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This article interrogates the limits and possibilities of interference as methodology and metaphor in video-based research aiming to disrupt ableist understandings of disability that create barriers to health care. We explore the overlapping terrain of diffractive and interference methodologies, teasing apart the metaphorical-material uses and implications of interference for video-makers in our project. Using the digital/multimedia stories created and an interview as research artifacts, we illuminate how interference manifested in disabled makers’ lives, how interference operated through the research apparatus, and how the videos continue to hold agency through their durability in the virtual realm. Drawing on feminist post-philosophies of matter (Barad) and use (Ahmed), we argue that the videos disrupt the gaze that fetishizes disabled bodies, thereby interfering with cultural-clinical processes that abnormalize disability. The research apparatus interfered with makers’ subjectivities yet also brought people together to generate something new—a community that creates culture and contests its positioning as marginal.

PurposeAlthough awareness is growing of the importance of employee mental health and the value of inclusive work practices, less is known about how to support employees with mental illness (MI). We aimed to explore organizational strategies and work practices that promote retention and support of employees living with MI in relation to past theory-driven research by building and extending current theory.Design/methodology/approachWe adopted a qualitative case-study approach focussed on organizations that have taken steps towards promoting workplace inclusion for employees with MI. Five diverse Canadian organizations were recruited based on their efforts to build psychologically safe and healthy workplaces, and actively support employees with MI. Data collection in each organization consisted of onsite observation and interviews with workplace stakeholders, including employees with MI, their co-workers, supervisors/managers and human resource professionals. Thirty interviews were conducted from across the five organizations. Data analysis was informed by interpretive description to identify challenges and opportunities.FindingsTwo key themes were noted in depictions of supportive workplaces: (1) relationship-focussed workplaces and (2) flexible, inclusive work practices.Originality/valueThese practices highlight how organizations support employees with MI. Despite our focus on organizations working towards inclusion, the stigma associated with MI and the rigidity of some workplace processes continue to limit support and retention. Our findings suggest that organizations should focus on communication processes, support mechanisms, how they reinforce flexibility, inclusion and oversight of employees with MI.

This paper frames the workshop spaces created through the arts-based methodology of digital/multi-media storytelling (DST) as ephemeral, affective communities with acts of difference-attuned witnessing and empathy at their core. We present a rich conceptualization of difference-attuned witnessing in the DST space as an affective and a potentially transformative process that recognizes power and difference while providing opportunities for meaningful connection. This methodology was developed by the Re•Vision Centre for Art and Social Justice, a research creation centre that investigates the power of the arts to influence decision-makers and imagine more just futures (Rice et al., 2017, 2018, 2020a). Across research projects, we work to create spaces in which interchange about difference, power, and oppression becomes possible, by bringing together minoritized and majoritized storytellers, including those located in systems (education, healthcare) implicated in minoritized groups’ alienation and oppression (Rice & Mündel, 2018; Douglas et al., 2020). This approach responds to the urgent need for new kinds of social science methods to address persistent, deepening social inequities; we hold that in our neoliberal, hyper-individual, and highly polarized world, arts and storytelling methods hold potential for making dialogue across social problems and uneven power relations possible, but do this in ways that do not erase power, collapse difference or ignore the psychic and material effects of systemic harms (Douglas et al., 2019; Rice et al., 2020b; Rice & Mündel, 2019). This manuscript reports on findings from a larger Canadian Institutes of Health Research-funded study entitled Mobilizing New Meanings of Disability and Difference: Using Arts-Based Approaches to Advance Healthcare Inclusion for Women with Disabilities. Grant # MPO106597.

We explored the experiences of people in larger bodies seeking fertility and/or pregnancy care through a reproductive justice lens, integrating an understanding of weight stigma with an understanding of who has access to reproductive technologies, who is “allowed” to become pregnant, and the discourses that surround pregnancy. We conducted a thematic analysis of the narratives of 17 participants who had been labelled “overweight” or “obese” while pregnant and/or seeking reproductive healthcare related to fertility and/or pregnancy. Participants’ narratives speak to experiences of being surveilled and controlled in medical settings; this surveillance and control negatively impacted their access to desired care. In order to receive the kinds of care they wanted, many participants had to become self-advocates. This self-advocacy speaks to resistance and “resilience”; we discuss how individualizing “resilience” represents an incomplete solution to navigating the shaming and blaming encounters participants experienced with healthcare providers. We argue for healthcare that is more caring and responsive to the needs of diverse individuals who are or who are seeking to become pregnant. This work was funded by a Canadian Institutes of Health Research (CIHR) operating grant #137019 2021-01-29

