Search

Many Chilean women employers desire domestic workers who are also ‘partners’ or ‘someone to do life with’. Taking ‘partnership’ or ‘compañerismo’ seriously, this paper draws on an affective labor framework and economic sociology to examine how care and power operate in affective and highly commodified labor relations between Chilean women employers and migrant Filipina domestic workers. We contextualize this discussion within historical relations of servitude in Chile and salient demands for more horizontal social and gender relations. We show that rather than reinforcing power or control, employers’ emphases on affective aspects of the labor relation enable their willful ignorance of power hierarchies, through normalizing the racialized presence of the worker in the household. However, explicit talk about money exposes the material conditions of affect and care in this racialized affective relationship. This reveals the uneven distribution and production of both care and power in the household, and highlights the disruptive nature of care work as affective labor.

Aim To identify the highest-priority clinical research areas related to children with neurological impairment and medical complexity among clinicians and caregivers. Method A modified, three-stage Delphi study using online surveys and guided by a steering committee was completed. In round 1, clinicians and family caregivers suggested clinical topics and related questions that require research to support this subgroup of children. After refinement of the suggestions by the steering committee, participants contributed to 1 (family caregivers) or 2 (clinicians) subsequent rounds to develop a prioritized list. Results A diverse international expert panel consisting of 49 clinicians and 12 family caregivers provided 601 responses. Responses were distilled into 26 clinical topics comprising 126 related questions. The top clinical topics prioritized for research were irritability and pain, child mental health, disorders of tone, polypharmacy, sleep, aspiration, behavior, dysautonomia, and feeding intolerance. The clinician expert panel also prioritized 10 specific research questions. Interpretation Study findings support a research agenda for children with neurological impairment and medical complexity focused on addressing clinical questions, prioritized by an international group of clinicians and caregivers.

Distal radius fractures (DRF) are common. They have a bimodal distribution typically occurring as a high-energy injury in the young or a low-energy injury in the older patient with osteoporosis. With the number of DRF predicted to rise, it is important to know how to manage DRF appropriately. The options for the surgical management of adult DRF can appear varied and bewildering. This is further confused by the expanse of literature available regarding the different options, the different types of plate design, and the almost bipartisan belief that either minimalist techniques may be all that are required versus the compulsion to meticulously restore normal anatomy in an attempt to maximize function and reduce disability.

Chief Caupolican is Emile Barrangon, an early 20th-century performer in the US who was born in Chile to an indigenous Mapuche father and a French mother. Despite his fame, he has not yet been included in studies on indigenous agency in Native American representations, likely because of his immigrant origins. We situate his indigenous self-identification and media success within the broader context of ongoing pan-indigenous activism in the country and Native Americans’ efforts to engage indigenous representations in the media. The pan-indigenous movement that sought to unify indigenous political claims, regardless of tribal affiliation, enabled and encouraged foreign-born aborigines and persons of mixed ancestry to identify with indigeneity in ways that transcend nation-state borders. By presenting and examining his multi-faceted life, performance, and political views, this article contributes to better understanding the complex dynamics of the indigenous performance landscape in the early 20th century.

