Documentary as alternative practice: Situating contemporary female filmmakers in Sinophone cinemas

Women’s documentary filmmaking in Sinophone cinemas has been marginalized in the film industry and understudied in film studies scholarship. The convergence of neoliberalism, institutionalization of pan-Chinese documentary films and the historical marginalization of women’s filmmaking in Taiwan, Hong Kong, and the People’s Republic of China (PRC), respectively, have further perpetuated the marginalization of documentary films by local female filmmakers. The orientalizing gaze from the global north does not take into account local women’s struggle in the industry whereas the local male-dominant industry in each region is strongly tied to and upheld by different discourses of nationalism. By addressing multiple layers of hegemony, my research examines the local and global impact on female documentary filmmakers in the above three regions since the 1980s and the ways in which they adjust their modes of production while continuing in their works to resist dominant ideologies that have shaped mainstream national/regional film culture. Drawing from production studies and feminist film criticism, I point out that each production trajectory reflects changing political systems, institutions and resources available over time. Female documentary filmmakers’ interpretative and communicative power have rewritten the traditionally male-dominant and neo-national narratives of film history and industry. Since the 1980s, Taiwanese female documentary filmmakers have carved out alternative representations during a time when defining the meaning of a national cinema was an urgent task. Hong Kong female documentarians share a consistently radical and humanistic concern regarding gender and ethnic diversity without resorting to political or cultural essentialism or antagonism. Documentary films by women in the PRC expose the incongruence between the state’s agenda and the lived reality of Chinese women. Sinophone female documentarians’ radical resistance does not only reside in their works but in their filmmaking practices, which foreground the periphery as the site in which place-based and community-based stories and identities are shaped and told

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Self-medication and knowledge among pregnant women attending primary healthcare services in Malang, Indonesia: a cross-sectional study

Background: Self-medication with over-the-counter (OTC) drugs is an important public health concern, especially in the vulnerable population of pregnant women due to potential risks to both the mother and fetus. Few studieshave studied how factors, such as knowledge, affect self-medication. This study investigated self-medication and its associated factors among pregnant women attending healthcare services in Malang, Indonesia. Methods: A cross-sectional study was conducted from July to September 2018 in five healthcare services. A selfadministered questionnaire was used and the data were analyzed using multiple regression models. Results: Of 333 female participants, 39 (11.7%) used OTC medication. Women with a higher level of knowledge of OTC medication were more likely to self-medicate—adjusted odds ratio (aOR) = 2.15, 95% confidence interval (CI) = 1.03–4.46. Compared with those with less knowledge, pregnant women with more correct knowledge of the possible risk of self-medication were less likely to self-medicate—aOR = 0.29; 95% CI = 0.14–0.60. The effect of a higher level of knowledge of OTC medication was significant among women who had middle school and lower education—aOR = 8.18; 95% CI = 1.70–39.35. The effect of correct knowledge on the possible risks of self medication was significant only among women with high school and higher education—aOR = 0.17; 95% CI = 0.07–0.42. Conclusion: Imparting specific knowledge of the potential risks of using non-prescribed medication during pregnancy may help pregnant women navigate and more safely manage their OTC use. We also suggest further collecting data from more healthcare services, such as hospitals, to obtain more findings generalizable to the Indonesian community

Predicting 1 Repetition Maximum Using Handheld Dynamometry.

BACKGROUND: Isometric assessment of muscular function using a handheld dynamometer (HHD) is frequently used in clinic environments. However, there is controversy in terms of the validity of isometric assessment to monitor changes in dynamic performance. One repetition maximum (1RM) is considered the gold standard for evaluating dynamic strength, though clinicians do not often use 1RM testing, preferring to be cautious with clients who have preexisting impairments. If strength testing using an HHD could be used to predict 1RM, this may have significant implications for the use of isometric testing to prescribe exercise in clinical environments. OBJECTIVE: To establish the relationship and agreement between 1RM and isometric strength scores measured using HHD for the biceps and quadriceps muscle groups and to determine if HHD measurements can be used to predict 1RM. DESIGN: Criterion standard comparison. SETTING: Tertiary institution gymnasium. PARTICIPANTS: Convenience sample of 50 healthy adults (26 women) aged 19-33 years (mean 23.38 ± 3.11 years). METHODS: Muscle strength of the biceps and quadriceps muscle groups measured by 1RM and isometric maximal voluntary contraction measured using an HHD. MAIN OUTCOME MEASURES: Statistical analysis of the relation between the measures of strength was established using Pearson correlation and a Bland-Altman plot. A linear regression analysis with included covariates (gender, age, resistance training history, and body mass index) was used to derive the prediction equations. RESULTS: A significant correlation was found between 1RM and HHD scores for the biceps (r = .83, P &lt; .001) and quadriceps muscle groups (r = .82, P &lt; .001). However, strength scores were not in agreement. Linear regression analysis found significance in predicting 1RM from all HHD scores (P &lt; .001). Gender as a covariate significantly influenced the prediction of 1RM for the biceps (P = .005) and quadriceps (P = .003) muscle groups. CONCLUSIONS: There is a significant relationship between 1RM and HHD measures of strength, and measures taken using an HHD can be used to predict 1RM in the biceps and quadriceps muscle groups. The use of an HHD may therefore provide a more accessible alternative to 1RM for muscle strength assessments. Further research is warranted to determine if results are applicable in clinical populations

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe