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"Robert Samuels"
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New media, cultural studies, and critical theory after postmodernism : automodernity from Zizek to Laclau
\"This book argues that we have moved into a new cultural period, automodernity, which represents a social, psychological, and technological reaction to postmodernity. In fact, by showing how individual autonomy is now being generated through technological and cultural automation, Samuels posits that we must rethink modernity and postmodernity. Part of this rethinking entails stressing how the progressive political aspects of postmodernism need to be separated from the aesthetic consumption of differences in automoderntiy. Choosing culturally relevant studies of The Matrix, Grand Theft Auto, Eminem and Jurassic Park, he interprets these medias through the lens of eminent theorists like Slavoj Zizek, Frederic Jameson, and Henry Jenkins. Ultimately, he argues that what defines postmodernity is the stress on social construction, secular humanism, and progressive social movements that challenge the universality and neutrality of modern reason\"--Provided by publisher.
Book
Respiratory virus surveillance in hospitalized children less than two-years of age in Kenema, Sierra Leone during the COVID-19 pandemic (October 2020- October 2021)
Globally, viral pathogens are the leading cause of acute respiratory infection in children under-five years. We aim to describe the epidemiology of viral respiratory pathogens in hospitalized children under-two years of age in Eastern Province of Sierra Leone, during the second year of the SARS-CoV-2 pandemic. We conducted a prospective study of children hospitalized with respiratory symptoms between October 2020 and October 2021. We collected demographic and clinical characteristics and calculated each participant´s respiratory symptom severity. Nose and throat swabs were collected at enrollment. Total nucleic acid was purified and tested for multiple respiratory viruses. Statistical analysis was performed using R version 4.2.0 software. 502 children less than two-years of age were enrolled. 376 (74.9%) had at least one respiratory virus detected. The most common viruses isolated were HRV/EV (28.2%), RSV (19.5%) and PIV (13.1%). Influenza and SARS-CoV-2 were identified in only 9.2% and 3.9% of children, respectively. Viral co-detection was common. Human metapneumovirus and RSV had more than two-fold higher odds of requiring O2 therapy while hospitalized. Viral pathogen prevalence was high (74.9%) in our study population. Despite this, 100% of children received antibiotics, underscoring a need to expand laboratory diagnostic capacity and to revisit clinical guidelines implementation in these children. Continuous surveillance and serologic studies among more diverse age groups, with greater geographic breadth, are needed in Sierra Leone to better characterize the long-term impact of COVID-19 on respiratory virus prevalence and to better characterize the seasonality of respiratory viruses in Sierra Leone.
Journal Article
Adaptable, quantitative CRISPR/Cas12a-based assay for cytomegalovirus DNA in infant saliva
Congenital cytomegalovirus (CMV) infection is the leading non-genetic cause of infant hearing loss worldwide, and a significant cause of neurodevelopmental disabilities. Reliance on polymerase chain reaction (PCR) for CMV DNA testing hampers diagnostic and research efforts in low-resource settings and universal screening implementation in high-resource settings. Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and CRISPR-associated protein (Cas) detection and recombinase polymerase amplification (RPA) can be used together for low-cost viral detection. Here we describe an adaptable RPA-Cas12a assay for CMV DNA quantification based on the WHO international standard. Adequate quantification accuracy was achieved with contrived CMV samples but performance with Sierra Leonean infant saliva remains suboptimal. While improved quantification accuracy will require further optimization, our assay achieves screening test requirements, including > 80% sensitivity/specificity, quicker and more economically than PCR. This work highlights RPA-Cas12a-based assays for DNA quantification and suggests a path towards increased congenital CMV screening using PCR and RPA-Cas12a synergistically.
Journal Article
Introduction: Teaching Critical University Studies
This issue of Radical Teacher focuses on why we should teach courses and collaborate with students in research in Critical University Studies (CUS)— a handy label, but please take “university” is a stand-in for many kinds of post-secondary institution.
