Early Follow-Up Phone Calls to Reduce 30-Day Readmissions For Stroke Patients Discharged to Home

Patients admitted to the acute stroke unit with minor neurologic deficits are frequently discharged directly to home rather than to a rehabilitation center. Data from our tertiary care comprehensive stroke center has shown that in a 7-month period, 37% of patients admitted to the stroke unit were discharged home versus discharged to rehab or other location. Our average 30-day readmission rate for home discharges is 5.14%. More than 30% of these readmitted patients had been discharged on a Thursday or Friday on their index admission. When discharged home, patients typically are tasked with several responsibilities including but not limited to medication management, organizing follow-up appointments, monitoring blood pressure, and coordinating home services. In addition to recovering mentally and physically from stroke, these tasks can lead to additional burden particularly on weekends when access to care may be limited. We hypothesize that those who are discharged home on a Thursday or Friday are at higher risk for readmission and predict that scripted phone calls to these patients over the weekend could result in reduction in readmissions

Moxibustion Modulates Sympathoexcitatory Cardiovascular Reflex Responses Through Paraventricular Nucleus

Electroacupuncture (EA) point specific (ST36-37) stimulation decreases cardiovascular reflex responses through supraspinal regions such as the hypothalamic paraventricular nucleus (PVN) while mechanical stimulation of acupoints decreases pressor responses through peripheral thermal transient receptor potential vanilloid type-1 (TRPV1). Moxibustion generating heat applied at acupoint in combination with antihypertensive drugs decreases elevated blood pressure. We hypothesized that moxibustion modulates sympathoexcitatory cardiovascular responses through the hypothalamic PVN and peripheral heat sensitive TRPV1 in the absence of antihypertensive drugs. Rats were anesthetized, ventilated, and heart rate and mean blood pressure were monitored. Gastric distention induced consistent pressor reflex responses every 10-min. Thirty-minutes of bilateral moxibustion at the acupoint ST36, overlying the deep peroneal nerves, reduced the gastric distention evoked elevation in blood pressure. Blood pressure reflex responses were not reduced by both EA and moxibustion at G39. The moxibustion inhibition but not EA inhibition of the cardiovascular responses was reversed with blockade of local heat sensitive TRPV1 at ST36. Accordingly, activation of thermal TRPV1 by moxibustion at an average of 44.2°C in contrast to 40°C reduced the pressor responses. Naloxone, an opioid receptor antagonist, microinjected into PVN inhibited transiently the effect of moxibustion. Thus, activation of peripheral heat sensitive TRPV1 mediated the moxibustion-inhibition, but not EA-inhibition, of sympathoexcitatory cardiovascular reflex responses through hypothalamic PVN opioid system

Quality assuring "Plan of the day" selection in a multicentre adaptive bladder trial: Implementation of a pre-accrual IGRT guidance and assessment module

Background and purpose Hypofractionated bladder RT with or without image guided adaptive planning (HYBRID) is a multicentre clinical trial investigating "Plan of the Day" (PoD) adaptive radiotherapy for bladder cancer. To ensure correct PoD selection a pre-accrual guidance and assessment module was developed as part of an image guided radiotherapy quality assurance (IGRT QA) credentialing programme. This study aimed to evaluate its feasibility and effectiveness across multiple recruiting centres.Materials and methods Individuals from participating centres remotely accessed an image database in order to complete the PoD module. An assessment score of ≥83% was required in order to receive QA approval. A questionnaire was used to gather user feedback on the module. PoD decisions for the first patient at each recruiting centre were retrospectively reviewed for protocol adherence.Results 71 radiation therapists (RTTs) from 10 centres completed the PoD module. The median assessment score was 92% (Range: 58-100%) with 79% of RTTs passing the assessment on first attempt. All questionnaire respondents reported that the PoD module prepared them for plan selection. In 51/60 of on-trial treatments reviewed, the PoD selected by the centre agreed with QA reviewers.Conclusions The PoD QA module was successfully implemented in a multicentre trial and enabled pre-accrual assessment of protocol understanding. This increased operator confidence and resulted in appropriate PoD selection on-trial

The Role of Oral Controlled Release Matrix Tablets in Drug Delivery Systems

Formulations that are able to control the release of drug have become an integral part of the pharmaceutical industry. In particular oral drug delivery has been the focus of pharmaceutical research for many years. This type of drug delivery has been at the centre of research due to its many benefits over conventional dosage. The focus of this review is on matrix tablets due to their widely use and simplicity of the formulation. This includes the discussion of various types of matrix tablets and factors affecting the drug release from these formulations. The mechanism of drug release from HPMC matrices is also discussed

Legalizing the racialization of Muslim : an anti-Orientalist discourse analysis of the Anti-terrorism Act of Canada