The current exposure of species assemblages to high environmental variability may grant them resilience to future increases in climatic variability. In globally threatened coral reef ecosystems, management seeks to protect resilient reefs within variable environments. Yet, our lack of understanding for the determinants of coral population performance within variable environments hinders forecasting the future reassembly of coral communities. Here, using Integral Projection Models, we compare the short- (i.e., transient) and long-term (i.e., asymptotic) demographic characteristics of tropical and subtropical coral assemblages to evaluate how thermal variability influences the structural composition of coral communities over time. Exploring spatial variation across the dynamics of functionally different competitive, stress-tolerant, and weedy coral assemblages in Australia and Japan, we show that coral assemblages trade-off long-term performance for transient potential in response to thermal variability. We illustrate how coral assemblages can reduce their susceptibility towards environmental variation by exploiting volatile short-term demographic strategies, thus enhancing their persistence within variable environments. However, we also reveal considerable variation across the vulnerability of competitive, stress-tolerant, and weedy coral assemblages towards future increases in thermal variability. In particular, stress-tolerant and weedy corals possess an enhanced capacity for elevating their transient potential in response to environmental variability. Accordingly, despite their current exposure to high thermal variability, future climatic shifts threaten the structural complexity of coral assemblages, derived mostly from competitive coral taxa within highly variable subtropical environments, emulating the degradation expected across global coral communities.

Predicting the viability of species exposed to increasing climatic stress requires an appreciation for the mechanisms underpinning the success or failure of marginal populations. Rather than traditional metrics of long-term population performance, here we illustrate that short-term (i.e. transient) demographic characteristics, including measures of resistance, recovery, and compensation, are fundamental in the poleward range expansion of hard corals, facilitating the establishment of coral populations at higher-latitudes. Through the annual census of tropical and subtropical Acropora spp. colonies in Japan, between 2017-2019, we show how the transient amplification potential of a subtropical coral population supports its enhanced growth within unstable environmental conditions. The transient dynamics of both the tropical and subtropical populations were strongly influenced by their corresponding recruitment patterns. However, we demonstrate that variation in colony survival and fragmentation patterns between the two populations determines their relative capacities for transient amplification. This latitudinal variation in the transient dynamics of Acropora spp. populations emphasizes that coral populations can possess the demographic plasticity necessary for exploiting more variable, marginal conditions.

Within the hydraulic fracturing domain, automation has begun to play a substantial role in logistics, supply chain, and manufacturing. A review of automation opportunities generally focuses on cost reduction arising from throughput improvements for service delivery. Although cost reduction efforts are important and are delivered in many ways, the automation efforts discussed in this paper take a different approach. Automation now plays a larger role in how stimulation operations are performed from the subsurface perspective. The automation processes reviewed in these studies focus on making more consistent decisions while breaking down the formation to promote an even distribution of fracture fluid placement for all stages. The metric for success is not necessarily focused on cost or time reduction; although these outcomes are occurring, the success metrics focus on the concept that more effective fracturing treatments can be consistently delivered by removing human inconsistency through automation during stimulation operations. This is accomplished is by automatically controlling the pump rate, based on the pressure response from the formation in real time. This paper highlights a series of cases in North American shale basins that include wells that are instrumented with fiber optics and downhole pressure gauges, as well as non-instrumented wells with wellhead pressure and flowrate measurements only. It reviews how automation improves placement consistency in stimulation operations, eliminating some of the risks associated with traditional approaches that can lead to inconsistent outcomes. All of the results communicated are based on the capability to place fracturing fluid and proppant with more uniformity and consistency across the target interval while making real-time automated rate adjustments during pumping operations. The studies include work conducted in all major North American plays. The major findings include a discernable capacity to treat more clusters within a given stage, using automated rate controls, and achieving more even distribution of proppant to the target clusters within a given stage.

While experiences of fear and distrust have been documented as a part of recipients’ interactions with disability benefits, there have been few attempts to explore how they are shaped by system features and their impact on employment pursuits. The purpose of this article is to unpack how fear and distrust emerge among people with mental illness who have recently entered the welfare system. Using an interpretative qualitative approach, the authors draw on the findings from 69 in-depth interviews with key stakeholders about their experiences with employment. Stakeholders included recipients, welfare program and policy staff, and service providers in the community. Data were analyzed by exploring similarities and differences across perspectives and contexts. The findings highlight how system features shape and perpetuate fear and distrust through poorly communicating information about the system, a chaotic state of constant change and complexity, a lack of attention to building trusting relationships between caseworkers and recipients, ongoing system errors, and excessive reporting requirements. The impact of the current state of affairs is significantly harmful to recipients, especially those living with mental illness. Our findings also highlight a possible way forward by building trusting relationships and finding ways to improve communication channels.

In the past decade, the number of children diagnosed with an autism spectrum disorder (ASD) has steadily increased. A common characteristic of ASD is the presence of stereotypical behaviors (e.g., hand flapping, echolalia), which some have suggested may be associated with heightened arousal and/or anxiety. The purpose of this study is to compare antecedent interventions that have been used to decrease stereotypical behaviors in three elementary students with ASD by modulating arousal. Using a single-case alternating treatments design across participants, we compared the relative efficacy of antecedent exercise with two forms of deep-pressure therapy (DPT; compression vest and weighted blanket). Results of the current study found mixed effects for the interventions, with DPT providing little reduction of stereotypical behaviors and antecedent exercise (riding a stationary bike) providing improvement in two of three cases. Implications for practitioners and future research are provided.

Purpose – The purpose of this paper was to identify safeguarding concerns for vulnerable adults, including exploring the implementation of safeguarding policy and procedures into practice. This was achieved by reviewing the content of reflective assignments written by pre-registration student nurses, identifying areas of concerns and proposing action plans. Design/methodology/approach – A qualitative approach was initially utilised to scrutinise a random 10 per cent sample of work, which was thematically analysed. From this, an audit tool was devised and then applied to evaluate a 35 per cent sample of work from the following cohort of students. Approval and consent was gained. Findings – From the initial 10 per cent sample, themes emerged around: practice issues; areas for student's development and marking or assessment issues. The standardised audit tool was devised and applied to a 35 per cent random sample of work. This determined that students identified local safeguarding policies and procedures were being followed in the majority of placement areas, although application of the Mental Capacity Act remained inconsistent. Research limitations/implications – The assessor feedback from the reflective assignments was not available to the reviewers, limiting the reviewers ability to identify if assessors had recognised and corrected any policy or practice issues that the student raised. Only assignments from the adult field of nursing were considered within the scope of this study. The authors recommend further empirical investigation into this area. Practical implications – This paper offers knowledge that can be applied in practice within both academic and health care provider services that deliver and facilitate nursing education. It has generated an audit tool that can be utilised to evaluate the knowledge of pre-registration students and has resulted in the implementation of safeguarding adults policies within an academic institution. Originality/value – Safeguarding adults concerns may be identified through studying pre-registration student assignments and promptly acting upon any concerns raised. Aspects of good practice can be acknowledged within health care provider services.

Photovoice is increasingly lauded as one of a number of emergent research methodologies designed to be empowering for participants. In this paper, we explore the findings from a photovoice study with 15 queer and trans youth in a small urban centre in Ontario, Canada and some of the challenges faced in navigating photovoice ethics when working with a marginalized community that must grapple with dilemmas of visibility and representation in their daily lives. This paper identifies some practical considerations in confronting issues of representation in photovoice research, and reflects on the interaction of the research study with participants’ ongoing negotiation of power imbalances in their daily lives.

Criminal Justice: An Introduction to Philosophies, Theories and Practice Reviewed by Aliraza Javaid Canadian Policing in the 21st Century: A Frontline Officer on Challenges and Changes Reviewed by Katie Cook

Nursing staff in a medical/surgical acute care 34-bed hospital unit were challenged by low percentages of patients able to recall nurse leader rounding activity (NLR). NLR occurred daily for all patients, yet many did not recall visits by nursing leaders when surveyed at discharge. Care giver credibility suffered as non-nursing executives questioned if NLR consistently occurred. Several mechanisms were used to facilitate patient NLR recall: scripted NLR verbiage/keywords, nursing uniform leadership insignia and white lab coats, sharing of business cards, handwritten notes on patient communication white boards, multimedia leadership insignia on leader e-tablets, and visits with family members: patient NLR recall did not improve. Nurses designed low effort, active learning, spaced repetition exchanges using the hospital nurse call system in reverse to distinguish NLR from other care-related activity. A pilot study saw NLR recall climb from a baseline measurement of 37.5% (n=88) to 88% (n=93) following implementation. Mann-Whitney U confirmed significant findings (U=2018.5, p

