Ink as Armor: An Examination into the Relationship Between Tattooing and the Ability to Cope with Negative Life Events

The author considers the history and evolution of tattooing, cultural differences and new contexts in tattooing, and a qualitative study of tattoos within Regis University

The Guilty Breast: A Fleshy Semiotics

The Guilty Breast: A Fleshy Semiotics takes up the subject of the nude female breast, from St. Augustine\u27s developing and a shifting semiotic theory of signs and the flesh in Christian doctrine through feminist theories and Foucault\u27s analysis of the scientific “Gaze†to the protests of breastfeeding on social media, such as Facebook and Instagram, and in the public sphere. The dissertation argues that boobs teach us how to see by examining the breast\u27s semiotic anatomy in five parts. “Chapter One: Nipple†asserts that breasts are both…and: maternal and sexual, subjective and objective, metaphoric and actual. “Chapter Two: Cleavage†juxtaposes St. Augustine with French feminist Hélène Cixous to reveal their shared life project of making “the sign†(and substance) of the guilty body—and by extension/ostension, female breasts—morally good. “Chapter Three: Milk†“mangles†and disrupts “the Gaze†of biological theory by dripping thirst, claiming that leaking itself is onto-epistemological. “Chapter Four: Areola†highlights social media\u27s censorship of breastfeeding to explore socially constructed borders. “Chapter Five: Ducts†investigates two political examples of breasts-as-weapon. “Chapter Six: Support†offers “breast semiotics†as a new hermeneutic by which to read nude female breast texts via the plurality of bodies and concludes with a visual example

Chest Masculinization Surgery: Outcomes, Challenges, And Opportunities For Innovation In Gender-Affirming Care

With the increasing demand for gender-affirming surgeries, it has become paramount for plastic and reconstructive surgeons to evaluate their techniques through assessment of clinical outcomes and patient satisfaction. Chest wall masculinization is the most commonly performed gender-affirming surgical intervention for transgender male and non-binary patients. The procedure has been cited to alleviate gender dysphoria, defined as the stress that results from the incongruence between one’s sex assigned at birth and one’s gender identity. Peri-areolar and double-incision mastectomy with free nipple grafts, are the most common techniques employed in chest masculinization surgery, but are limited by their relative inconsistency and inefficiency in reconstructing a natural anterior contour that comprehensively resembles that of a cis-masculine chest. The proposed “hockey stick” approach expands on the widely performed double-incision mastectomy to the axilla, with an additional step of revising the lateral chest wall folds of tissue excess. The central purpose of this study is to compare the “hockey stick” incision to existing reconstructive options, with respect to clinical outcomes and patient satisfaction. In addition, this review will discuss multiple challenges and considerations, with respect to validated survey instruments, access to care, healthcare disparities, legislative acts, insurance coverage, medical education, the Coronavirus pandemic, and evolving terminology, that may complicate the delivery of gender-affirming care. With such investigations and analyses, we hope to provide a valuable introduction and resource for healthcare providers, trainees, and medical students to refer to in the context of gender-affirming care. Patients who received chest masculinization surgery at Yale-New Haven Hospital were included in our analysis. A retrospective chart review, comprising demographic variables, procedural details, and post-operative events, was conducted. Selected modules from a validated survey instrument, the BODY-Q, were measured. Patients were classified by body mass index and incision, which included peri-areolar, inframammary fold, and “hockey stick” incision by date. 27 of 73 (37.0%) participants completed the full survey and were included in the analysis. The “hockey stick” incision had comparable patient satisfaction and post-operative outcomes, compared to peri-areolar and double-incision mastectomy with free nipple graft techniques. Greater BMI patients had a higher incidence of wound dehiscence, compared to other weight classifications. The “hockey stick” incision is a readily performed, effective surgical technique for building a cis-masculine appearing chest in transgender men with efficient and predictable outcomes. While performed in patients with higher BMI, the “hockey stick” confers equivalent patients. Future outcomes should include a greater sample of patients. Gender-affirming surgery presents with promising opportunities to innovate new techniques and study clinical outcomes and patient satisfaction. Amidst such advancements, it is imperative to recognize the barriers in delivering gender-affirming care, to collaborate with other stakeholders, and together, strengthen efforts in medical education, policy, entrepreneurship, research, and advocacy for transgender and non-binary patients. There is great potential for plastic surgeons and their colleagues to lead the movement - to best serve the social and healthcare needs of such communities

