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With neither national nor local-level discussions of Senate Bill 1070 adequately addressing bottom line issues such as marginalization, access, and civic engagement, an exploration of marginalized rhetorical acts can provide an informative lens for understanding challenges among marginalized people, their rhetorical tools, and their relations to public spheres. Through an exploration of anti-Senate Bill 1070 graffiti, this article examines how the practice of graffiti points to difference manifesting and playing out in the wider public sphere. It calls for scholars and activists to recognize graffiti as a rhetorical tool worthy of study and cross-cultural discourse.

Introduction/Background: Dialyser membranes can trigger immune responses that can cause clinical deterioration. Prompt identification and elimination of potential causes can be critical for patient safety. Case description: Intradialytic tachycardia, hypotension, gastro-intestinal disturbance, and itch were identified in a new patient commencing haemodialysis (HD). A thorough systematic screen was performed over several weeks to identify the potential causes. Following this, various nursing strategies in relation to HD treatment were instigated e.g., minimal ultrafiltration, increased circuit rinse volume, administration of antihistamine and changes of dialysers. Discussion: Although mildly elevated eosinophils were noted prior to this patient's commencement of HD therapy, no clear cause was identified. Increasing clinical instability during HD sessions with pruritis, tachycardia, hypotension, dyspnoea, hypoxia, urge to defecate triggered regular Nurse Practitioner and medical review. It was noted that eosinophils were increasingly elevated, up to 8.2 x 10^9/L. This led to a hospital admission, five months after commencement of HD, with multiple investigations including eosinophilia screen which encompassed schistosomiasis, JAK2 and strongyloides, and all results were negative. Symptom improvement during HD and tolerability of treatment resulted after changing from synthetic to cellulose triacetate dialyser membrane. Conclusion: This incidence of synthetic membranes dialyser reaction has led to greater identification of this phenomenon which will ultimately improve the patient's dialysis experience. Increased awareness of clinical manifestations of membrane intolerance leads to better patient outcomes. Clear communication, investigation and documentation of these incidents are essential to support patient safety. [ABSTRACT FROM AUTHOR]