentrations to offer novel insights for total knee arthroplasty and total knee revision procedures, as well as their complications. Ultimately, this information could provide additional, quantitative measurements of tissue to aid clinical decision making and patient treatment options

Measure for Measure: The relationship between measures of instructional practice in middle school English Language Arts and teachers’ value-added scores

Even as research has begun to document that teachers matter, there is less certainty about what attributes of teachers make the most difference in raising student achievement. Numerous studies have estimated the relationship between teachers' characteristics, such as work experience and academic performance, and their value-added to student achievement; but, few have explored whether instructional practices predict student test score gains. In this study, we ask what classroom practices, if any, differentiate teachers with high impact on student achievement in middle school English Language Arts from those with lower impact. In so doing, the study also explores to what extent value-added measures signal differences in instructional quality. Even with the small sample used in our analysis, we find consistent evidence that high value-added teachers have a different profile of instructional practices than do low value-added teachers. Teachers in the fourth (top) quartile according to value-added scores score higher than second-quartile teachers on all 16 elements of instruction that we measured, and the differences are statistically significant for a subset of practices including explicit strategy instruction.

Cascading Globalization and Local Response: Indian Fishers’ Response to Export Market Liberalization

Scholars have long debated whether trade liberalization has positive or negative effects on resource use and ecosystems. This study examines the conditions under which resource use increases or decreases in response to reduced trade barriers, specifically after the 2008 World Trade Organization decision that led the United States to reduce anti-dumping duties on Indian shrimp. At the district level in South India, fishing fleet expansion was correlated with access to global market information via mobile phones. Model simulations indicate that increased mobile phone saturation could expand fish- ing effort sufficiently to deplete multiple marine species groups, while other species benefit from the loss of predators. However, scenario analysis suggests that regulatory interventions could mitigate these ecosystem pressures while still permitting fishers to benefit from increased access to global market information

Parks Canada’s adaptation framework and workshop approach: Lessons learned across a diverse series of adaptation workshops

In 2017, the Canadian Parks Council Climate Change Working Group, a team of federal, provincial, and territorial representatives, developed a Climate Change Adaptation Framework for Parks and Protected Areas, guiding practitioners through a simple, effective five-step adaptation process. This framework was adapted by Parks Canada into a two-day adaptation workshop approach, with 11 workshops subsequently held from September 2017 to May 2019 at Parks Canada sites in the Yukon, Quebec, Manitoba, Alberta, Nova Scotia, British Columbia, Newfoundland, and Ontario. Lessons learned from each workshop have been integrated into the approach, with the development of tools and guidance for each phase of the process, and a shareable, visual “placemat” that describes each step of the framework, acting as a map for those navigating the process

Design and methods of Shape Up Under 5: Integration of systems science and community-engaged research to prevent early childhood obesity

Shape Up Under 5 (SUU5) was a two-year early childhood obesity prevention pilot study in Somerville, Massachusetts (2015–2017) designed to test a novel conceptual framework called Stakeholder-driven Community Diffusion. For whole-of-community interventions, this framework posits that diffusion of stakeholders’ knowledge about and engagement with childhood obesity prevention efforts through their social networks will improve the implementation of health-promoting policy and practice changes intended to reduce obesity risk. SUU5 used systems science methods (agent-based modeling, group model building, social network analysis) to design, facilitate, and evaluate the work of 16 multisector stakeholders (‘the Committee’). In this paper, we describe the design and methods of SUU5 using the conceptual framework: the approach to data collection, and methods and rationale for study inputs, activities and evaluation, which together may further our understanding of the hypothesized processes within Stakeholder-driven Community Diffusion. We also present a generalizable conceptual framework for addressing childhood obesity and similar complex public health issues through whole-of-community interventions

Multicentre open label randomised controlled trial of immediate enhanced ambulatory ECG monitoring versus standard monitoring in acute unexplained syncope patients:the ASPIRED study

Introduction Diagnosing underlying arrhythmia in emergency department (ED) syncope patients is difficult. There is a evidence that diagnostic yield for detecting underlying arrhythmia is highest when cardiac monitoring devices are applied early, ideally at the index visit. This strategy has the potential to change current syncope management from low diagnostic yield Holter to higher yield ambulatory monitoring, reduce episodes of syncope, reduce risk of recurrence and its potential serious consequences, reduce hospital admissions, reduce overall health costs and increase quality of life by allowing earlier diagnosis, treatment and exclusion of clinically important arrhythmias. Methods and analyses This is a UK open prospective parallel group multicentre randomised controlled trial of an immediate 14-day ambulatory patch heart monitor vs standard care in 2234 patients presenting acutely with unexplained syncope. Our patient focused primary endpoint will be number of episodes of syncope at 1 year. Health economic evaluation will estimate the incremental cost per syncope episode avoided and quality-adjusted life year gained. Ethics and dissemination Informed consent for participation will be sought. The ASPIRED trial received a favourable ethical opinion from South East Scotland Research Ethics Committee 01 (21/SS/0073). Results will be disseminated via scientific publication, lay summary and visual abstract