Nursing resources and patient outcomes in intensive care: a systematic review of the literature

Objectives: To evaluate the empirical evidence linking nursing resources to patient outcomes in intensive care settings as a framework for future research in this area. Background: Concerns about patient safely and the quality of care are driving research on the clinical and cost-effectiveness of health care interventions, including the deployment of human resources. This is particularly important in intensive care where a large proportion of the health care budget is consumed and where nursing staff is the main item of expenditure. Recommendations about staffing levels have been trade but may not be evidence based and may not always be achieved in practice. Methods: We searched systematically for studies of the impact of nursing resources (e.g. nurse-patient ratios, nurses' level of education, training and experience) on patient Outcomes, including mortality and adverse events, in adult intensive care. Abstracts of articles were reviewed and retrieved if they investigated the relationship between nursing resources and patient Outcomes. Characteristics of the studies were tabulated and the quality of the Studies assessed. Results: Of the 15 studies included in this review, two reported it statistical relationship between nursing resources and both mortality and adverse events, one reported ail association to mortality only, seven studies reported that they Could not reject the null hypothesis of no relationship to mortality and 10 studies (out of 10 that tested the hypothesis) reported a relationship to adverse events. The main explanatory mechanisms were the lack of time for nurses to perform preventative measures, or for patient surveillance. The nurses' role in pain control was noted by One author. Studies were mainly observational and retrospective and varied in scope from 1 to 52 units. Recommendations for future research include developing the mechanisms linking nursing resources to patient Outcomes, and designing large multi-centre prospective Studies that link patient's exposure to nursing care oil a shift-by-shift basis over time. (C) 2007 Elsevier Ltd. All rights reserved.

Representations of multicultural identities in British Cinema

This paper explores the transnational and interstitial dimensions of cultural production in Britain today, and the representation of migrant and diasporic identities in contemporary mainstream British cinema. The box office success of films like Gurindha Chadha’s Bhaji on the Beach (1993) and Bend it Like Beckham (2002) and East is East (Daniel O’Donnell 1999) and their precursors My Beautiful Launderette (Stephen Frears 1985), Sammy and Rosie Get Laid (Stephen Frears 1987) and the TV mini-series Buddha of Suburbia (Roger Mitchell 1993) seem to celebrate and articulate a set of values around hybridity and alterity: a discourse of multiculturalism. This paper will engage with a series of key questions. Are there ideological values implicit within and common to all these texts? Can we map a rhetoric or discourse of multiculturalism within popular culture? Do mainstream representations of immigrant identities represent a discourse of resistance, a decolonising global culture or is this Western brand of multiculturalism still located within an Orientalising gaze? In what ways are multiculturalism and postcolonialism overlapping and yet opposing rhetorics? [From the Author]

A grey literature review of the Cultural Olympiad

This article considers the development of the UK Cultural Olympiad supporting London's successful bid to stage the Olympic Games in 2012. It suggests that the Cultural Olympiad is a complex event itself and needs to be better understood if any impacts are to be felt in a meaningful sense. The event is thus considered through review of over 50 documents relating to its management, in the context of a number of identified themes: cultural development, developing institutional frameworks, social benefit, educational benefit and promotional benefit.

Rats, floods and flowers: London's Gothicized nature

AUTHOR's OVERVIEW This chapter attempts a definition of London eco-gothic, beginning with an ecocritical reading of the ubiquitous London rat. Following Dracula, popular London gothic has been overrun, from the blunt horror-schlock of James Herbert’s 1970s Rats series to China Miéville’s King Rat. Maud Ellman’s elegant discussion of the modernist rat as a protean figure associated with a ‘panoply of fears and fetishes’, underlines how the rat has always featured in anti-urban discourse: as part of racist representations of immigration; as an expression of fear of disease and poverty; or through a quasi-supernatural anxiety about their indestructible and illimitable nature which makes them a staple feature of post-apocalyptic landscapes. Even so, the London rat is a rather more mundane manifestation of urban eco-gothic than the ‘city wilderness’ metaphors common to representations of New York or Los Angles as identified by eco-critic Andrew White. London’s gothic noses its way out through cracks in the pavements, grows from seeds in suburban gardens or accumulates through the steady drip of rainwater. However, I will suggest, in texts such as Maggie Gee’s The Flood and P. D. James’ Children of Men, London eco-gothic becomes less local and familiar as it responds to global environmental crisis with more dramatic tales of minatorial nature.

