In this paper, we consider how references to ‘development’ are deployed to convince communities to lease their land to agribusiness investors in Sierra Leone. We argue that promises of development ...made by companies resonate with the aspirations for development that communities already have. The already existing ‘imaginaries’ of development, actual conditions of economic hardship and the material relations of power bound up in who does the ‘asking’ for land mean that communities need little convincing to give their land. Imaginaries of development are effective not only because of the promises of development themselves, but also because of how these imaginaries function through the role of coloniality – and ‘whiteness’ in particular. Analyses that focus only on the coercive power of elites in making land deals miss the degree to which companies’ promises of development fit into already existing imaginaries of a more prosperous future.
Unplanned extubation (UE) in pediatric patients can result in significant harm or mortality. In our institution, efforts to reduce UE in the ICU were siloed and learnings were not shared. Our goal ...was to implement shared initiatives across ICUs in a pediatric institution using quality improvement methodology, with the global aim of reducing serious harm caused by UEs.
The study was conducted as a single-center prospective quality improvement initiative in the pediatric, neonatal, and cardiac ICUs of a large, freestanding academic pediatric hospital. Using the model for improvement and plan-do-study-act cycles, our multidisciplinary team implemented multiple interventions to reduce UEs. The primary measure monitored was the monthly UE rate, defined as the number of UEs per 100 ventilator days, which was tracked over time using statistical control charts.
The overall monthly institutional UE rate was reduced from 1.22 UE per 100 ventilator days to 0.2 UE per 100 ventilator days, representing an 84% improvement in rate and reduction of harm. Sixteen percent to 21% of UEs required additional resources because of a difficult airway, and 10% to 22% of UEs resulted in cardiovascular collapse requiring resuscitation.
Significant harm is associated with UEs in pediatric patients. We implemented a bundle for UE reduction across all ICU populations in a pediatric hospital and significantly reduced the rate of UE within our institution and within each individual unit. Allowing variation for implementation of interventions by unit, although targeting a common goal, contributed to overall success and sustainability.
Lesbian, gay, bisexual, and transgender (LGBT) youth and young adults are known to have compromised physical and mental health, and family rejection has been found to be an important risk factor. Yet ...few studies have examined the positive role that support from parents, friends, and the community have for LGBT young adults. In a cross-sectional study of 245 LGBT non-Latino White and Latino young adults (ages 21-25) in the United States, sexuality-related social support was examined in association with measures of adjustment in young adulthood. Family, friend, and community support were strong predictors of positive outcomes, including life situation, self-esteem, and LGBT esteem. However, family acceptance had the strongest overall influence when other forms of support were considered. Implications for the unique and concurrent forms of social support for LGBT youth and young adult adjustment are discussed.
Studies of adults who experienced sexual orientation change efforts (SOCE) have documented a range of health risks. To date, there is little research on SOCE among adolescents and no known studies of ...parents' role related to SOCE with adolescents. In a cross-sectional study of 245 LGBT White and Latino young adults (ages 21-25), we measured parent-initiated SOCE during adolescence and its relationship to mental health and adjustment in young adulthood. Measures include being sent to therapists and religious leaders for conversion interventions as well as parental/caregiver efforts to change their child's sexual orientation during adolescence. Attempts by parents/caregivers and being sent to therapists and religious leaders for conversion interventions were associated with depression, suicidal thoughts, suicidal attempts, less educational attainment, and less weekly income. Associations between SOCE, health, and adjustment were much stronger and more frequent for those reporting both attempts by parents and being sent to therapists and religious leaders, underscoring the need for parental education and guidance.
ISSUE: The role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established.
METHODS: A quantitative measure ...with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N= 245).
FINDINGS: Family acceptance predicts greater self‐esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors.
CONCLUSIONS: Family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities.
This study investigated the sex education experiences of adults with visual impairments who attended either an itinerant or residential service delivery model during their school age years in the ...United States. We sought to answer the research questions through an online survey instrument that included quantifiable survey items. Findings demonstrate particular sex education content presented to participants in the school curriculum was more frequent for participants who attended residential schools. However, there were little or no meaningful methods or materials (e.g., role plays, explicit talk, tactile graphics, electronic materials, anatomically correct models) used by the participants in their sex education experiences regardless of their educational school setting. The information reported by participants in this study underscores the claim that more thorough and in-depth sex education is needed in all types of service delivery models that takes into account the needs of students with visual impairments.
Past research documents that both adolescent gender nonconformity and the experience of school victimization are associated with high rates of negative psychosocial adjustment. Using data from the ...Family Acceptance Project's young adult survey, we examined associations among retrospective reports of adolescent gender nonconformity and adolescent school victimization due to perceived or actual lesbian, gay, bisexual, or transgender (LGBT) status, along with current reports of life satisfaction and depression. The participants included 245 LGBT young adults ranging in age from 21 to 25 years. Using structural equation modeling, we found that victimization due to perceived or actual LGBT status fully mediates the association between adolescent gender nonconformity and young adult psychosocial adjustment (i.e., life satisfaction and depression). Implications are addressed, including specific strategies that schools can implement to provide safer environments for gender-nonconforming LGBT students.
This paper considers how the use of 'hybridity' in the peacebuilding literature overlooks the gendered dimensions of hybrid interactions. It does so by examining the United Nations Security Council ...(UNSC) Resolution 1325 national action plans (NAPs) for Liberia and Sierra Leone. By asking the gendered questions of 'who participates?' and 'how do they participate?' it draws from Mac Ginty's conception of hybridity and traces the compliance and incentivizing power in hybridized peace, as well as the ability of local actors to resist and provide alternatives. However, Mac Ginty's model is found to be inadequate because of its inattention to the gendered nature of power. It is found that with a gendered approach to hybridity, it is easier to trace the processes of hybridization of NAPs in post-conflict states where their implementation is limited. In asking the questions of 'who' and 'how', three conclusions about the gendered nature of hybrid peacebuilding are drawn: international intervention relies upon the 'feminization' of local actors; issues framed within the realm of the 'masculine' are more likely to get attention; and the Resolution 1325 agenda in post-conflict states can be subverted by framing it as a 'soft' issue.
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