Gender representation and textual strategies in the films of Pilar Miro

PhD ThesisThis thesis aims to demonstrate the interrelatedness of the rebellious form and content of Pilar MirO's first six films - La petición (1976), El crimen de Cuenca (1979), Gary Cooper gue estás en los cielos (1980), Hablamos esta noche (1982), Werther (1986) and Beltenebros (1991). The Introduction provides a brief outline of the director's life and an insight into some of the core themes of her cinema, summaries of relevant theoretical arguments from psychoanalysis and gender theory in the context of sociology and film studies and an outline of the situation of men and women in Spain vis-à-vis the law, social prejudices, attitudes to sexuality and work. Part I (chapters 1-6) examines gender issues and character portrayal in each of the films in chronological order using these theories. Part II deals with the metafictional textual strategies of Miró's works. Chapter 7 outlines features of metafiction, such as stylistic intertextuality, literal intertextuality, mise-en-abime devices and other cinematic strategies which highlight the constructed nature of the films by laying bare the processes of fictional creation and disturb the viewer, making him or her an active reader, who cannot acquiesce in a passive spectatorial position. It also discusses the issue of authorship in film to posit that Miró abdicates from the position of onmiscient auteur through intertextuality and her use of assistant authors, another strategy of metafictional, postmodern art. Chapters 8 and 9 look at specific examples of intertextuality. The first section of chapter 8 examines the thematic and stylistic influence of the American artist, Edward Hopper, on the setting of Beltenebros and José Gutiérrez Solana's tremendista paintings as a visual reference for El crimen de Cuenca: the chapter also takes into account the joint stylistic influence of Carol Reed's The Third Man (1949) on Beltenebros. The second section of chapter 8 applies theories of historiographic metafiction and intrahistory to Miró's depiction of a miscarriage of justice in the Spanish legal system and the imprisonment of two innocent men in El crimen de Cuenca. Chapter 9 outlines a special instance of intertextuality in Miró's employment of stars. Using recent work in star studies, I consider the contributions and implications of her choice of two actresses - Ana Belén and Patsy Kensit - to La petición and Beltenebros. The conclusion suggests that, while Miró demonstrates an active interest in and sympathy for the victims of oppression, her use of intertextuality may be unconscious and that this thesis presents just one possible argument or interpretation. An interview with Miró in 1995 is included in an Appendix, as are relevant stills of Ana Belén.The British Academy : University of Newcastle from 1994-1997

The Development and Testing of a New Version of the Cognitive Reflection Test Applying Item Response Theory (IRT)

The cognitive reflection test (CRT) is a short measure of a person's ability to resist intuitive response tendencies and to produce a normatively correct response, which is based on effortful reasoning. Although the CRT is a very popular measure, its psychometric properties have not been extensively investigated. A major limitation of the CRT is the difficulty of the items, which can lead to floor effects in populations other than highly educated adults. The present study aimed at investigating the psychometric properties of the CRT applying item response theory analyses (a two-parameter logistic model) and at developing a new version of the scale (the CRT-long), which is appropriate for participants with both lower and higher levels of cognitive reflection. The results demonstrated the good psychometric properties of the original, as well as the new scale. The validity of the new scale was also assessed by measuring correlations with various indicators of intelligence, numeracy, reasoning and decision-making skills, and thinking dispositions. Moreover, we present evidence for the suitability of the new scale to be used with developmental samples. Finally, by comparing the performance of adolescents and young adults on the CRT and CRT-long, we report the first investigation into the development of cognitive reflection. Copyright (C) 2015 John Wiley & Sons, Ltd

Patient experience of the acute post-surgical period following total laryngectomy during the COVID-19 era

