“The one with Ross’s fat sister”:a critical discourse analytic study of fatphobia in the TV show Friends

Abstract. Research shows that visual media plays a part in reinforcing the internalization of the thin body ideal, the idealization of an extremely thin body, which can then result in the devaluation of bodies that do not fit the body ideal. This can lead to fatphobia, the social stigma of obesity. In this thesis, my aim is to examine how the TV show Friends (1994–2004) uses humor, language and character representation to oppress and degrade fat people and reinforce fatphobia, and how fatphobia in Friends is constructed through language. I will refer to fat feminist theory while using critical discourse analysis to analyze the dialogue, non-verbal communication and characters in Friends. My main research materials will be pre-written transcripts of selected episodes of Friends. I will combine the analysis of both the transcripts and the audiovisual material from the episodes. I will discuss my findings in reference to the superiority theory of laughter as well as Albert Bandura’s social learning theory and the concept of observational learning through models. The findings show that Friends uses humor and jokes to oppress and degrade fat people and reinforce fatphobia. This is done by enforcing hurtful stereotypes, positioning fat characters as comic scapegoats, positioning fat characters as inferior to the viewers using the superiority theory of laughter, using fat characters as models of failure and creating drastic contrast and comparison between thin and fat people. Furthermore, it can be argued that Friends influences viewers and reinforces hatred towards fat people and thus contributes to fatphobia in society.”The one with Ross’s fat sister” : kriittinen diskurssianalyyttinen tutkimus fatphobiasta TV-sarja Frendeissä. Tiivistelmä. Tutkimusten mukaan medialla on merkittävä rooli laihuuden ihannoinnissa ja idealisoinnissa. Laihuuden ihannointi voi johtaa siihen, ettei kehoja, jotka eivät sovi kehoihanteeseen, pidetä enää arvokkaina. Tämä voi pahimmillaan johtaa ‘fatfobiaan’, lihavuuspelkoon, eli lihaviin ihmisiin kohdistuvaan syrjintään, kielteisiin ennakkoluuloihin sekä perusteettomiin, negatiivisiin asenteisiin. Tavoitteeni on tutkia, miten TV-sarja Frendit (1994–2004) käyttää huumoria, kieltä ja hahmoja luodakseen ja tukeakseen haitallisia stereotypioita ja ennakkoluuloja lihavia ihmisiä kohtaan, vahvistaakseen lihavien ihmisten kohtaamaa syrjintää, sekä heikentääkseen heidän asemaansa yhteiskunnassa. Käytän kehofeminististä teoriaa sekä kriittistä diskurssianalyysiä analysoidessani Frendit-sarjan jaksojen dialogia, kehonkieltä ja hahmoja. Pääasiallinen tutkimusmateriaalini on puhtaaksi kirjoitetut transkriptiot valituista Frendit-jaksoista, joita analysoin yhdessä jaksojen audiovisuaalisen materiaalin kanssa. Tarkastelen analyysiäni naurun paremmuusteoriaan sekä Albert Banduran kehittämän sosiaalisen oppimisen teoriaan viitaten. Tulokset osoittavat, että Frendit käyttää huumoria ja vitsejä vahvistaakseen fatfobiaa vahvistamalla haitallisia stereotypioita, luomalla lihavien ihmisten painoon liittyvää komiikkaa, luomalla illuusion katsojista ylempi- ja lihavista hahmoista alempiarvoisina, käyttämällä lihavia hahmoja epäonnistumisen malleina sekä asettamalla lihavat ja laihat henkilöhahmot vastakkain vertaillakseen heitä keskenään, vain ylistääkseen laihoja henkilöhahmoja ja halventaakseen lihavia henkilöhahmoja. Voidaan siis väittää, että Frendit käyttää vaikutusvaltaansa katsojiinsa lisäämällä ennakkoluuloja ja negatiivisia asenteita lihavia ihmisiä kohtaan, siten edistäen fatfobiaa yhteiskunnassa

Acute bleeding obstruction pancreatitis after Roux-en-Y anastomosis in total gastrectomy: a single center experience

