In economic geography and beyond, a call for attention to difference or multiplicity – of logics, subjects, geographies – within capitalist and economic relations is often interpreted as a critique ...in the vein of JK Gibson-Graham: a call to explore capitalism’s alternatives, weaknesses – ‘cracks and fissures’. But there are feminist political economists for whom the multiplicity within and outside capitalism is a source of capitalism’s power; capitalism functions, accumulates and reproduces itself through heterogeneity. In this commentary, we focus on a particular underused theorist who exemplifies such an approach: Maria Mies. We put Mies in conversation with the much better-known Gibson-Graham via each of their depictions of economic relations as an iceberg. We consider each iceberg (and the understanding of capitalism they represent) in relation to capitalist natures scholarship in particular, drawing on our research on the production of emaciated caribou natures in Canada as a mini ‘field test’ for where the icebergs direct our analytical attention. We present these icebergs as a small step towards opening up a broader terrain of feminist theorisations of capitalism and difference than is sometimes recognised in economic geography and political ecology.
Many caribou populations in Canada face extirpation despite dozens of provincial and federal legislative instruments designed to protect them. How are industrial developments that impact caribou ...justified and permitted despite governments' commitments to caribou protection? Toward an answer, this paper scrutinizes an approval process for major projects in Canada: environmental assessment (EA). We identify 65 EAs for major projects with potentially significant adverse impacts for caribou—all projects but one were approved. The results show that most projects were approved on the basis of proposed mitigation measures that promise to render adverse effects “insignificant”; yet mitigation effectiveness is largely unknown. Further, several projects were approved even though mitigation measures were insufficient, citing public or national interest. Finally, some projects' approval rested in part on scientific claims that the project area is already degraded or absent of caribou. Based on these findings, EA is failing caribou, acting as a means by which the state licenses major developments with potentially significant adverse effects for caribou, with a pretense of protection. The failure stems in part from a broader tension within the state that manifests in EA: a tension between the state's roles promoting economic growth and protecting against this growth's negative effects. Recognition of this tension needs to be more central to conservation biology.
Caribou on a pipeline in northeast BC. Photo credit: Land Use Department of West Moberly First Nations.
Parental hesitancy related to human papillomavirus (HPV) vaccines has increased during the pandemic, and there is a call to action by the National HPV Vaccination Roundtable to improve vaccination ...rates. While there are evidence-based strategies available to address parental hesitancy, there are few clear guidelines on how to engage parents to build confidence in the HPV vaccine within the clinical settings. The purpose of this investigation is to explore practice protocols, individual provider strategies, and perceived tools needed to address HPV vaccine hesitant parents from the perspective of providers during the COVID-19 pandemic in the United States. Fifteen healthcare providers participated in qualitative, semi-structured interviews between May 2021 and March 2022. An inductive, qualitative content analysis approach was used to analyze the data. Five themes were described: 1) Provider experiences engaging with HPV vaccine hesitant parents; 2) Existing protocols in the clinics to address HPV vaccine hesitant parents; 3) Strategies used by providers to address parental HPV vaccine hesitancy; 4) Sample message content used by providers to address parental HPV vaccine concerns; and 5) Perceived strategies and tools needed to address parental vaccine hesitancy. Recommendations to address parental hesitancy include recommending HPV vaccinationat 9 years, using a strong recommendation and continued discussion, applying evidence-based approaches and/or promising strategies, linking parents to credible outside sources, and ongoing follow-up if delayed or declined. These findings can be used by researchers and clinicians to improve strategies and messages to inform the development of a protocol to standardize encounters and communication for patient-parent-provider encounters that can influence parental decision-making around HPV vaccine uptake.
To determine how the obstructive sleep apnea (OSA) patient's pathophysiological traits predict the success of the treatment aimed at stabilization or increase in respiratory motor outputs, we studied ...26 newly diagnosed OSA patients apnea-hypopnea index (AHI) 42 ± 5 events/h with 92% of apneas obstructive who were treated with O2 supplementation, an isocapnic rebreathing system in which CO2 was added only during hyperpnea to prevent transient hypocapnia, and a continuous rebreathing system. We also measured each patient's controller gain below eupnea change in minute volume/change in end-tidal Pco2 (ΔVe/ΔPetCO2), CO2 reserve (eupnea-apnea threshold PetCO2), and plant gain (ΔPetCO2/ΔVe), as well as passive upper airway closing pressure (Pcrit). With isocapnic rebreathing, 14/26 reduced their AHI to 31 ± 6% of control (P < 0.01) (responder); 12/26 did not show significant change (nonresponder). The responders vs. nonresponders had a greater controller gain (6.5 ± 1.7 vs. 2.1 ± 0.2 l·min(-1)·mmHg(-1), P < 0.01) and a smaller CO2 reserve (1.9 ± 0.3 vs. 4.3 ± 0.4 mmHg, P < 0.01) with no differences in Pcrit (-0.1 ± 1.2 vs. 0.2 ± 0.9 cmH2O, P > 0.05). Hypercapnic rebreathing (+4.2 ± 1 mmHg PetCO2) reduced AHI to 15 ± 4% of control (P < 0.001) in 17/21 subjects with a wide range of CO2 reserve. Hyperoxia (SaO2 ∼95-98%) reduced AHI to 36 ± 11% of control in 7/19 OSA patients tested. We concluded that stabilizing central respiratory motor output via prevention of transient hypocapnia prevents most OSA in selected patients with a high chemosensitivity and a collapsible upper airway, whereas increasing respiratory motor output via moderate hypercapnia eliminates OSA in most patients with a wider range of chemosensitivity and CO2 reserve. Reducing chemosensitivity via hyperoxia had a limited and unpredictable effect on OSA.