Background Funders now frequently require that sex and gender be considered in research programmes, but provide little guidance about how this can be accomplished, especially in large research programmes. The purpose of this study is to present and evaluate a model for promoting sex- and gender-based analysis (SGBA) in a large health service research programme, the Ontario Pharmacy Evidence Network (OPEN). Methods A mixed method study incorporating (1) team members’ critical reflection, (2) surveys (n = 37) and interviews (n = 23) at programme midpoint, and (3) an end-of-study survey in 2016 with OPEN research project teams (n = 6). Results Incorporating gender and vulnerable populations (GVP) as a cross-cutting theme, with a dedicated team and resources to promote GVP research across the programme, was effective and well received. Team members felt their knowledge was improved, and the programme produced several sex- and gender-related research outputs. Not all resources were well used, however, and better communication of the purposes and roles of the team could increase effectiveness. Conclusions The experience of OPEN suggests that dedicating resources for sex and gender research can be effective in promoting SGBA research, but that research programmes should also focus on communicating the importance of SGBA to their members. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0182-z) contains supplementary material, which is available to authorized users.

DNA microarrays can be used to measure environmental stress responses. If they are to be predictive of environmental impact, we need to determine if altered gene expression translates into negative impacts on individuals and populations. A large cDNA microarray (14000 spots) was created to measure molecular stress responses to cadmium in Daphnia magna,the most widely used aquatic indicator species, and relate responses to population growth rate (pgr). We used the array to detect differences in the transcription of genes in juvenile D. magna (24 h old) after 24 h exposure to a control and three cadmium concentrations (6, 20, and 37 mu g Cd2+ L-1). Stress responses at the population level were estimated following a further 8 days exposure. Pgr was approximately linear negative with increasing cadmium concentration over this range. The microarray profile of gene expression in response to acute cadmium exposure begins to provide an overview of the molecular responses of D. magna, especially in relation to growth and development. Of the responding genes, 29% were involved with metabolism including carbohydrate, fat and peptide metabolism, and energy production, 31% were involved with transcription/translation, while 40% of responding genes were associated with cellular processes like growth and moulting, ion transport, and general stress responses (which included oxidative stress). Our production and application of a large Daphnia magna microarray has shown that measured gene responses can be logically linked to the impact of a toxicant such as cadmium on somatic growth and development, and consequently pgr.

A diastereoselective process for the formation of intermediates suitable for the preparation of C1 substituted carbapenems was developed. The process is readily scalable and does not involve organometallics or strong bases such as LDA.

Traditional stage models of LGBTQ identity development have conceptualized coming out as a linear process from “closeted” to “out” that all queer/trans individuals must follow if they are to be considered healthy and well adjusted. These stage models have been critiqued for their rigidity and absence of a dynamic understanding of the coming out process. In this article we explore the findings from a qualitative photovoice study with 15 LGBTQ youths in a small urban center in Ontario that supports these critiques. We explore the efficacy of the photovoice technique in investigating questions of sexual and gender identity. This article identifies some contextual factors that are important in understanding coming out as a social (rather than internal) process; it also identifies some of the ways in which these youths’ experiences challenge normative understandings of the “good, out queer.”

This exercise provides students hands-on experience with the topics of glycosidation, hemiacetal and acetal formation, proton nuclear magnetic resonance (1H NMR) spectroscopy, and kinetic and thermodynamic product formation. In this laboratory experiment, the methyl acetal of ribose is synthesized, and the kinetic and thermodynamic products of the reaction are identified using a 300 MHz NMR spectrometer with a variable temperature probe. The results of this reaction under two different sets of conditions reveal that alpha forms of ribosides are less stable than beta forms and that the kinetic products are furanosides, whereas the thermodynamic products are pyranosides. It can be performed as a single 3-h laboratory session or as a series of several sessions if students collect their own NMR spectra and use longer reaction times.

