Ambiguity, Absurdity, and Reversibility: Indeterminacy in De Beauvoir, Camus, and Merleau-Ponty

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Fits and Misfits: Rethinking Disability, Debility, and World with Merleau-Ponty

This piece lays out the framework for a special issue on the topic of "Fits and Misfits," published as volume 7, issue 1 of Puncta: A Journal of Critical Phenomenology. We discuss the relationship between the concept of misfitting, coined by Rosemarie Garland-Thomson, and debility, coined by Jasbir Puar, in relationship to scholarship on Merleau-Ponty. We then introduce each of the eight articles in the special issue: Rosemarie Garland-Thomson's "What Misfitting Makes," Susan Bredlau's "Conversational Accessibility: Healthcare, Community, and the Ethics of Everyday Encounters," Helen A. Fielding's "Being Touched by Wellness: Merleau-Ponty, Nancy, and the Intensive Care Unit," Ann Murphy's "The Spirited Interworld: Caregiving and the Liminal Phenomenology of Dementia," Rachel Elliott's "Sharing Time with Misfits: We-Experience across Bodily Difference," David Morris's "An-Archic Time: Melting the Clock as Hypernorm of the I Can -- and Philosophy," Rebecca Longtin's "Merleau-Ponty's Cézanne as Misfit Artist," and, finally, Laura McMahon's "The Politics of Vulnerability and the School for Peace: Insights from Butler, Merleau-Ponty, and Family Systems Theory.

Increased ocular lens density in HIV-infected individuals with low nadir CD4 counts in South Africa: evidence of accelerated aging.

BACKGROUND: HIV infection is thought to be associated with an increased risk of age-related morbidity and premature aging. Lens density increases with age and may function as a biomarker of aging. The relationship of lens density measurements with clinical and demographic characteristics in HIV-infected individuals in comparison with a matched population of HIV-seronegative individuals was investigated. METHODS: Case-control study of 490 adults aged greater than or equal to 30 years composed of 242 HIV-infected adults and 248 age- and sex-matched HIV-seronegative individuals. Lens density was assessed using lens densitometry (Pentacam) imaging. Measurements were divided into quartiles, and comparison of HIV status and HIV-related factors was assessed by multivariate and multinomial logistic regression. RESULTS: The mean age was 41.2 years in HIV-infected adults and 42.3 years in HIV-seronegative individuals (P = 0.14). Of the HIV-infected adults, 88% were receiving antiretroviral therapy (ART) (median duration, 58 months), and within this group, their median CD4 count was 468 cells per microliter and 84% had undetectable viral load. Although adjusted lens densities were similar by HIV serostatus, participants on ART and who had nadir CD4 counts less than 200 cells per microliter had a higher risk of high lens density compared with HIV-seronegative individuals (P trend = 0.04). Lens density was weakly associated with detectable HIV viremia despite ART, but not with current CD4 count. CONCLUSIONS: HIV-infected individuals on ART with nadir CD4 counts <200 cells per microliter had increased risk of higher lens density. Lens density may represent a novel biomarker of aging, providing insight into accelerated aging trajectories in HIV infection

Measuring Nurses’ Impact on Health Care Quality: Progress, Challenges, and Future Directions

Background: Quality measurement is central in efforts to improve health care delivery and financing. The Interdisciplinary Nursing Quality Research Initiative supported interdisciplinary research teams to address gaps in measuring the contributions of nursing to quality care. Objective: To summarize the research of 4 interdisciplinary teams funded by The Interdisciplinary Nursing Quality Research Initiative and reflect on challenges and future directions to improving quality measurement. Methods: Each team summarized their work including the targeted gap in measurement, the methods used, key results, and next steps. The authors discussed key challenges and recommended future directions. Results: These exemplar projects addressed cross-cutting issues related to quality; developed measures of patient experience; tested new ways to model the important relationships between structure, process, and outcome; measured care across the continuum; focused on positive aspects of care; examined the relationship of nursing care with outcomes; and measured both nursing and interdisciplinary care. Discussion: Challenges include: measuring care delivery from multiple perspectives; determining the dose of care delivered; and measuring the entire care process. Meaningful measures that are simple, feasible, affordable, and integrated into the care delivery system and electronic health record are needed. Advances in health information systems create opportunities to advance quality measurement in innovative ways. Conclusions: These findings and products add to the robust set of measures needed to measure nurses’ contributions to the care of hospitalized patients. The implementation of these projects has been rich with lessons about the ongoing challenges related to quality measurement