Doctor of Philosophy

dissertationBoundary violations between the human and the more-than-human serve as unruly "crossings" that queer and rewild the world as we know it. Animate Rhetoric, Queer Beasts: Rewilding Domesticity explores such puncturings of our everyday worlds. Specifically, I am interested in how animals challenge and transform naturalized human boundaries and barriers. How do animals breach the boundaries surrounding anthroponormativity? Animal crossings at unsanctioned intersections have the power not simply to disrupt, but to animate the world. This project challenges the essentialist claim that rhetoric is the domain of humans, and puts forward the concept of animate rhetoric. Animate rhetoric expresses the potential that everything might be speaking: mountains conversing with wind, rain, sun and pica; chickens clucking in soil and fussing with insouciant Scrub Jays; rivers churning against asphalt and whispering amongst tree roots. Animate rhetoric does not claim that everything is speaking or that it is speaking to us, merely that there is the possibility of such engagement. Such an approach opens up a vibrant, multivocal space for encounters with animal others, rather than silencing them or forcing them to speak in human terms. These discursive productions are events which encourage us to reconsider the world as perceived from the animal's perspective. Social media present unique avenues to consider these multiple worlds. Disruptive animals who rewild the screen reveal the importance of looking at animals, not as mere spectacle, but as animate agents who challenge humans and our own perspective of the world. These productions can challenge the boundaries surrounding the human and spark possibilities for new relationships where borderlines are incoherent and unstable. Linking images of animals together produces an unruly force that plays a role in shaping realities and serving as unexpected sites for resistance. Using case studies that span a range of species, we encounter animal others who bound into our domestic sphere via the digital screen

Dirty, Pretty Trash: Confronting Perceptions through the Aesthetics of the Abject

Both abjection and the return of the abject are crucial feedback. We send away what we don’t want, but the forced confrontation of the abject can have a transformative power when we actually perceive what is a part of us and not apart from us. Visual feedback serves as a potential “event” that can let us experience how our behaviors are problematic; in turn, this knowledge can result in potential for change. When the abject appears in the form of art, it becomes enframed for our scopic pleasure and itself becomes an object to observe and reflect upon: abject as object. When it comes to our encounters with the material world of nature and art, both are more than the picturesque or the sublime, but instead embody the cultural connections that we sometimes wish we could ignore and keep safely out of sight or at a distance. This is why confrontations with the aestheticized abject can serve as potential sites for encounter and possibly of transformation. Artist Mark Dion conceives of art as part of this transformation, asserting that one way to encourage care for the more-than-human world is through an “aesthetic sensibility.” It is this sensibility that Dion employs in his work to address environmental concerns. Rather than ruminate on the sublime or pastoral, Dion explores the frequently invisible urban ecologies that the vast majority of people encounter but frequently keep at a distance. Dion’s work explores what happens to trash and the othered animals that inhabit such trashscapes. By framing the aestheticized abject in the gallery, we grant our bodies the opportunity to perceive and not to simply to look away

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care