Background Data regarding the efficacy of directly administered antiretroviral therapy (DAART) are mixed. Opioid treatment programs (OTPs) provide a convenient framework for DAART. In a randomized controlled trial, we compared DAART and self-administered therapy (SAT) among HIV-infected subjects attending five OTPs in Baltimore, MD. Methods HIV-infected individuals attending OTPs were eligible if they were not taking antiretroviral therapy (ART) or were virologically failing ART at last clinical assessment. In subjects assigned to DAART, we observed one ART dose per weekday at the OTP for up to 12 months. SAT subjects administered ART at home. The primary efficacy comparison was the between-arm difference in the average proportions with HIV RNA

Women’s choice and control impact birthing experiences. This study used a qualitative, descriptive approach to explore how women develop their initial birth plan and how changes made to the plan affect overall birth experiences. Narrative, semistructured interviews were conducted with 15 women who had given birth in Waterloo Region, Ontario, Canada, and data were analyzed using a phenomenological approach. Findings showed that women relied on many resources when planning a birth and that changes made to a woman’s initial birth plan affected her recollection of the birth experience. Conclusions are that women’s positive and negative recollections of their birth experiences are related more to feelings and exertion of choice and control than to specific details of the birth experience.

Background HIV-infected drug users are at higher risk of non-adherence and poor treatment outcomes than HIV-infected non-drug users. Prior work from our group and others suggests that directly administered antiretroviral therapy (DAART) delivered in opioid treatment programs (OTPs) may increase rates of viral suppression. Methods/Design We are conducting a randomized trial comparing DAART to self-administered therapy (SAT) in 5 OTPs in Baltimore, Maryland. Participants and investigators are aware of treatment assignments. The DAART intervention is 12 months. The primary outcome is HIV RNA < 50 copies/mL at 3, 6, and 12 months. To assess persistence of any study arm differences that emerge during the active intervention, we are conducting an 18-month visit (6 months after the intervention concludes). We are collecting electronic adherence data for 2 months in both study arms. Of 457 individuals screened, a total of 107 participants were enrolled, with 56 and 51 randomly assigned to DAART and SAT, respectively. Participants were predominantly African American, approximately half were women, and the median age was 47 years. Active use of cocaine and other drugs was common at baseline. HIV disease stage was advanced in most participants. The median CD4 count at enrollment was 207 cells/mm3, 66 (62%) had a history of an AIDS-defining opportunistic condition, and 21 (20%) were antiretroviral naïve. Conclusions This paper describes the rationale, methods, and baseline characteristics of subjects enrolled in a randomized clinical trial comparing DAART to SAT in opioid treatment programs. Trial Registration ClinicalTrials.gov: NCT00279110

Opioid dependence is common in HIV clinics. Buprenorphine-naloxone (BUP) is an effective treatment of opioid dependence that may be used in routine medical settings.To compare clinic-based treatment with BUP (clinic-based BUP) with case management and referral to an opioid treatment program (referred treatment).Single-center, 12-month randomized trial. Participants and investigators were aware of treatment assignments. (ClinicalTrials.gov registration number: NCT00130819)HIV clinic in Baltimore, Maryland.93 HIV-infected, opioid-dependent participants who were not receiving opioid agonist therapy and were not dependent on alcohol or benzodiazepines.Clinic-based BUP included BUP induction and dose titration, urine drug testing, and individual counseling. Referred treatment included case management and referral to an opioid-treatment program.Initiation and long-term receipt of opioid agonist therapy, urine drug test results, visit attendance with primary HIV care providers, use of antiretroviral therapy, and changes in HIV RNA levels and CD4 cell counts.The average estimated participation in opioid agonist therapy was 74% (95% CI, 61% to 84%) for clinic-based BUP and 41% (CI, 29% to 53%) for referred treatment (P0.001). Positive test results for opioids and cocaine were significantly less frequent in clinic-based BUP than in referred treatment, and study participants receiving clinic-based BUP attended significantly more HIV primary care visits than those receiving referred treatment. Use of antiretroviral therapy and changes in HIV RNA levels and CD4 cell counts did not differ between the 2 groups.This was a small single-center study, follow-up was only moderate, and the study groups were unbalanced in terms of recent drug injections at baseline.Management of HIV-infected, opioid-dependent patients with a clinic-based BUP strategy facilitates access to opioid agonist therapy and improves outcomes of substance abuse treatment.Health Resources and Services Administration Special Projects of National Significance program.

Many students with Autism Spectrum Disorders (ASD) have delays learning to recognize emotions. Social behavior is also challenging, including initiating interactions, responding to others, developing peer relationships, and so forth. In this single case design study we investigated the relationship between use of computer software ( Mind Reading: The Interactive Guide to Emotions) and emotion recognition (ER) and social behavior change. After using Mind Reading for 7 to 10 weeks with a tutor, four boys with ASD improved ER scores and social interactions with peers. However, observed behavior changes were not strong enough to claim a causal relationship between variables. Findings, practice implications, and future research are discussed.