Donor conception and (dis)closure in the UK::siblingship, friendship and kinship

As many aspects of assisted conception become familiar, others emerge not only as unfamiliar, but also unpredicted. This article focuses on a newly emergent kin figure – the donor sibling. It suggests that the anthropology of friendship might have as much to tell us about the significance of the donor sibling in Euro-American kinship thinking as the anthropology of kinship. The article locates the donor-sibling in changes in UK legislation and policy that have increasingly promoted more transparency and ‘openness’ in donor conception

True blues, blacks and in-betweens : urban regeneration in Moss Side, Manchester

In this thesis I describe state directed transformation through urban regeneration policy in the context of Moss Side, Manchester in the North West of England. The thesis explores connections between the state project of urban regeneration and the lives of residents’ who were targeted by strategies. The thesis therefore moves from economic and political contexts that informed the policies of urban regeneration to how they were implemented and by whom, and then into the personal lives of residents in order to demonstrate connections between these. The latter half of the thesis focuses particularly on residents who were associated with the gang “GCG” who were often the targets of regeneration strategies. The thesis deals with a variety of themes: global cities, governance, constructing race, recognition politics, localities, simulations and violence. These are grounded in detailed ethnography describing Moss Side through residents lives which transformed as a result of regeneration policy. The thesis argues that urban regeneration strategies do not (as is often argued by regeneration practitioners) relieve the difficulties existing residents experience and yet often have far reaching consequences. I demonstrate this through a variety of examples: new governing structures, consultation processes, anti-social behaviour orders (ASBOs), gang members strategies opposing displacement, pirate radio disc jockeys searching for legitimacy, and the threat of sexual violence.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

trans-K3[TcO2(CN)4]

The structure of the title compound, tripotassium trans-tetra­cyanidodioxidotechnetate(V), is isotypic with its Re analogue. The [TcO2(CN)4]3− trans-tetra­cyanido­dioxido­technetate anion has a slightly distorted octa­hedral configuration. The Tc atom is located on a center of inversion and is bound to two O atoms in axial and to four cyanide ligands in equatorial positions. The Tc—O distance is consistent with a double-bond character. The two potassium cations, one located on a center of inversion and one in a general position, reside in octa­hedral or tetra­hedral environments, respectively. K⋯O and K⋯N inter­actions occur in the 2.7877 (19)–2.8598 (15) Å range

Results of surgical management of acute thromboembolic lower extremity ischemia

ObjectiveAcute lower extremity ischemia secondary to arterial thromboembolism is a common problem. Contemporary data regarding this problem are sparse. This report examines a 10-year single-center experience and describes the surgical management and outcomes observed.MethodsProcedural codes were used to identify consecutive patients treated surgically for acute lower extremity embolization from January 2002 to September 2012. Patients presenting >7 days after onset of symptoms, occlusion of grafts/stents, and cases secondary to trauma or iatrogenic injury were excluded. Data collected included demographics, medical comorbidities, presenting clinical characteristics, procedural specifics, and postoperative outcomes. Results were evaluated using descriptive statistics, product-limit survival analysis, and logistic regression multivariable modeling.ResultsThe study sample included 170 patients (47% female). Mean age was 69.1 ± 16.0 years. Of these, 82 patients (49%) had a previous history of atrial fibrillation, and four (2%) were therapeutically anticoagulated (international normalized ratio ≥2.0) at presentation. Presentation for 83% was >6 hours after symptom onset, and 9% presented with a concurrent acute stroke. Femoral artery exploration with embolectomy was the most common procedural management and was used for aortic, iliac, and infrainguinal occlusion. Ten patients (6%) required bypass for limb salvage during the initial operation. Local instillation of thrombolytic agents as an adjunct to embolectomy was used in 16%, fasciotomies were performed in 39%, and unexpected return to the operating room occurred in 24%. Ninety-day amputation above or below the knee was required during the index hospitalization in 26 patients (15%). In-hospital or 30-day mortality was 18%. Median (interquartile range) length of stay was 8 days (4, 16 days), and 36% of patients were discharged to a nursing facility. Recurrent extremity embolization occurred in 23 patients (14%) at a median interval of 1.6 months. The 5-year amputation freedom and survival estimates were 80% and 41%, respectively. Predictors of 90-day amputation included prior vascular surgery, gangrene, and fasciotomy. Predictors of 30-day mortality included age, history of coronary artery disease, prior vascular surgery, and concurrent stroke.ConclusionsDespite advances in contemporary medical care, lower extremity arterial embolization remains a condition that is associated with significant morbidity and mortality. Furthermore, the condition is resource-intensive to treat and is likely preventable (initially or in recurrence) in a substantial subset of patients