In this conversation, Claire Alexander discusses the overlap between her social research and biographical trajectories, showing us how shifts in academic work are linked to broader transformations, in this case, linked to the politics of identity, ethnicity, and race in the United Kingdom. Alexander also tells us about the meaning and value of ethnographic work, including her experience of “revisiting” places and maintaining links with her research participants over time. Strongly influenced by Stuart Hall, Claire also talks about the importance of communicating ideas to and generating dialogues with those outside of academia. She reflects on her interdisciplinary academic collaborations and work with civil society organizations, and invites us to be committed to and engaged with our contexts and social transformation. RESUMEN: En esta conversación, Claire Alexander aborda la imbricación entre trayectoria en investigación social y biográfica, y nos muestra, además, cómo giros en el trabajo académico se vinculan con transformaciones más amplias; en este caso, con las políticas de identidad, etnicidad y raza en el Reino Unido. Habla también del significado y del valor que tiene el trabajo etnográfico, a través de su experiencia de revisitar lugares y de mantener vínculos con sus participantes de investigación a lo largo del tiempo. Fuertemente influenciada por Stuart Hall, la profesora Alexander se refiere además a la importancia de comunicar ideas y generar diálogos fuera de la academia, de sus colaboraciones interdisciplinarias y con organizaciones de la sociedad civil, y nos invita a comprometernos con nuestros contextos y la transformación social. RESUMO: Nesta entrevista, Claire Alexander aborda a imbricação entre trajetória em pesquisa social e biográfica, mostrando-nos, além disso, como viradas no trabalho acadêmico são vinculadas com transformações mais amplas; nesse caso, com as políticas de identidade, etnicidade e raça no Reino Unido. Alexander nos fala também do significado e do valor que o trabalho etnográfico tem, por meio de sua experiência de “revisitar” lugares e de manter vínculos com seus participantes de pesquisa ao longo do tempo. Fortemente influenciada por Stuart Hall, a professora Alexander também trata da importância de comunicar ideias e gerar diálogos fora da academia, de suas colaborações interdisciplinares e com organizações da sociedade civil, e nos convida a um comprometimento com nossos contextos e com a transformação social.

Background Between 30% and 80% of survivors of critical illness experience cognitive impairment, but the underlying mechanisms remain unknown. Objective To determine whether intensive care unit (ICU) delirium biomarkers align with the National Institute on Aging–Alzheimer’s Association (NIA-AA) research framework for diagnostic biomarkers for Alzheimer disease and other related dementias (ADRD). Methods Ovid MEDLINE, PsycInfo, Embase, and the Cochrane Library were systematically searched for articles published between January 1, 2000, and February 20, 2020, on the relationship between delirium and biomarkers listed in the NIA-AA framework. Only studies that addressed delirium in the ICU setting and fluid biomarkers were included in these analyses. Results Of 61 256 records screened, 38 studies met inclusion criteria, 8 of which were suitable for meta-analysis. In pooled analysis, significant associations were found between ICU delirium and amyloid β-peptide 1-40 (standard mean difference [SMD], 0.42; 95% CI, 0.09-0.75), interleukin (IL)-1 receptor antagonist (SMD, 0.58; 95% CI, 0.21-0.94), and IL-6 (SMD, 0.31; 95% CI, 0.06-0.56). No significant association was observed in pooled analyses between ICU delirium and the other biomarkers. Few studies have examined ICU delirium and pathologic tau or neurodegeneration biomarkers. Conclusions Inflammatory biomarkers and amyloid β are associated with ICU delirium and point to potential overlapping mechanisms between delirium and ADRD. Critical care providers should consider integrating diagnostic approaches used in ADRD in their assessment of post–ICU cognitive dysfunction.

Aims Despite the COVID-19 pandemic, incidence of hip fracture has not changed. Evidence has shown increased mortality rates associated with COVID-19 infection. However, little is known about the outcomes of COVID-19 negative patients in a pandemic environment. In addition, the impact of vitamin D levels on mortality in COVID-19 hip fracture patients has yet to be determined. Methods This multicentre observational study included 1,633 patients who sustained a hip fracture across nine hospital trusts in North West England. Data were collected for three months from March 2020 and for the same period in 2019. Patients were matched by Nottingham Hip Fracture Score (NHFS), hospital, and fracture type. We looked at the mortality outcomes of COVID-19 positive and COVID-19 negative patients sustaining a hip fracture. We also looked to see if vitamin D levels had an impact on mortality. Results The demographics of the 2019 and 2020 groups were similar, with a slight increase in proportion of male patients in the 2020 group. The 30-day mortality was 35.6% in COVID-19 positive patients and 7.8% in the COVID-19 negative patients. There was a potential association of decreasing vitamin D levels and increasing mortality rates for COVID-19 positive patients although our findings did not reach statistical significance. Conclusion In 2020 there was a significant increase in 30-day mortality rates of patients who were COVID-19 positive but not of patients who were COVID-19 negative. Low levels of vitamin D may be associated with high mortality rates in COVID-19 positive patients. Cite this article: Bone Joint J 2021;103-B(4):782–787.