Chronological Age vs. Biological Maturation: Implications for Exercise Programming in Youth

Biological maturation is associated with significant change to a number of physiological and structural processes throughout childhood and, in particular, adolescence. Mismatched rapid growth in the long bones relative to muscular lengthening may disrupt structure, neuromuscular function, and physical performance. Practitioners who work with school-age youth should be aware of the age-related changes that typically take place during a child's development to ensure that their strength and conditioning programming is as safe and effective as possible for enhancing performance and reducing injury risk. Although there are several methods available to assess biological maturation, practitioners who work with youth can benefit from assessment methods that are available and feasible, and that provide utility in the quantification of the degree and stages of biological maturation that affect motor performance in children and adolescents. This article synthesizes the relevant assessment methods and provides a rationale for understanding usable biological maturation assessment tools that can aid in the development of training program design for youth

Optimising baby to breast attachment (OBBA) : a mixed methods study

PhD ThesisPurpose – Only around 1% of mothers breastfeed their infants exclusively for the recommended first 6 months of life. Many problems causing early breastfeeding (BF) cessation can be caused by poor baby to breast attachment (BBA). The purpose of this research was to use BF mothers as co-designers to develop, refine, feasibility test and process evaluate a complex intervention which would teach new mothers how to optimise BBA in the first six weeks of BF. Design – The research was designed in three phases with the MRC framework as the overarching architecture Methodology – A mixed methods methodology enabled the collection of qualitative and quantitative data. Methods - Phase one used cognitive interviewing techniques to elicit women’s responses to undertake development and refinement of the intervention; Phase two was a pilot randomised controlled trial (RCT) to test the feasibility of delivering the intervention within a clinical setting and collect data to inform the design of a future definitive study; Phase three used in-depth interviews with women to undertake a thorough process evaluation and collect contextual information which was further expanded using focus groups with BF supporters. Findings – Feasibility was demonstrated and data collected to inform the design of a future definitive study. Although women used the intervention in different ways the key messages of when and how to optimise attachment was delivered. Possible enhancements to the intervention were identified. Health professionals felt the intervention was useful and had the potential to reduce their workload. Limitations – The pilot RCT was not powered to compare outcomes. A maximum variation sample used throughout all three phases sought to include as many different perspectives as possible. Originality – An intervention co-designed by women for women easily transfers information on why, when and how to optimise BBA, which may reduce the number of BF problems causing BF cessation. Next – A test of effectiveness including costs is now required.National Institute for Health Research (NIHR)’s Doctoral Research Training Programm

What is the impact of TRAM flap breast reconstruction on self-esteem and perceived body image for women with breast cancer?

Breast cancer is the most common of all cancers in women (26%) in Australia (Australian Institute Health Welfare AIHW, 1996; National Breast Cancer Centre NBCC, 1999). It is estimated that the lifetime incidence of one in eleven women in Australia will be diagnosed with breast cancer by the age of seventy-four (National Health and Medical Research Council NHMRC, 2000). Surgical resection continues to be the mainstay of treatment for early breast cancer, with approximately 50% of women diagnosed with breast cancer undergoing mastectomy (NBCC, 1999). Both the diagnosis of breast cancer and subsequent mastectomy raises a number of psychosocial issues for women. In addition to the diagnosis of a potentially life threatening illness, these women contend with the psychological consequences that accompany the loss of a breast. During the height of development of breast reconstructive techniques in the 1980\u27s, mastectomy became more commonly recognised as an important aspect of a woman\u27s experience with breast cancer. Breast cancer not only causes pain, suffering and the possibility of death, but also threatens a woman\u27s self-concept, self-esteem and feminine identity through its attack on her body (Derogatis, 1986). To reduce the psychological impact associated with removal of the breast, breast reconstruction is increasingly being offered. In the past five years there has been an increase in the number of women seeking breast reconstruction, with an increasing focus on quality of life issues and survivorship for women diagnosed with breast cancer (Wilkins et al., 1995). To date little is known about women\u27s experiences of undergoing breast reconstruction. Using a qualitative, exploratory descriptive approach this study investigated the impact of the transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction, on self-esteem and perceived body image for women with breast cancer. In depth semi-structured interviews, using both individual and focus group methods, were undertaken with ten women who had undergone a TRAM flap breast reconstruction between January 1st 2001 and January 1st 2003. Data was analysed using the process of thematic analysis to determine key concepts and themes that described these women\u27s experiences. Three main themes emerged from the findings of this study: Loosing a breast matters , \u27\u27The process of adjusting to a changing body image , and Redefining normality . These themes and their sub-themes describe the experience of breast cancer survival and TRAM flap breast reconstruction for the women who participated in this study. These findings will further the current knowledge base on this topic and therefore assist nurses in providing sound information and psychosocially appropriate support to TRAM flap breast reconstruction patients and their significant others. Furthermore, this study\u27s findings will be a further resource for women considering breast reconstruction treatment options following mastectomy

