75 research outputs found

    Implementation of a Validated Suicide Screening Tool in a University Student Health Center

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    Purpose. Suicide is the second leading cause of death among adults in the United States and Nebraska. Death by suicide impacts millions of adults every year in the United States but warning signs are often missed during visits with primary care providers. The University of Nebraska at Kearney (UNK) Student Health Center (SHC), like many other primary care clinics, did not routinely screen patients for suicide risk. According to the Joint Commission, all patients over 12 years of age should be screened for suicide using a validated screening tool if the visit is for any behavioral health concern. The project’s goals were to implement a validated suicide screening tool, evaluate the use and effectiveness of the suicide screening tool, and evaluate the relationship between the depression screening tool and suicide screening tool. Theoretical Framework. The Advancing Research and Clinical Practice through Close Collaboration (ARCC) model was used to guide this project. The ARCC model is a five-step quality improvement plan that includes, assessment of culture and organizational readiness, identification of facilitators and barriers, identification of evidence-based practice (EBP) mentors, implementation of the evidence into practice, and evaluation of the outcomes (University of Maryland School of Nursing, 2020, para. 3). Methods. UNK is a public university in central Nebraska with over 6,000 undergraduate and graduate students. The Columbia Suicide Screening Scale (C-SSRS), a validated six-question yes/no style screening questionnaire, was implemented in UNK\u27s SHC campus clinic for all patients who screened positive for depression on the Patient Health Questionnaire (PHQ-2) or by provider preference. The C-SSRS was administered to the patients by the nurse practitioners to determine the patient\u27s level of suicide risk and appropriate intervention. Interventions included a mental health resource sheet for lowrisk patients, establishing a safety plan with the provider for moderate-risk patients, or referral to an inpatient psychiatric facility for a full psychiatric evaluation for high-risk patients. Results. Over a 14-week period, UNK’s SHC had a total of 773 visits with 729 (94.3%) PHQ-2 screenings completed and 301 (38.9%) C-SSRS screenings completed. Of the 301 C-SSRS screenings completed, 69.8% of patients were at no risk, 17.6% were at low risk, 9.6% were at moderate risk and no patients were at high risk of suicide. Two hundred fifty-eight students completed the PHQ-2 and the C-SSRS screenings. Seven patients (3.7%) were at low risk and three patients (1.6%) were at moderate risk of suicide while scoring two or less on the PHQ-2 screening. Of the patients who scored three or higher on the PHQ-2, six patients (8.6%) declined the C-SSRS screening, 31 patients (44.3%) were at no risk, 19 patients (27.1%) were at low risk, and 14 patients (20%) were at moderate risk for suicide. Eight patients declined the C-SSRS but had an average PHQ-2 score of 4.25. Conclusions. Based on the data, implementation of a validated suicide screening tool is sustainable and beneficial for recognition of suicide risk in the college population. It is vital to screen for suicide risk and connect at-risk college students with appropriate, algorithm-based interventions to work toward decreasing suicide rates across the country. Of note, it may be beneficial to implement the C-SSRS to all students as there were a small number of students (n=10) identified at low or moderate risk without a PHQ-2 score of three or higher. It is also important to ensure the patients who decline the suicide screening still may need to receive intervention as if they are low or moderate risk of suicide based on provider discretion

    Stigma Resistance through Body-in-Practice:Embodying Pride through Creative Mastery

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    Stigma, as a process of shame, fosters social exclusion and diminishes bodily competences. Thus, stigmatized consumers often turn to the marketplace for respite. Based on an ethnographic study of drag artists, this study proposes a new understanding of the body that emerges from the mastery of creative consumption practices to combat shame. We theorize a novel “body-in-practice” framework to examine how consumers transform from an imagined persona to an accomplished body to embody pride. Six novel stigma resistance strategies emerged—experimenting, guarding, risk-taking, spatial reconfiguring, self-affirming, and integrating. Body-in-practice thus explains how shame weakens, pride strengthens, emotions stabilize, and self-confidence grows. This research contributes by explaining the hard work of identity repair, exploring stigma resistance across safe and hostile social spaces, and highlighting the emancipatory potential of embodied mastery

    Refining trunk injection strategies for control of foliar insect pests and disease in Michigan apple orchards