Anastomotic intraluminal bleeding is a well-known complication after total gastrectomy. Nevertheless, few data are published on acute bleeding obstruction pancreatitis (BOP) due to a bleeding from the jejunojejunostomy (JJ). In this paper we describe our experience. A total of 140 gastrectomies for EGJ cancer were performed in our Institute from January 2012 to January 2017. All reconstructions were performed with a Roux-en-Y anastomosis: a mechanical end-to-side esophago-jejunostomy and a mechanical end-to-side JJ. Three patients suffered from a bleeding at the JJ with a consequent BOP. We analyzed the time of diagnosis, the treatment and the outcomes. The three patients presented anemia at the laboratory findings on postoperative day (POD) 1. In patient I laboratory findings of acute pancreatitis were found in POD 2. CT scan was performed and showed signs of BOP. Endoscopic treatment was tried without success. Therefore, patient underwent surgery: JJ take down, bleeding control and anastomosis rebuild were performed. In spite of this the patient died of MOF in POD 4. Patient II had a persistent anemia treated with blood transfusions until POD 3, when laboratory tests showed increased lipase and bilirubin levels. Patient was successfully treated with endoscopy but several blood transfusions and a prolonged recovery were necessary. Patient III had laboratory findings of acute pancreatitis on POD 1. Immediate surgery was performed and patient was discharged on POD 9 without sequelae. BOP is a rare but deadly complication after Roux-en-Y anastomosis. An early diagnosis and an aggressive treatment seem to improve the outcome

Supporting LGBTQ+ students: a focus group study with Junior High School nurses

LBGTQ+ students often miss the support and information they need in the school nursing, but little is known about junior high school (JHS) nurses’ work with LGBTQ+ students. 15 JHS nurses were interviewed in focus groups about their perceptions of supporting LGBTQ+ students. Four interconnected themes were identified with inductive thematic analysis: (1) JHS nurses’ professional identity and practice; (2) Recognition of sexual and gender diversity in school; (3) Family acceptance process; and (4) LGBTQ+ students as school nursing clients. JHS nurses self-identified as accepting professionals, but having limited skills, knowledge, and education needed in supporting LGBTQ+ students. Supporting LGBTQ+ students is a complex phenomenon, and to enhance JHS nurses’ competence in providing care for these students, sexual and gender diversity needs to be included in evidence-based nursing information sources, covered in nursing education, and the school needs to be secured as LGBTQ+ safe place

Saamelaisen varhaiskasvatuksen arki

Tiivistelmä Artikkelissa käsittellään saamelaista varhaiskasvatusta Suomessa. Aihetta lähestytään käsitteellisestä ja arjen toteutuksen näkökulmista. Varhaiskasvatuksessa työskentelevät lastentarhanopettajat ja lastenhoitajat ovat avainasemassa arjen toteutuksessa. Artikkelissa avataan saamelaisessa varhaiskasvatuksessa työskentelevien kokemuksia ja ajatuksia arjen toteutuksesta. Kasvatus toteutetaan tavallisessa arjessa. Se perustuu, niin instituutioissa kuin niiden ulkopuolella, julkilausuttuihin ja julkilausumattomiin perusteisiin, lakeihin, normeihin ja arvoihin. Nykyisessä lainsäädännössä ja varhaiskasvatuksen normiohjauksessa saamelaista kulttuuria eikä yhteiskuntaa tuoda esille yhtenä toiminnan perustana ja lähtökohtana. Saamen kielellä toteutettavassa varhaiskasvatuksessa työskentelevät pitävät saamelaista kulttuuria institutionaalisen toimintansa merkittävänä lähtökohtana.Čoahkkáigeassu Artihkkalis gieđahallo sápmelaš árrabajásgeassin Suomas. Fáddá lahkonuvvo doahpagiid ja árgga ollašuhttima geahččanguovlluin. Mánáidgárdeoahpaheaddjit ja mánáiddikšut, geat barget árrabajásgeassimis, leat guovddážis árgga ollašuhttimis. Artihkkalis rahppojuvvojit sápmelaš árrabajásgeassima bargiid vásáhusat ja jurdagat árgga ollašuhttimis. Bajásgeassin ollašuhttojuvvo dábálaš árggas. Dat vuođđuduvvá nu institušuvnnain go daid olggobealde, albmosis celkojuvvon ja albmosii cealkkekeahtes vuođuštusaide, lágaide, norpmaide ja árvvuide. Dálá láhkaásaheamis ja árrabajásgeassima norpmastivremis sápmelaš kultuvrra ja servodat ii buktojuvvo ovdan oktan doaimma vuođđun ja vuolggasadjin. Sámegielain ollašuhttojuvvon árrabajásgeassimis bargi olbmot atnet sápmelaš kultuvrra sin institušuvnnalaš doaimma mearkkašahtti vuolggasadjin

