The Work of Classroom Safe Spaces

Rosemary Clark-Parson’s critical reflection, “The Work of Classroom Safe Spaces,” historicizes and contextualizes the ongoing debate of “safe spaces” on university campuses in the United States. She offers an intervention into the safe spaces debate, arguing that safe space is a pedagogical practice, something contextual, contingent, and above all, a form of work, rather than a stable, closed concept. Drawing on her own ethnographic work, Parsons asks three fundamental questions regarding what constitutes a safe space: who is the space for, what is this space safe from, and what is safe to do in this space. She carries these questions into the classroom to collaborate with her students on the possible answers.&nbsp

Doing It Ourselves: The Networked Practices Of Feminist Media Activism

Feminist organizing in the United States is undergoing a paradigm shift. Whereas 1960s-era feminism unfolded through the in-person activities of formal organizations, today, feminist movements are mediated and networked. Contemporary feminism manifests as hashtags, blogs, print zines, digitally coordinated protests, online communities, and more. Case studies of recent movements suggest that, for feminists, to be networked is to be both politically empowered and politically vulnerable. At the same time that emerging media platforms enable activists to quickly reach wide audiences at little or no expense, networked movements face online harassment, commercial cooptation, and activist burnout. This qualitative study examines how feminists are navigating the double-edged nature of networked activism. In particular, I demonstrate how feminists are drawing on networked media to organize resistance, mobilize protests, and cultivate communities, all while juggling the affordances and limitations of their media tools. Data for this study come from an ethnographic analysis of grassroots feminist media activism in the city of Philadelphia, textual analyses of national and transnational feminist media campaigns, and interviews with and archived reflections from activists. Through this data, I argue that feminists’ negotiations among media platforms, the political context, and their intersectional values produce a particular activist praxis. I call this praxis do-it-ourselves (DIO) feminism, an organizing paradigm that draws on networked media to build feminist movements from the ground up that reflect feminist values and meet the challenges of the current climate. Faced with an electoral system and a history of collective organizing that has failed to address intersecting systems of oppression, DIO feminists do not rely on existing political institutions. Instead, they draw on networked media to create their own communities, discourses, and protests, cutting out the middlemen of political leaders, organizations, parties, and policy-makers and integrating protest into everyday life. Feminists’ turn toward diffuse, decentralized media networks and away from formal organizations raises questions about movement accessibility, sustainability, backlash, impact, and cooptation. But the do-it-ourselves praxis is a distinctly feminist form of networked activism that models new possibilities for what collective action and social transformation can look like in the networked era

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Doing It Ourselves: The Networked Practices Of Feminist Media Activism

Feminist organizing in the United States is undergoing a paradigm shift. Whereas 1960s-era feminism unfolded through the in-person activities of formal organizations, today, feminist movements are mediated and networked. Contemporary feminism manifests as hashtags, blogs, print zines, digitally coordinated protests, online communities, and more. Case studies of recent movements suggest that, for feminists, to be networked is to be both politically empowered and politically vulnerable. At the same time that emerging media platforms enable activists to quickly reach wide audiences at little or no expense, networked movements face online harassment, commercial cooptation, and activist burnout. This qualitative study examines how feminists are navigating the double-edged nature of networked activism. In particular, I demonstrate how feminists are drawing on networked media to organize resistance, mobilize protests, and cultivate communities, all while juggling the affordances and limitations of their media tools. Data for this study come from an ethnographic analysis of grassroots feminist media activism in the city of Philadelphia, textual analyses of national and transnational feminist media campaigns, and interviews with and archived reflections from activists. Through this data, I argue that feminists’ negotiations among media platforms, the political context, and their intersectional values produce a particular activist praxis. I call this praxis do-it-ourselves (DIO) feminism, an organizing paradigm that draws on networked media to build feminist movements from the ground up that reflect feminist values and meet the challenges of the current climate. Faced with an electoral system and a history of collective organizing that has failed to address intersecting systems of oppression, DIO feminists do not rely on existing political institutions. Instead, they draw on networked media to create their own communities, discourses, and protests, cutting out the middlemen of political leaders, organizations, parties, and policy-makers and integrating protest into everyday life. Feminists’ turn toward diffuse, decentralized media networks and away from formal organizations raises questions about movement accessibility, sustainability, backlash, impact, and cooptation. But the do-it-ourselves praxis is a distinctly feminist form of networked activism that models new possibilities for what collective action and social transformation can look like in the networked era

Doing It Ourselves: The Networked Practices of Feminist Media Activism

Feminist organizing in the United States is undergoing a paradigm shift. Whereas 1960s-era feminism unfolded through the in-person activities of formal organizations, today, feminist movements are mediated and networked . Contemporary feminism manifests as hashtags, blogs, print zines, digitally coordinated protests, online communities, and more. Case studies of recent movements suggest that, for feminists, to be networked is to be both politically empowered and politically vulnerable. At the same time that emerging media platforms enable activists to quickly reach wide audiences at little or no expense, networked movements face online harassment, commercial cooptation, and activist burnout. This qualitative study examines how feminists are navigating the double-edged nature of networked activism. In particular, I demonstrate how feminists are drawing on networked media to organize resistance, mobilize protests, and cultivate communities, all while juggling the affordances and limitations of their media tools. Data for this study come from an ethnographic analysis of grassroots feminist media activism in the city of Philadelphia, textual analyses of national and transnational feminist media campaigns, and interviews with and archived reflections from activists. Through this data, I argue that feminists’ negotiations among media platforms, the political context, and their intersectional values produce a particular activist praxis. I call this praxis do-it-ourselves (DIO) feminism, an organizing paradigm that draws on networked media to build feminist movements from the ground up that reflect feminist values and meet the challenges of the current climate. Faced with an electoral system and a history of collective organizing that has failed to address intersecting systems of oppression, DIO feminists do not rely on existing political institutions. Instead, they draw on networked media to create their own communities, discourses, and protests, cutting out the middlemen of political leaders, organizations, parties, and policy-makers and integrating protest into everyday life. Feminists’ turn toward diffuse, decentralized media networks and away from formal organizations raises questions about movement accessibility, sustainability, backlash, impact, and cooptation. But the do-it-ourselves praxis is a distinctly feminist form of networked activism that models new possibilities for what collective action and social transformation can look like in the networked era