Forensic Dentistry - Bite Mark Distortion

The major challenge in forensic dentistry is the analysis of bite marks in human skin. A recurring difficulty in analysis arises from the distortion which is a variable feature of bite marks. Distortion may complicate or even preclude proper comparison of the bite mark and the causal dentition. Distortion may arise in a number of ways. The action of biting may produce tissue distortion and dynamic distortion. Evidence recording of the bite mark may produce posture distortion and photographic distortion. Ante and post mortem changes may also introduce distortion. The present research initially consisted of a retrospective review of forensic bite mark cases analysed in Glasgow between 1971 and 1989. The review, reported in Chapter 2, demonstrated that the breast was the most commonly bitten anatomical location in females and that the quality of recording of individual tooth elements in the bite marks was variable; good quality elements formed the minority group. Experimental research of human bite marks in human skin is, by its nature, difficult to conduct. Consequently, previous studies have mainly used experimental bite marks in animal skin or experimental bite marks in artificial media. One study in America recorded bite marks accurately in wax and established criteria which would require to be satisfied in bite mark cases. The retrospective review of bite mark cases found that bite marks which demonstrated good quality individual tooth elements formed the minority group and consequently the requirements for valid comparisons set by the American research were infrequently met in case work. A particular forensic bite mark case in Liverpool demonstrated distortion of a bite mark in the female breast; the posture distortion was produced by varying the victim's arm position during evidence recording. The posture distortion percentage values were of the order of 25%. This case provided the stimulus to research posture distortion in the female breast. In addition, the relevance of the female breast as an anatomical site for study had been established in the retrospective review. A preliminary study of two subjects was undertaken to quantify posture distortion in the female breast, to compare posture distortion in different breast sites and to study the influence of arm movement on posture distortion. The preliminary study is described in Chapter 3. As an alternative to experimental bites, a die stamp was designed with approximate dimensions of a human bite. Marks were made on different areas on the breast with the subject's arm in several positions. Dimensional changes were measured and expressed as percentage changes. The posture distortion percentage values of the preliminary study were similar to those in the Liverpool case. Therefore, the preliminary study was assessed as realistic in demonstrating posture distortion comparable to that in a forensic bite mark case. The preliminary study produced general conclusions which provided the basis for further research. The initial stages of the main study, reported in Chapter 4, of 20 subjects of varying ages and anatomical proportions was undertaken to quantify posture distortion in the female breast, to compare posture distortion in multiple axes of four breast sites and to study the influence of arm movement on posture distortion. In addition, the main study assessed the influence of age, bust size, cup size and ptosis on posture distortion, The dimensions of the marks were recorded photographically and defined elements of the marks were digitised manually for computer analysis. The study showed that maximum posture distortion was mainly related to older subjects with increased ptosis and a larger cup size. In view of the large volume of data, it was considered appropriate to concentrate initially on certain measurements from the left breast. The longest measurements in each axis reflected the major dimensions encountered in bite mark cases. In this way the main study produced six measurement tables of data. The analyses of the six sets of measurements are presented in Chapters 5, 6, 7 and 8. The main study researched posture distortion in the female breast. Clearly, the technique could be applied to other relevant anatomical sites which are potentially liable to posture distortion. In this way, a scientific database of posture distortion values and significant factors would be created