Evaluation and management of an early pregnancy diagnosis are clinically pertinent to multiple specialties that will encounter reproductive-age patients. We designed an interactive, small-group, ...flipped classroom session teaching concepts related to early pregnancy for obstetrics and gynecology clerkship students.
Students received advance preparation materials prior to joining the small group facilitated by clinical educators in the OB/GYN department. Following each 2-hour session, students and facilitators were asked to voluntarily complete a satisfaction survey.
Over six clerkships, which occurred across 9 months, 116 students participated. Eighty-three students completed the satisfaction survey, with 98% agreeing that the session was helpful in applying learned principles to patient care. A very high rate of students (average: 93%) self-reported that they achieved the session's learning objectives after completing the prework and interactive small-group teaching. Eleven clinical instructors completed the survey, with 91% agreeing that they were able to facilitate active learning using the materials and 82% agreeing that the curriculum reduced their personal preparation time to teach compared to traditional didactics.
This interactive flipped classroom session achieves specified learning objectives and helps students apply learned concepts in the evaluation of early pregnancy while standardizing clerkship education and reducing the burden on clinical educators.
Most studies examining post-menopausal menopausal hormone therapy (MHT) use and ovarian cancer risk have focused on White women and few have included Black women.
We evaluated MHT use and ovarian ...cancer risk in Black (n = 800 cases, 1783 controls) and White women (n = 2710 cases, 8556 controls), using data from the Ovarian Cancer in Women of African Ancestry consortium. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of MHT use with ovarian cancer risk, examining histotype, MHT type and duration of use.
Long-term MHT use, ≥10 years, was associated with an increased ovarian cancer risk for White women (OR = 1.38, 95%CI: 1.22-1.57) and the association was consistent for Black women (OR = 1.20, 95%CI: 0.81-1.78, p
= 0.4). For White women, the associations between long-term unopposed estrogen or estrogen plus progesterone use and ovarian cancer risk were similar; the increased risk associated with long-term MHT use was confined to high-grade serous and endometroid tumors. Based on smaller numbers for Black women, the increased ovarian cancer risk associated with long-term MHT use was apparent for unopposed estrogen use and was predominately confined to other epithelial histotypes.
The association between long-term MHT use and ovarian cancer risk was consistent for Black and White women.
Fixing biodiversity loss Dempsey, Jessica
Environment and planning. A,
12/2015, Letnik:
47, Številka:
12
Journal Article
Recenzirano
In the midst of the “sixth extinction” and declarations of the so-called Anthropocene, scientists and conservationists are debating the nature of planetary limits. They are also rethinking the very ...goal of nature conservation in a postnatural direction that is less oriented on saving pristine nature. To shed light on this contemporary debate, this paper looks back to examine three “circuits of power and knowledge” where biodiversity loss is constituted as an ecological crisis with humanity in its crosshairs and later as a more flexible problem of trade-offs. The paper contributes a grounded, empirical examination of the production of, and changing nature of “global biodiversity limits,” showing how they emerge through articulations between power laden and elite ecological-economic knowledge and frameworks, global biopolitical and ethical concerns, state-capital accumulative logics, and national security interests. Reaffirming a critical stance on limits and tracing a persistent ontology of scarcity in global biodiversity science and policy, the paper draws from the story of global biodiversity limits to inform the current discussion of the postnatural turn.
•Preferences for school/child care choice and predicted behaviors were measured.•In this context, parents value knowing school/child care vaccination rates.•Vaccine-hesitant and non-hesitant parents ...value vaccination rate information.•Reporting these rates may affect school/child care choice.
Several states require schools and child cares to report vaccination rates, yet little is known about the impact of these policies. Our objectives were to assess: (1) predicted impact of vaccination rates on school/child care choice, (2) differences between vaccine hesitant and non-hesitant parents, and (3) differences by child’s age.
In 2016, a cross-sectional email survey of Colorado mothers with children ≤12 years old assessed value of vaccination rates in the context of school/child care choice. A willingness-to-pay framework measured preference for schools/child cares with different vaccination rates using tradeoff with commute time.
Response rate was 42% (679/1630). Twelve percent of respondents were vaccine hesitant. On a scale where 1 is “not important at all” and 4 is “very important” parents rated the importance of vaccination rates at 3.08. Respondents (including vaccine-hesitant respondents) would accept longer commutes to avoid schools/child cares with lower vaccination rates. Parents of child-care-age children were more likely to consider vaccination rates important.
This study shows parents highly value vaccination rates in the context of school and child care choice. Both hesitant and non-hesitant parents are willing to accept longer commute times to protect their children from vaccine-preventable diseases.
Smartphone and wearable device use is rising broadly and can be leveraged for chronic disease management. Just-in-time adaptive interventions promise to deliver personalized, dynamic interventions ...directly to patients through use of push notifications from mobile devices. Although just-in-time adaptive interventions are a powerful tool for shaping health behavior, their application to cardiovascular disease management has been limited as they can be challenging to design. Herein, we provide a general overview and conceptual framework for microrandomized trials, a novel experimental study design that can be used to optimize just-in-time adaptive interventions. Microrandomized trials leverage mobile devices to sequentially randomize participants to types or levels of an intervention to determine the effectiveness of an intervention and time-varying moderators of those effects. Microrandomized trials are an efficient study design that can be used to determine which intervention components to include in just-in-time adaptive interventions and to optimize their decision rules while maintaining the strength of causal inference associated with traditional randomized controlled trials.
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