BACKGROUND: Total laryngectomy (TL) results in permanent functional changes requiring rapid development of complex new skills. A significant portion of this learning happens in the acute post‐surgical stage. There is increasing interest in enhanced recovery after surgery (ERAS) protocols in TL; however, implementation has been difficult. COVID‐19 has placed significant pressures on acute services, requiring rapid service changes for TL patients. AIMS: To understand the acute patient experience of having a TL both before and during COVID‐19. METHODS & PROCEDURES: Semi‐structured interviews using a pre‐designed topic guide were conducted with 10 people who had undergone a TL within the last 2 years. Participants were recruited by their speech and language therapists using purposive sampling. Braun and Clarke's iterative approach to data collection and thematic analysis was used to generate key themes from the data. OUTCOMES & RESULTS: Thematic analysis identified four main themes: (1) pre‐operative information‐giving: ‘it was just words’; (2) decision‐making influences: ‘I just wanted them to get it all out and get it over with’; (3) coping with adjustment to the new normal: ‘this is part of me now’; and (4) the importance of relationship‐building: ‘when you've had something like this, you need some care and understanding’. CONCLUSIONS & IMPLICATIONS: The need for an individualized approach to TL intervention which incorporates medical and psycho‐social approaches from pre‐treatment to acute discharge is vital. ERAS models should be reviewed to shift beyond the medical model alone. Rapid service changes due to COVID‐19 did not contribute any major changes to the acute patient‐reported experience. WHAT THIS PAPER ADDS: WHAT IS ALREADY KNOWN ON THE SUBJECT: We know that ERAS protocols have the potential to improve patient outcomes following TL. However, the research does not consider anything other than the early oral feeding debate and it has therefore been difficult to implement ERAS protocols in current service models. COVID19 required head and neck cancer services to make quick changes to surgical pathways, with the potential that some ERAS protocols had been adopted inadvertently. In order to understand the impact of this, we need to understand the patient experience following TL both before and during COVID19. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE: This paper used qualitative interviews to understand the acute patient experience following TL both during and before COVID19. Findings from these interviews highlighted that people were on the most part, well prepared for the functional changes they would experience after surgery. However, people felt there were gaps in service delivery at the pre‐treatment and early discharge home period. Overall, the gaps identified were from a more psycho‐social need suggesting that future ERAS models of care should consider both medical and psycho‐social principles to enhance patient experience and outcome. WHAT ARE THE POTENTIAL OR ACTUAL CLINICAL IMPLICATIONS OF THIS WORK? Pre‐treatment services provided to people who have a TL could be reviewed to help maximize long‐term adjustment to life. Areas which could be reviewed include the method and mode of information delivery. Further work needs to be done in partnership with community services to improve the immediate discharge home experience

Internet Use and Perceived Parental Involvement among Adolescents from Lower Socioeconomic Groups in Europe: An Exploration

Internet usage is a salient developmental factor in adolescents’ lives. Although relevant correlates of Internet use have been documented earlier, there is a lack of information on lower socioeconomic status groups. This is important, as these adolescents have increased risk of negative online experiences. The current survey aimed to explore Internet use and parental involvement amongst adolescents from areas of socio-economic disadvantage in 30 urban schools across five European countries. A total of 2594 students participated, of whom 90% were 14–16 years. Virtually all adolescents of socioeconomic disadvantage had Internet access, with 88.5% reporting spending more than two hours per day online, often on apps such as Instagram, Snapchat, and YouTube. Almost one-third of adolescents did not talk with their parents about their Internet use and almost two-thirds indicated that their parents were only a little or not interested in their Internet use. A consistent finding across countries was that girls more often talked with their parents about their Internet use and more often reported that their parents were interested in their Internet use than boys. The results suggest that parents have an important task in explicitly showing interest in their adolescents’ Internet use, with special attention needed for boys

A prospective study to evaluate the accuracy of pulse power analysis to monitor cardiac output in critically ill patients

<p>Abstract</p> <p>Background</p> <p>Intermittent measurement of cardiac output may be performed using a lithium dilution technique (LiDCO). This can then be used to calibrate a pulse power algorithm of the arterial waveform which provides a continuous estimate of this variable. The purpose of this study was to examine the duration of accuracy of the pulse power algorithm in critically ill patients with respect to time when compared to measurements of cardiac output by an independent technique.</p> <p>Methods</p> <p>Pulse power analysis was performed on critically ill patients using a proprietary commercial monitor (PulseCO). All measurements were made using an in-dwelling radial artery line and according to manufacturers instructions. Intermittent measurements of cardiac output were made with LiDCO in order to validate the pulse power measurements. These were made at baseline and then following 1, 2, 4 and 8 hours. The LiDCO measurement was considered the reference for comparison in this study. The two methods of measuring cardiac output were then compared by linear regression and a Bland Altman analysis. An error rate for the limits of agreement (LOA) between the two techniques of less than 30% was defined as being acceptable for this study.</p> <p>Results</p> <p>14 critically ill medical and surgical patients were enrolled over a three month period. At baseline patients showed a wide range of cardiac output (median 7.5 L/min, IQR 5.1 -9.0 L/min). The bias and limits of agreement between the two techniques was deemed acceptable for the first four hours of the study with percentage errors being 29%, 22%, and 285 respectively. The percentage error at eight hours following calibration increased to 36%. The ability of the PulseCo to detect changes in cardiac output was assessed with a similar analysis. The PulseCO tracked the changes in cardiac output with adequate accuracy for the first four hours with percentage errors being 20%, 24% and 25%. However at eight hours the error had increased to 43%.</p> <p>Conclusion</p> <p>The agreement between lithium dilution cardiac output and the pulse power algorithm in the PulseCO monitor remains acceptable for up to four hours in critically ill patients.</p