A complete medical examination includes vital signs and a detailed physical examination. This include a full neurologic examination assessing cranial nerves, speech, motor and sensory abilities, balance and coordination, and posture and gait. Many components of this examination can also be observed while taking a clinical history from the patient and observing how they move and speak. Standard initial laboratory tests include a complete metabolic panel and blood count, with reflexive T4 level, fasting lipid panel, HbA1c, and vitamin B12 level. The decision to obtain more specific medical and neurologic exam assessments and laboratory studies should be guided by the differential diagnosis. It is common to include neuro-imaging at this point, especially for acute changes in presentation and when a neurocognitive disorder is suspected.

The research agenda in pediatric hospital medicine has seldom considered the perspectives of young people, parents and caregivers, and health care professionals. Their perspectives may be useful in identifying questions on topics for research.To prioritize unanswered research questions in pediatric hospital medicine from the perspectives of young people, parents/caregivers, and health care professionals.Between August 4, 2020, and August 19, 2021, two online surveys and a virtual workshop were conducted, using modified Delphi technique and nominal group technique. Young people, parents/caregivers, and health care professionals with experiences in pediatric hospital medicine in Canada were included.The established James Lind Alliance Priority Setting Partnership method was used. In phase 1, a survey collected unanswered questions regarding pediatric hospital medicine via 3 open-ended questions. Survey responses were used to develop summary questions that went through an evidence-checking process. Unanswered questions were brought to a phase 2 interim prioritization survey. The top 10 unanswered research questions in pediatric hospital medicine were established at the final priority setting workshop.Survey responses, top 10 research questions.The phase 1 survey was completed by 188 participants (148 of 167 [89%] females; 17 of 167 [10%] males; mean [SD] age, 39.5 [12.4] years) and generated 495 unanswered research questions and comments, of which 58 were deemed out of scope. The remaining 437 responses were grouped into themes (eg, communication, shared decision-making, health service delivery, and health service management) and then refined to 75 unanswered research questions. Of these 75, only 4 questions had sufficient evidence. To make the number of questions in phase 2 manageable, 21 questions submitted by only 1 respondent were eliminated. Fifty unanswered research questions were included in the phase 2 survey, which was completed by 201 participants (165 of 186 [89%] females; 19 of 186 [10%] males; mean [SD] age, 40.0 [11.0] years). A short list of 16 questions-the top 10 questions from patient partners (youths, parents/caregivers) and clinicians-was presented at the final priority setting workshop and the top 10 questions were prioritized. The top 10 questions focused on the care of special inpatient populations (eg, children with medical complexity), communication, shared decision-making, support strategies in the hospital, mental health supports, shortening length of stay, and supporting Indigenous patients, parents/caregivers, and families.This patient-oriented pediatric hospital medicine priority setting partnership identified the most important unanswered research questions focused on the care of children in the hospital. These questions provide a possible roadmap for research on areas deemed important to young people, parents/caregivers, and clinicians.

El aniversario de los cien años de Independencia de Chile, en 1910, remarcó el triunfo de la libertad nacional para el país, pero también un desafío para la modernización y la construcción de identidad. El mayor desarrollo de los medios de comunicación y la opinión pública se combinó con debates intelectuales por discutir una identidad chilena, proceso que reveló las tendencias e influencias sobre la concepción de lo otro. En ese contexto encontramos las revistas magazinescas en las que, según se propone en este artículo, es posible identificar el imaginario chino disponible en el periodo. Una revisión de estas revistas durante la primera mitad del siglo XX evidencia la presencia de estereotipos que permearon transversal y profundamente en la sociedad y que aún persisten en Chile contemporáneo.

