Empiricist Interventions:Strategy and Tactics on the Ontopolitical Battlefield

Recent papers by prominent scholars in science and technology studies (notably John Law and Bruno Latour) have crystallized a fundamental disagreement about the scope and purpose of intervention in actor-network theory or what we here choose to bracket as empirical philosophy. While the precept of agnostic description is taken as a given, the desired effects of such descriptions are highly debated: Is the goal to interfere with the singularity of the real through the enactment of multiple and possibly conflicting ontologies? Or is it (also) to craft new and comprehensive common worlds supported by notions of due process and parliamentary procedure? In this paper we think about this disagreement as a question of research strategy (a normative discord about the desirable outcome of an intervention) in order to assess its implications for research tactics (a descriptive accord about the practical crafting of an adequate account). A key point here is to challenge the impermeability of such a division and show how the strategic dispute, if to be taken seriously, invariably spills over to swamp the level of tactics. To illustrate this point, we draw upon materials from our recent doctoral research projects and to facilitate the discussion we make two deliberate caricatures: Firstly, we operate with a simplified history of actor-network theory in which a strategy of epistemological critique has been replaced by two contending agendas for ontological intervention. Secondly, we address these two contending agendas as distinct options which map on to the positions of our two main interlocutors. In doing so, it becomes possible to compare their respective tactical implications as we work through two examples of what might constitute an empiricist intervention

Pilotstudie av en ny metod för mätning av endotoxinaktiviteten i blodet hos tikar med pyometra

Förhöjda halter av endotoxin i blodet förekommer ofta vid sjukdomen pyometra hos tik och kan orsaka många av de allmänna symtom som ses vid sjukdomen. Endotoxin Activity Assay (EAA) är en ny, snabb metod för mätning av endotoxinaktivitet i helblod. EAA-metoden är anpassad för humanpatienter, men har testats i forskningsstudier och visats fungera även för hundar och efter viss modifiering också för hästar. Två olika apparaturer från finns att tillgå för EAA (från Spectral Diagnostics Incorporated). Den apparatur som utvärderas i den här studien har aldrig tidigare testats på djurslaget hund. Resultaten som erhållits i denna pilotstudie har dock inte varit lika positiva som förväntat. Inkonsekventa EAA-värden uppmättes hos friska tikar, vilket gör att liten tillit kan sättas till de värden som erhållits hos tikarna med pyometra. Analysen fungerar därmed i dagsläget inte tillförlitligt för djurslaget hund. Dock kan sannolikt metoden modifieras och möjligen därefter fungera även för hundar

Dem Leibkörper auf der Spur. Theoretischer Begründungsrahmen professioneller reflexiver Könnerschaft im Berufsfeld Pflege

Professionalism in nursing and care finds expression in the interactive dialogue of physical encounters between the professional carer (actor perspective) and the patient (client perspective). In their day-to-day work, professional carers face the challenge of discovering, culturally and historically informed traces of the life course and socialisation of their patients, searching, constructing and reconstructing them, and then integrating the findings in a resource-oriented care and treatmant process. The performativity of professional care highlights the relevance of the body, mimetic processes and concomitant practices of enactment, presentations and performance. Understood thus, a professional reflexive ability, based on an understanding of the cases from a carer perspective and the ability to form judgement, is a prerequisite of care work. From an interdisciplinary angle the theoretical framework is explained for developing a professional reflexive ability for nursing and care education and practice

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Something Happening. On the Geographies of a Mummified Body

EThOS - Electronic Theses Online ServiceGBUnited Kingdo