Evidence for the Validity of a Tool for Improved Pressure Ulcer Staging by the Non-Expert in the Live Patient

Background and Purpose: Pressure ulcers (PrUs) are a costly issue for the health care system. The utilization of a tool that increases the accuracy of PrU identification and staging may allow the health care team to better manage these wounds. The purpose of this study was to determine the validity of the NE1 Wound Assessment Tool (NE1 WAT) for increasing the wound assessment accuracy of novice nurses. Subjects: A convenience sample of 11 novice nurses evaluated 11 wounds on eight patients at a 730 bed, hospital in Las Vegas, Nevada. Methods: Subjects assessed 11 wounds on the patients independently. They then received brief orientation to the NE1 WAT. The subjects then re-assessed the same 11 wounds utilizing the NE1 WAT. Accuracy in wound assessment was then compared when performed with and without the tool. Results: Wilcoxon signed-rank tests were used to compare scores before and after training on how to use the tool. The subjects showed a significant improvement in pressure ulcer staging (p=.005), identification of wounds other than pressure ulcers (p = .024), and overall score across all aspects of wound assessment when using the NE1 WAT (p = .017). Discussion: This study provides evidence for the validity of the NE1 WAT. Improved wound assessment would likely improve care. Due to Medicare billing rules, the NE1 WAT has the potential to impact hospital remuneration. Conclusion: Following brief orientation on tool use, there was increased accuracy of novice nurse wound assessment on live patients

Radiation therapy reduces local failure and improves overall survival in sPNET

No abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/58650/1/21513_ftp.pd

Obesity, Complexity, and the Role of the Health System

As obesity continues to increase throughout the world, there is still no well-defined solution to the issue. Reducing obesity poses a significant challenge for the health care system because it is a complex problem with numerous interconnections and elements. The complexity of obesity challenges traditional primary care practices that have been structured to address simple or less complicated conditions. Systems thinking provides a way forward for clinicians that are discouraged or overwhelmed by the complexity of obesity. At any given level, individuals matter and system functioning is optimized when our capacity is well matched to the complexity of our tasks. Shifting paradigms around the causes of obesity is essential for creating a health care system that promotes innovative and collaborative practice for healthcare practitioners and individuals dealing with obesity

Gender and the Cultural Preoccupations of the American West

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139590/1/Cordell and Johnston_intro.pdf-

The Third Library and the Commons

The idea of the “commons” is often invoked in discussions of the academic library’s future, but these references are usually vague and rhetorical. What exactly does it mean for the library to be organized as a commons, and what might such a library look like? Does the concept of the commons offer a useful lens for identifying the library’s injustices or shortcomings? How might we draw on the concept of the commons to see beyond the horizon of the contemporary library, toward a “Third Library” that truly advances decolonial and democratic ends? This essay engages with such questions and explores how the constituent elements of the academic library—its knowledge assets, its workers, and its physical spaces—might be reoriented toward the commons. It argues that such an orientation might facilitate the emergence of a Third Library that is able to organize resistance to contemporary capitalism’s impetus toward the privatization and enclosure of knowledge, and to help recover a democratic conception of knowledge as a public good

(Post-)queer citizenship in contemporary republican France

1996 saw the publication of Frédéric Martel’s Le Rose et le noir, a comprehensive study of three decades of gay life in metropolitan France. The predominantly anti-communitarian stance adopted by Martel in the epilogue to the first edition of his work had evolved, by the time of the book’s publication en poche in 2000, into a more nuanced view of the interactions and intersections between queer and republican identities in contemporary France. This development was influenced, in large part, by concrete changes which took place over the second half of the 1990s, centring around the introduction of the PACS in 1999, and leading to an ever-broadening debate. This paper will begin by setting forth the ways in which Martel’s position changed and analysing the attitudinal, social, and legislative backdrop which paved the way for such a change to occur. It will then bring Martel’s work into a dialogue with the writings of Eric Fassin and Maxime Foerster, both of whom have, like Martel, offered crucial analyses of the place of queer citizens within the contemporary French republic. Particular attention will first be paid to the ways in which Fassin, in his writings, has underlined the salience of the ‘droit du sol/droit du sang’ debate, traditionally associated with questions of ethnic belonging, in light of public and political discussions revolving around questions of queer kinship raised by the introduction of the PACS. This will lead into an examination of Foerster’s assertion that gay citizens of the Republic, in the era of the PACS, find themselves in a role previously held by women, in other words, as elements that require integration within a republican model. Foerster argues that this requirement to integrate is indicative of the fact that the traditional republican claim that the citizen is a blank canvas is at best misguided, and, at worst, has been deliberately subverted. This paper will examine the manner in which Martel and Fassin’s observations can be used to further strengthen the points raised by Foerster, concluding with the latter that a true engagement with the issues raised by debates around queer citizenship over the past decade can, in fact, allow the contemporary republican citizen to ‘devenir ceux [qu’il] est’. In other words, the article will conclude that the potential impact of the PACS legislation and the broader discussions it has provoked could be a renegotiation of the relationship between queer citizens and the republic