Background Complex Care for Kids Ontario (CCKO) is a multi-year strategy aimed at expanding a hub-and-spoke model to deliver coordinated care for children with medical complexity (CMC) across Ontario. Objective This paper aims to identify the facilitators, barriers and lessons learned from the implementation of the Ontario CCKO strategy. Method Alongside an outcome evaluation of the CCKO strategy, we conducted a process evaluation to understand the implementation context, process and mechanisms. Semi-structured interviews were conducted with 38 healthcare leaders, clinicians and support staff from four regions involved in CCKO care delivery and/or governance. Results Facilitators to CCKO implementation were sustained engagement of system-wide stakeholders, inter-organizational partnerships, knowledge sharing and family engagement. Barriers to CCKO implementation were resources and funding, fragmentation of care, aligning perspectives between providers and clinical staff recruitment and retention. Conclusion A flexible approach is required to implement a complex, multi-centre policy strategy. Other jurisdictions considering such a model of care delivery would benefit from attention to contextual variations in implementation setting, building cross-sector engagement and buy-in, and offering continuous support for modifications to the intervention as and when required.

Recognising the growing importance of clinical leadership and entrepreneurship to implement innovative healthcare solutions, final year UK medical students developed a near-peer elective module for first- and second-year students. To date, five cohorts have completed the module and developed skills in the fields of medical technology, quality improvement, and leadership.

Objectives To identify whether delirium biomarkers aligned with the National Institute on Aging-Alzheimer's Association (NIA-AA) research framework, a conceptual model that describes the use of diagnostic biomarkers for Alzheimer's disease and other related dementias (ADRD). Design Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Setting Acute care and outpatient settings. Participants Adults diagnosed with delirium. Methods and measurements MEDLINE, PsycInfo, Embase, and the Cochrane Library were searched for English-language studies published from January 2010 to February 2020. Studies included adults older than 18 years, identified delirium with a standardized assessment tool, and measured an ADRD biomarker. Independent reviewers determined whether an association between delirium and ADRD biomarker was found, the quality of biomarker data based on the REMARK (REporting recommendations for tumor MARKer prognostic studies) checklist, and the study bias based on the Newcastle-Ottawa Scale. Results A total of 61,256 citations were identified; 113 studies were included. Most studies did not examine amyloid, tau, or neurodegeneration biomarkers. Delirium may be associated with neurodegeneration biomarkers, but few to no studies found an association with amyloid and tau biomarkers. Delirium was not consistently associated with inflammatory biomarkers. The quality of biomarker data was moderate, and the risk of bias was moderate to high. Studies often did not collect prehospital and posthospital cognitive data. Conclusion Most delirium diagnostic biomarker studies did not measure amyloid, tau, and/or neurodegenerative biomarkers, making characterization of the relationship between delirium and ADRD difficult. Future delirium biomarker diagnostic studies could improve the understanding of pathophysiologic links between delirium with other conditions affecting cognition.

Chinese migrants are often used as an example of socio-spatial self-segregation, exemplified in Chinatown studies. Drawing on scholarship on citizenship and multiculturalism, I analyze the case stu...

Ethnic Chinese and Asians have historically been excluded, invisibilized, or experienced conditional inclusion in South America. In Chile, the global pandemic provoked an increase in older patterns...

Despite a long history of Chinese presence in Chile and the Americas, the Chinese tend to remain in a state of conditional visibility. Questioning the paradoxical ubiquity and invisibility of expressions of Chineseness in the physical and cultural landscape of Santiago, we examine cultural and discursive processes of (re)production that contribute to this scenario. Informed by understandings of identity and contextualized by the history of the Chinese presence in Chile, we consider the diverse ways in which Chinese people and Chineseness are portrayed on Chilean television and in films and theatre plays. We examine how these representations enable forms of subordination and silencing, and/or highlight the agency of Chinese persons. We show that while Chineseness and Chinese people are typically depicted as one-dimensional and incomprehensible, some productions visibilize and problematize such empty stereotypes. Finally, we demonstrate how these representations resignify Chineseness in a broader Latin American and global context.