Jung’s cultural writing: spiral essays and performing symbols (in literature)

Performance is a key ingredient of Jung’s writings on culture and of the function of the Jungian symbol in literature. This paper will compare and contrast Jung’s performance of cultural analysis and healing in his essays with the way his notion of the symbol works in literature to knit the individual psyche into the collective. It will explore Jung’s unique essay form of the spiral as a literary innovation, and look at the way a Jungian reading of literary reveals a significant contribution to cultural studies. [From the Author]

Literature and the shaman: Jung, trauma stories and new origin stories in The Lion, the witch and the wardrobe by C.S. Lewis

The paper first considers the role of Jungian ideas in relation to academic disciplines and to literary studies in particular. Jung is a significant resource in negotiating developments in literary theory because of his characteristic treatment of the ‘other’. The paper then looks at The Lion, the Witch and the Wardrobe (1950) by C.S. Lewis whose own construction of archetypes is very close to Jung’s. By drawing upon new post-Jungian work from Jerome Bernstein’s Living in the Borderland (2005), the novel is revealed to be intimately concerned with narratives of trauma and of origin. Indeed, a Jungian and post-Jungian approach is able to situate the text both within nature and in the historical traumas of war as well as the personal traumas of subjectivity. Where Bernstein connects his work to the postcolonial ethos of the modern Navajo shaman, this new weaving of literary and cultural theory points to the residue of shamanism within the arts of the West. [From the Publisher]

Discourse and soul: Jung, literature, science and tragedy as mythical writing

This paper will propose that literature and science, far from being discrete spheres of cultural activity, are, in fact, the cultural expressions of interlocking myths. They therefore overlap and even take each other’s places, as examination of the ‘science’ of C.G. Jung and the ‘art’ of a writer such as John Cowper Powys, will show. ‘Dis-course’, I argue, is the material aspect of the mythical structuring of psychic experience. In the work of Jung and Powys, discourse is the articulation of the soul in the world that spans personal, social, natural and cosmic space. [From the Author]

Postcolonial futures: postcolonial literature and the Obama moment

Since the late 1970s the western academy has encouraged the development of postcolonial literary theory and the formulation of a postcolonial literary canon existing outside the prescriptive narratives of the ‘mother’ country and empire. Having lost faith in the binary oppositions underpinning such narratives, we turned to alternative fictions that contested the construction of the ‘other’, the world divided between the ‘West and the Rest’. The publication of Edward Said’s Orientalism in 1978 marked the beginning of the discipline now known as postcolonial studies with its new ways of understanding ‘the west’s’ relationship with ‘the east’ and, by extension, all the former colonies of empire. Despite these radical origins, however, postcolonialism’s more recent emphasis on the psychological and its affirmation of the hybrid text and self has, for many, served to obscure real economic social realities that have very little to do with the magical or wondrous textual expression of a postcolonial identity. This paper considers problems associated with defining the postcolonial and proposes that, in a literary context, we broaden its meaning to include texts traditionally outside the category of postcolonial literature. To extend the meaning of postcolonial is timely as we are now witnessing its relocation from ‘margin’ to ‘centre’ with the election of Barack Obama. This moment may be seen as a disruption of conventional understandings of what constitutes postcolonial literature, essentially as oppositional discourse that could only define itself as peripheral to, or ‘post’, metropolitan and economic concerns. [From the Author]

The Great War on the small screen: televisual narratives of the First World War.

In Britain since the 1960s television has been the site where the Western Front of popular culture has clashed with the Western Front of history. This talk will examine the ways in which those involved in the production of historical documentaries for this most influential media have struggled to communicate the stories of the First World War to British audiences. From the landmark epic series The Great War (BBC, 1964) up to more recent controversial productions such as The Trench (BBC, 2002) and Not Forgotten: The Men Who Wouldn't Fight (BBC, 2008), Emma Hanna will give an overview of the production, broadcast and reception of a number of British television documentaries to examine the difficult relationship between the war's history and its popular memory. [From the Author]

Trade credit linkages along the supply chain: evidence for the Italian textile sector

We examine the trade credit linkages among firms within a supply chain to reckon the effect of such linkages on the propagation of liquidity shocks from downstream to upstream firms. We choose a sample appropriate for this task, consisting of a large data set of Italian firms from the textile industry, a well known example of a comprehensive manufacturing cluster featuring a large number of small and specialized firms at each level of the supply chain. The results of the analysis indicate that the level of trade credit that firms provide to their suppliers is positively related to the level of trade credit granted to their clients: when the level of trade credit granted to clients divided by sales goes up by 1, the level of trade credit provided to suppliers divided by cost-of goods-sold goes up by an amount that varies between 0,22 and 0,52. Since all firms along the chain are linked by trade credit relationships, an increase in the level of trade credit granted by wholesalers generates a liquidity cascade throughout the chain. We designate the overall increase in the level of trade credit among all firms in the chain as a result of a unitary impulse in the level of trade credit granted by wholesalers as the multiplier effect of trade credit for the industry chain. We estimate such multiplier to vary between 1.28 and 2.04. We also investigate the effect of final demand on the level of trade credit sourced by firms at various levels of the chain and, in particular, whether such effect is amplified for firms further up in the chain as a result of liquidity propagation via trade credit linkages. We uncover evidence of such amplification when the links of liquidity transmission along the chain are individually modeled and estimated. An unitary increase in wholesalers’ sales is found to produce an effect on trade payables among firms at the top of the chain (i.e., Preparers and Spinners) that is more than twice as big as the corresponding effect among firms at the bottom of the chain (i.e., Wholesalers).