Programs and Communities

Children often present to the emergency department (ED) for treatment of abuse-related injuries. ED healthcare providers (HCPs) do not consistently screen children for physical abuse, which may allow abuse to go undetected and increases the risk for re-injury and death. ED HCPs frequently cite lack of knowledge or confidence in screening for and detecting child physical abuse.

The purpose of this evidence-based quality improvement project was to implement a comprehensive screening program that included ED HCP education on child physical abuse, a systematic screening protocol, and use of the validated Escape Instrument. After a 20-minute educational session, there was a significant increase in ED HCP knowledge and confidence scores for child physical abuse screening and recognition (p < .001). There was no difference in diagnostic coding of child physical abuse by ED HCPs when evaluating a 30-day period before and after implementation of the screening protocol.

In a follow-up survey, the Escape Instrument and educational session were the most reported screening facilitators, while transition to a new electronic health system was the most reported barrier. The results of this project support comprehensive ED screening programs as a method of improving HCP knowledge and confidence in screening for and recognizing child physical abuse. Future research should focus on the impact of screening on the diagnosis and treatment of child physical abuse. Efforts should also be made to standardize child abuse screening programs throughout all EDs, with the potential for spread to other settings.

Suicide has become a national concern due to the increasing rates across the country. The 2012 National Strategy for Suicide Prevention aims to improve the area of clinical prevention. Emergency departments (ED) play a key role in addressing this effort as they have multiple opportunities to connect with patients who are at risk. There exists a high-risk period of time immediately following a patient’s discharge from emergency care. To address this period of concern, a review of the literature was conducted on the effectiveness of follow-up contacts as a means to prevent suicide and suicide related attempts in this at-risk population.

Based on this review, a follow-up intervention was proposed to increase patients’ social support and knowledge on suicide prevention through a safety plan and the use of caring postcards. The aim was to evaluate the degree to which implementation of a safety plan and follow-up using postcards reduces suicide risk in the ED. ED suicide prevention practices such as safety planning and caring contacts with postcards have shown to be feasible and cost-effective methods to reduce patients’ risk of suicide as they provide education and address the high-risk period of time after discharge.

Using a quasi-experimental pre and post-test design, English speaking adults 18 years of age and older, admitted to an ED in the Phoenix Metropolitan area with suicidal ideation, were voluntarily recruited for two weeks. The self-rated Suicidal Behaviors Questionnaire-Revised (SBQ-R) was used as a baseline assessment along with the introduction of a safety plan. Participants were then followed with the receipt of postcards with caring messages over a two-week period, and a final SBQ-R. The SBQ-R has shown beneficial reliability and validity measuring suicidality in the adult population. Data from the pre-SBQ-R was analyzed using descriptive statistics as no post-SBQ-Rs were received. Outcomes for this project included a reduction in suicidal ideation and suicide risk.

This project provides insight into the implementation of a safety plan and follow-up intervention in the ED and their attempts to reduce acute suicide risk as well as highlight the value that post-ED support provides.

Keywords: suicide, prevention, safety plan, caring messages, postcards, emergency department, follow-up, contacts, brief intervention

Journal of Surrealism and the Americas, Cinema Issue (2016)

Robert Desnos’s and Man Ray’s 1928 film L'Etoile de mer has long been considered an exemplar of the surrealist love story, thematically similar to Salvador Dalí’s and Luis Buñuel’s Un Chien andalou (1929) but less overtly shocking. In comparison to the elaborate iconographical analyses of Chien, critiques of L'Etoile tend to describe its avant-garde cinematic style, to distinguish how it illustrates or deviates from Desnos’s scenario, or to provide summary analysis of some of its more obviously Freudian iconography. There have been fewer scholarly explorations of specific symbolism, yet the film exhibits many political-philosophical intertexts, one of which explicitly builds a bridge between the surrealist revolution and America’s core self-signifier, Liberty.

Journal of Surrealism and the Americas, Cinema Issue (2016)

La Ciudad Frente al Río (The City in Front of the River) is an Argentinian, ten-minute long film directed by Italian Surrealist Enrico Gras in 1949. The film was part of the promotional material for Bajo Belgrano, a modern housing plan sponsored by the Buenos Aires City Hall under the auspice of populist president Juan Perón. As part of this promotion, German photographer Grete Stern designed a brochure with images from the film and text by the Study for the Plan of Buenos Aires (Estudio del Plan de Buenos Aires, hereafter EPBA). I compare the film and brochure to contemporaneous work by Stern: a series of photomontages illustrating a women’s advice column. The column mined its readers’ dreams for insights into their unconscious, and advised them on proper behavior. Following a similar method, the film found Buenos Aires’ unconscious in the chaos of city life, and revealed what I have termed as "pastoral modernity" as the cure. Masked behind a veneer of revolutionary modernity, the message of these works was that of a nostalgic return to the past—an invitation to sleep, and to dream. Complicating this message, subtle hints in both the film and the photomontages point to the artists’ awareness of the totalizing vision they were collaborating with.

Journal of Surrealism and the Americas, Cinema Issue (2016)

This paper deals with a version of Surrealism that emerged in San Francisco in the late 1940s, and its influence on Wallace Berman’s film Aleph (1966) and Harry Smith’s Early Abstractions.

Many San Francisco poets of the 1940s through the 1970s understood poets as a visionary company possessing a nearly sacerdotal authority arising from their capacity to put aside the individual self and open themselves to influences from beyond—in a peculiar turn, these influences came to be understood as energy waves that are transmitted through the ether and operate the poet/artist—and cinema and the radio became models for these transmissions. The collage art that resulted was understood as anemic, cobbled together from insecurely apprehended fragments of thought carried in radio signals nearly drowned out by static. I conclude with comments relating the idea of artists’ feeble imaginations being operated by remote control to film and electric media.