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    In conventional apple orchards, insect pests are managed with insecticides delivered to the canopy using airblast sprayers, which provide good canopy coverage. However, spraying results in significant product loss: as little as 26% is estimated to reach the tree canopy due to spray drift and less than 0.1% of insecticide ends up reaching the target pest. The remainder is lost to the environment with potential to harm people or non-target organisms. Trunk injection is a discriminating pesticide delivery system which reduces insecticide inputs and environmental exposure by delivering chemicals directly to the vascular system. It is commonly used to deliver pesticides in ornamental and shade trees. Recent work with trunk injection in apple orchards has shown promise, but more research must be done to determine efficacy and safety in tree fruit crops. In the following studies, we injected emamectin benzoate, imidacloprid, dinotefuran, spinosad, chlorantraniliprole, and abamectin into apple trees to expand the list of insecticides compatible with trunk injection. Nectar and pollen were sampled from trees to compare the effects of injection timing on insecticide concentration in floral resources. In addition, two fundamental injection tool types were compared: drill-based and needle-based. To test compatibility of combined insect and disease management, an insecticide and a fungicide were injected simultaneously. Finally, low-volume injections were performed on nursery apple trees, which normally require high pesticide inputs and do not produce fruit for several years. Emamectin benzoate, chlorantraniliprole and abamectin resulted in moderate to high mortality and reduced feeding in Choristoneura rosaceana bioassays using leaves sampled from trunk injected apple trees. Neonicotinoids reduced Empoasca fabae density in field evaluations, and also showed activity on C. rosaceana at higher concentrations. Spinosad was not well-transported within the apple tree vascular system. Numbers of E. fabae nymphs were lower on trees injected with imidacloprid using a drill-based tool compared with untreated trees in all years, despite a trend of initially higher foliar concentrations with the needle-based tool. This demonstrated that delivery method is an important factor in effective trunk injection based apple management. We found that when an insecticide and a fungicide are injected, they can interact dynamically within the vascular system of a tree. Injections of emamectin benzoate followed by phosphorous acid into the same set of injection ports resulted in higher mortality of C. rosaceana larvae and lower incidence of apple scab compared with untreated trees. This has important implications for expanding the utility of trunk injection for fruit tree management. Nursery tree injections were most effective when emamectin benzoate was injected into the trunk versus the taproot. A rate equivalent to 1/8 the rate used for mature tree injection reduced insect pests more than a 1/80 rate. The higher rate of emamectin benzoate was also persistent in the following year. Imidacloprid and emamectin benzoate were injected in the spring and fall, and nectar and pollen were sampled the following spring. Imidacloprid was not detected in nectar or pollen when injected in the previous spring. Conversely, emamectin benzoate was detected when injected in the previous spring, but was not detected in nectar or pollen when injected in the fall. This study expanded the list of insecticides compatible with trunk injection, demonstrated novel uses of trunk injection to reduce insect pests in apple trees, and introduced possible ways to mitigate accumulation of insecticides in nectar and pollen.Thesis (Ph. D.)--Michigan State University. Entomology, 2017Includes bibliographical references (pages 94-99

    Collectors, investors and speculators: gatekeeper use of audience categories in the art market

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    This research examines gatekeepers' categorization work to assess and sort audience members. Using a multi-sited ethnography and interpretivist qualitative lens, we explore how high-value art gallerists sort buyers via categories, but also encourage conformity with preferred audience categories, both for artistic consecration goals and to discourage disruptive speculation. Categories served as reference points, with preferred and problematic buyer categories providing a discursive socialization tool, but also informing gatekeeping strategies, for example, problematic behaviors and buyer categories led to value-protecting gatekeeping and exclusion, often justified in moral terms. Monitoring continued throughout the relationship, with decisions considered both fair and necessary for gallerists’ professional practice. Gatekeeping decisions included long-term temporal considerations, prompting strategies including ‘placement,’ monitoring and audience recategorization. This extends gatekeeping beyond simply passing muster at the ‘gate.’ We also illustrate the dynamic and fluid nature of hidden categories, which provide gatekeepers with heightened abilities to punish perceived wrongdoing

    Uncertainty, strategic sensemaking and organisational failure in the art market: What went wrong with LVMH's investment in Phillips auctioneers?

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    Strategic decision-making in the volatile and uncertain art market is not only instigated by rational interpretation of the external environment, but also by expert-based intuition. This paper investigates organisational failure at Phillips auctioneers between 1999 and 2002, a period in which it was owned by the multinational luxury goods conglomerate Louis Vuitton Moët Hennessy (LVMH). To analyse this case, we develop a conceptual framework for strategic sensemaking in art organisations that includes the processes of scanning, interpreting, strategising, acting and adjusting, which take place in non-linear and recursive patterns in supporting continuous loops of improvement. Our analysis identifies the merits of intuitive decision-making when realising a novel artistic and entrepreneurial vision which established Phillips as a boutique auction house. However, it also highlights the limitations of emotional and opportunistic decision-making which could lead to blinded management if any of the processes of strategic sensemaking is ignored.National Research Foundation of Kore

    Physical and Epistemic Objects in Museum Conservation Risk Management

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    The Financialisation of the Art Market

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    London and New York are primary centres for both finance and the art market, indicating the continuing power of place. Both cities have become havens for wealth, wealth that has poured into the art market, and sometimes into the newer practices of art investment. Under what can be termed the financialisation of art, we can see the rise of a new industry sector that further knits together the art market and financial services, explaining the growth of art investment and its supporting industries, and highlight the enabling role of geographic location. Original article available at publisher's website: http://www.e-ir.info/2016/03/01/the-financialisation-of-the-art-market

    BOOK REVIEW: Beyond price: Value in culture, economics, and the arts

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    How is it that we can understand value in markets and society? As opposed to letting economists answer this question, there is now a growing interest in the social sciences on questions of value and valuation outside of economics, breaking down what David Stark has called ‘Parsons’ Pact,’ that economists study value, and sociologists—as an example here—study values. Michael Hutter and David Throsby’s Beyond Price: Value in Culture, Economics and the Arts provides an excellent challenge to this narrowing divide, contributing to an area of work that we might call valuation studies or the sociology of valuation
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