Journal Article
Why Public Higher Education Should Be Free
Universities tend to be judged by the test scores of their incoming students and not on what students actually learn once they attend these institutions. While shared tests and surveys have been developed, most schools refuse to publish the results. Instead, they allow such publications asU.S. News & World Reportto define educational quality. In order to raise their status in these rankings, institutions pour money into new facilities and extracurricular activities while underfunding their educational programs.InWhy Public Higher Education Should Be Free, Robert Samuels argues that many institutions of higher education squander funds and mislead the public about such things as average class size, faculty-to-student ratios, number of faculty with PhDs, and other indicators of educational quality. Parents and students seem to have little knowledge of how colleges and universities have been restructured over the past thirty years.Samuels shows how research universities have begun to function as giant investment banks or hedge funds that spend money on athletics and administration while increasing tuition costs and actually lowering the quality of undergraduate education. In order to fight higher costs and lower quality, Samuels suggests, universities must reallocate these misused funds and concentrate on their core mission of instruction and related research.Throughout the book, Samuels argues that the future of our economy and democracy rests on our ability to train students to be thoughtful participants in the production and analysis of knowledge. If leading universities serve only to grant credentials and prestige, our society will suffer irrevocable harm. Presenting the problem of how universities make and spend money, Samuels provides solutions to make these important institutions less expensive and more vital. By using current resources in a more effective manner, we could even, he contends, make all public higher education free.
eBook
Antibiotic prescribing practices for acute respiratory illness in children less than 24 months of age in Kenema, Sierra Leone: is it time to move beyond algorithm driven decision making?
Background
Lower respiratory tract infections are the leading cause of mortality in young children globally. In many resource-limited settings clinicians rely on guidelines such as IMCI or ETAT + that promote empiric antibiotic utilization for management of acute respiratory illness (ARI). Numerous evaluations of both guidelines have shown an overall positive response however, several challenges have also been reported, including the potential for over-prescribing of unnecessary antibiotics. The aims of this study were to describe the antibiotic prescribing practices for children less than 24 months of age with symptoms of ARI, that were admitted to Kenema Government Hospital (KGH) in the Eastern Province of Sierra Leone, and to identify the number of children empirically prescribed antibiotics who were admitted to hospital with ARI, as well as their clinical signs, symptoms, and outcomes.
Methods
We conducted a prospective study of children < 24 months of age admitted to the KGH pediatric ward with respiratory symptoms between October 1, 2020 and May 31, 2022. Study nurses collected data on demographic information, medical and medication history, and information on clinical course while hospitalized.
Results
A total of 777 children were enrolled. Prior to arrival at the hospital, 224 children (28.8%) reported taking an antibiotic for this illness without improvement. Only 15 (1.9%) children received a chest radiograph to aid in diagnosis and 100% of patients were placed on antibiotics during their hospital stay.
Conclusions
Despite the lives saved, reliance on clinical decision-support tools such as IMCI and ETAT + for pediatric ARI, is resulting in the likely over-prescribing of antibiotics. Greater uptake of implementation research is needed to develop strategies and tools designed to optimize antibiotic use for ARI in LMIC settings. Additionally, much greater priority needs to be given to ensuring clinicians have the basic tools for clinical diagnosis, as well as greater investments in essential laboratory and radiographic diagnostics that help LMIC clinicians move beyond the sole reliance on algorithm based clinical decision making.
Journal Article
Adaptive Design for Phase II/III Platform Trial of Lassa Fever Therapeutics
The current recommendation for treating Lassa fever with ribavirin is supported only by weak evidence. Given the persistent effects in areas with endemic transmission and epidemic potential, there is an urgent need to reassess ribavirin and investigate other potential therapeutic candidates; however, a robust clinical trial method adapted to Lassa fever epidemiology has not yet been established. We propose an adaptive phase II/III multicenter randomized controlled platform trial that uses a superiority framework with an equal allocation ratio and accounts for challenges selecting the primary end point and estimating the target sample size by using an interim analysis.
Journal Article