The central argument in this research is that the knowledges produced through the Antiterrorism Act naturalize the Orientalist construction of male Muslim bodies as threats to the nation, while simultaneously legitimizing the Canadian nation as white. This study disrupts the binary of the security versus civil liberties debates surrounding the dominant discourses about the Anti-terrorism Act. Using race, space and the law as critical tools of analysis, I examine the Orientalist rationalities underpinning the successful mobilization of the Antiterrorism Act as a "juridical discourse" of the Canadian nation. I read for the racialized power in the Act in order to argue that the seemingly neutral language of the Act disguises the way it represents the Orientalist construction of male Muslim bodies as inherently violent, and as a threat to the spaces of the white nation. Within this discussion, I also examine how the Orientalist imagining of Muslim women's bodies has been deployed by the Canadian state to reify the image of Muslim man as 'barbaric' and 'uncivilized'. I situate my analysis of the Act within the broader socio-political history of colonized Canada to argue that the Anti-terrorism Act is part of the historically racist and exclusionary discourses of the nation built on stolen land where mythologies of white supremacy are still rampant as official narratives of the nation.Education, Faculty ofCurriculum and Pedagogy (EDCP), Department ofGraduat

THE "INDIAN" OF FOUR CONTINENTS: READING FOR HORIZONTAL RELATIONS OF VIOLENCE, COMPLICITY, AND THE MAKING OF WHITE SETTLER COLONIALISM

This research study asks: How do we theorize the place of non-Black people of colour vis-à-vis Indigenous peoples and Black people in North America? Paying attention to transnational power relations, and colonial entanglements of differential racialization, I particularly inquire into the place of South Asian diaspora in North America. This study draws upon critical Indigenous, Black, anti-caste, and transnational feminist theories to argue for the urgent need to place analyses of white settler colonialism here in conversation with other entangled histories, presented through discrepant spatialities and temporalities, in order to examine what we know and have yet to learn about entanglements of race, Indigeneity, gender, sexuality, caste, and relations of labor. My “unlikely archive” (Lowe, 2015) of complicity consists of a wide array of legal, representational and cultural artifacts. Drawing upon Edward Said’s contrapuntal reading of texts, and Lisa Lowe’s methodology of paying attention to past conditional temporality, this study travels from analyzing lingering coloniality in a series of photographs titled An Indian from India by a contemporary South Asian artist to Bengal of 19th century where I study Neel Darpan, an anti-colonial protest play. In both these chapters, I show how anti-colonial resistance narratives can often replicate the logics of Empire and leave the very people who are the most marginalized subjects of history as subaltern, silent, and vestigial. My chapter on the figure of the wide circulation of the "Indian Queen" in 18th century Europe examines how she is formed at the nexus of race, coloniality, and capitalism but also understudied or suppressed histories of Europe's Crusades against its Muslim Other. This analysis places anti-Muslim sentiments of the Old World into a much- needed conversation with conquest of the New World. In my last chapter, I study "Indian Arrival Day" a national holiday in the Caribbean celebrating the first arrival of Indians as indentured laborers. This chapter adds to the growing scholarship that moves us away from binaries of free versus unfree or coercive labor and towards more complex readings of modern racialized division of labor.Ph.D.2020-11-19 00:00:0

“We Cannot Write About Complicity Together”: Limits of Cross-Caste Collaborations in Western Academy

Grounded in a friendship that began in the academy, we write together to problematize collaborative writing across our distinct caste positionalities. Writing as caste-oppressed Pakistani Muslim settler (Patel) and dominant caste Indian settler (Da Costa), we write primarily across caste power lines to focus on the failure in our own efforts at collaborative writing. This article, initially meant to focus on our complicities in white settler colonialism in its present form, reflects on the detours we undertook to arrive at this place of certainty that “we cannot write about our complicity together.” Specifically, we reconsider some assumptions underlining prominent methodological commitments of transnational collaborative writing across uneven locations in, for, and beyond the academy. Collaborative writing has been championed for its capacity to generate dialogue across disagreements, praxis grounded in social change, a challenge to the academy’s notions of individual knowledge-production and merit, and as a means of holding people across hierarchies accountable to structures of violence that remain at work within social movements and collective struggles. Considering the contours of what Sara Ahmed (2019) calls structural “usefulness” of collaborative writing to the colonial and neoliberal academy, we use historical and life-writing approaches to make caste violence legible in order to refuse the cover that collaborative writing provides to dominant caste South Asians engaged in research with Indigenous, Black, Muslim, caste-oppressed and multiply and differentially colonized communities. Our purpose is to foreground the historical and ordinary violence of caste as it shapes North American academic relationships, intimacies, and scholarship, in order to challenge the assumption that caste-privileged South Asian scholars of postcolonial and transnational studies in western academia are best poised to collaborate with Indigenous, Black, other racialized, and Dalit scholars and actors toward a decolonial, abolitionist, and anti-casteist feminist praxis. While focusing on writing across caste lines, our analysis can also be read as offering a space to engage ethically with complexities informing collaborative projects across differential horizontal and vertical power relations informed by race, class, gender, sexuality, citizenship, north/south and other differences. In the process of writing this article, we have also paid particular attention to our citational practices