The role of 18fluoro-deoxyglucose positron emission tomography/computed tomography in resectable pancreatic cancer

BACKGROUND: The role of 18fluoro-deoxyglucose positron emission tomography/computed tomography in pancreatic ductal adenocarcinoma is debated. We retrospectively assessed the value of 18fluoro-deoxyglucose positron emission tomography/computed tomography in addition to conventional imaging as a staging modality in pancreatic cancer. METHODS: 18Fluoro-deoxyglucose positron emission tomography/computed tomography was performed in 72 patients with resectable pancreatic carcinoma after multi-detector computed tomography positron emission tomography was considered positive for a maximum standardized uptake value >3. RESULTS: Overall, 21% of patients had a maximum standardized uptake value 643, and 60% of those had undergone neoadjuvant treatment (P=0.0001). Furthermore, 11% of patients were spared unwarranted surgery since positron emission tomography/computed tomography detected metastatic disease. All liver metastases were subsequently identified with contrast-enhanced ultrasound. Sensitivity and specificity of positron emission tomography/computed tomography for distant metastases were 78% and 100%. The median CA19.9 concentration was 48.8U/mL for the entire cohort and 292U/mL for metastatic patients (P=0.112). CONCLUSIONS: The widespread application of 18fluoro-deoxyglucose positron emission tomography/computed tomography in patients with resectable pancreatic carcinoma seems not justified. It should be considered in selected patients at higher risk of metastatic disease (i.e. CA19.9>200U/mL) after undergoing other imaging tests. Neoadjuvant treatment is significantly associated with low metabolic activity, limiting the value of positron emission tomography in this setting

Perianastomotic drainage in Ivor-Lewis esophagectomy, does habit affect utility? An 11-year single-center experience

Anastomotic leakage (AL) is a deadly complication after Ivor-Lewis esophagectomy. The use of an anastomotic drainage (AD), to diagnose and to potentially treat the leakage, is still a widespread practice. At present, scientific literature is lacking in this topic and its use is based on each center experience. We performed a retrospective analysis of 239 consecutive patients who underwent an Ivor-Lewis esophagectomy in our Department from 01/01/2006 to 31/12/2017. Until 28/02/2014, a transthoracic anastomotic drainage was routinely placed in 119 patients (anastomotic-drain group). Drainage removal was planned on POD 5 after the resume of oral intake. In the remaining 120 cases, no drainage was placed (no anastomotic-drain group). We compared the two groups to assess whether the anastomotic drainage had an impact on the timing of the anastomotic leakage diagnosis and treatment. In our series, we observed 9 anastomotic leaks in the first group (7.6%) and 3 in the second one (2.5%). In the anastomotic-drain group, median time for leak diagnosis was 10 days, and notably, in seven cases, the anastomotic drainage was already removed. Considering all the patients who experienced an AL, a re-operation was mandatory in one case, while endoscopic treatment was chosen for five cases and conservative treatment was adopted in three cases. The median hospital length of stay in these patients was 31 days. In the no anastomotic-drain group, one patient with anastomotic leakage was treated conservatively and discharged after 34 days. The other two cases were re-operated and an esophageal prosthesis was placed in both cases, and these patients were discharged, respectively, on POD 28 and POD 38. Concluding, the role of the anastomotic drain in Ivor-Lewis esophagectomy is still unclear. There is a shortage of the literature on this topic and our experience shows that the anastomotic drain has a limited sensibility in AL diagnosis and cannot replace the clinical signs and symptoms. Moreover, the drain it is often removed before the leakage becomes visible. In selected patients with a less severe leak, the anastomotic drain can be an effective treatment, but often a percutaneous drainage, it is an effective alternative choice. In severe dehiscence with sepsis, a reoperation remains the mainstay to control the mediastinal contamination and to eventually treat the leakage