Cost-effectiveness findings from the Agewell pilot study of behaviour change to promote health and wellbeing in later life

Background: Participation in cognitive and physical activities may help to maintain health and wellbeing in older people. The Agewell study explored the feasibility of increasing cognitive and physical activity in older people through a goal-setting approach. This paper describes the findings of the cost-effectiveness analysis.Method: Individuals over the age of 50 and attending an Agewell centre in North Wales were randomised to one of three conditions: control (IC), goal-setting (GS), or goal-setting with mentoring (GM). We undertook a cost-effectiveness analysis comparing GS vs. IC, GM vs. IC and GM vs. GS. The primary outcome measure for this analysis was the QALY, calculated using the EQ-5D. Participants’ health and social care contacts were recorded and costed using national unit costs.Results: Seventy participants were followed-up at 12 months. Intervention set up and delivery costs were £252 per participant in the GS arm and £269 per participant in the GM arm. Mean health and social care costs over 12 months were £1,240 (s.d. £3,496) per participant in the IC arm, £1,259 (s.d. £3,826) per participant in the GS arm and £1,164 (s.d. £2,312) per participant in the GM arm. At a willingness to pay threshold of £20,000 per QALY there was a 65% probability that GS was cost-effective compared to IC (ICER of £1,070). However, there was only a 41% probability that GM was cost-effective compared to IC (ICER of £2,830) at a threshold of £20,000 per QALY.Conclusion: Setting up and running the community based intervention was feasible. Due to the small sample size it is not possible to draw a firm conclusion about cost-effectiveness; however, our preliminary results suggest that goalsetting is likely to be cost-effective compared to the control condition of no goal-setting, the addition of mentoring was effective but not cost-effective

Outcomes of acute intraoperative surgical conversion during endovascular aortic aneurysm repair

PurposeOutcomes and predictors of acute surgical conversion during endovascular aortic aneurysm repair (EVAR) were examined using the American College of Surgeons-National Safety and Quality Improvement Project (ACS-NSQIP) Database (2005 to 2008).MethodsAcute intraoperative surgical conversions occurring during elective EVAR were identified using Current Procedural Terminology codes. Nonemergent EVAR and primary open surgical repairs of infrarenal aneurysms were examined for comparison. Perioperative morbidity was categorized as wound, pulmonary, venous thromboembolic, genitourinary, cardiovascular, operative, and septic. Mortality, overall morbidity, and length of stay (LOS) were examined.ResultsWe identified 72 acute conversions, 2414 open repairs, and 6332 EVAR without acute conversion. Demographics and comorbidities were generally similar among operative groups. Mean operative time was 274 minutes for acute conversion vs 226 minutes for primary open repair and 162 minutes for EVAR (conversion vs EVAR and open repair vs EVAR P < .0001 for each; conversion vs open repair P = .0014; analysis on rank operative time). Blood transfusion was required in 69% of acute conversions (mean volume, 6.0 units) vs 73% of open repairs (mean volume, 3.3 units) and 12% of EVARs (mean volume, 2.6 units; P < .0001 for each pair-wise comparison; analysis on rank number of units among those transfused). Major morbidity was 28% for acute conversions, 28% for open repairs, and 12% for EVARs. Mortality was 4.2% for acute conversions, 3.2% for open repairs, and 1.3% for EVARs. Median (quartile 1, quartile 3) LOS was 7 (5, 9) days for acute conversion and open repair, and 2 (1, 3) days for EVAR. Morbidity and mortality were significantly higher for acute conversion and open repair vs EVAR. The OR (95% confidence interval) for morbidity was 2.9 (1.7-4.8) after conversion and 2.8 (2.5-3.2) after open repair (P < .0001 for both) and for mortality was 3.4 (1.0-10.9; P = .0437) for conversion and 2.5 (1.9-3.5; P < .0001) for open repair. Morbidity and mortality were similar between acute conversion and open repair. A similar pattern among repair groups was demonstrated for LOS, with similar LOS for acute conversions and open repair, which were significantly longer than those observed for EVAR. No significant demographic or medical risk factor predictors of acute conversion during EVAR were identified.ConclusionAcute surgical conversion was a rare complication affecting 1.1% of EVAR cases, with no broadly identifiable at-risk population. When conversion did occur, morbidity and mortality rates paralleled those observed for elective open repair