2,117 research outputs found
The Un'Gathering of the Tribes: performing, writing, and remaking masculine identity at 1990s alternative rock festivals
Title from PDF of title page, viewed on June 21, 2013Thesis advisor: Miriam Forman-BrunellVitaIncludes bibliographic references (pages 120-133)Thesis (M.A.)--Dept. of History. University of Missouri--Kansas City, 2013In the early 1990s, a number of up-and-coming American rock bands working in the so-called "alternative rock" genre coupled boyish sensitivity with aggressive sounds that fused punk rock, hard rock, and underground styles to create a genre that provided a thoughtful twist on the angry young man archetype. During this same period, a new wave of traveling all-day, multi-band rock festivals offered bands and audiences a venue for performing their new thoughtful alternative identities. Although Lollapalooza--the first major American alternative festival of the '90s--”was initially successful in bringing together diverse groups from America's alternative-aligned countercultures, musicians, fans, and journalists ultimately abandoned the festival when it traded passionate, high volume sensitivity for aggressive hyper-masculinity. As Lollapalooza's popularity waned, new niche festivals such as the neo-hippie H.O.R.D.E. Tour, the all-female Lilith Fair, and the heavy metal Ozzfest emerged, splitting the alternative rock audience and fostering environments where fans and bands could construct subgenre-specific identities. By challenging, rejecting, and remaking Lollapalooza-style alternative identity--using both the power of the press and the development and championing of new musical styles--bands, fans, and journalists helped create an array of (sometimes incompatible) alternative styles with their own notions of genre-appropriate masculinity. When these various alternative "tribes" reunited at the Woodstock '99 festival in Rome, NY, at the end of the decade, the event devolved into rape, riot, and arson. My investigation found that as journalists attempted to make sense of these tragic events, many blamed out of control masculinity and hyper-masculine nu-metal bands for fostering a dangerous culture at the festival. Although rock journalists have largely treated the events of Woodstock '99 and the nu-metal bands associated with them as the result of an unfortunate, fleeting fad for hyper-masculinity in alternative rock, bands, fans, and critics continue to use gender to negotiate differences in both rock style and substance, suggesting that alternative rock's gender issues are far from settled.Introduction -- 'Do you have to time to listen to me whine': playing with masculinity at Lollapalooza -- Building a mystery: how gender issues and identity politics fractured the 1990s alternative rock fanbase -- 'Just give me something to break': violence, masculinity, and youth culture in the media reception of Woodstock '99 -- Epilogue: identity, gender, and alt/indie culture in the twenty-first centur
Complications and functional outcomes after total hip arthroplasty and total knee arthroplasty: results from the Global Orthopaedic Registry (GLORY)
The Global Orthopaedic Registry (GLORY) has been designed to monitor a broad range of complications and outcomes that occur following total hip arthroplasty (THA) and total knee arthroplasty (TKA). GLORY provides global \u27real-world\u27 data, in contrast to the data generated by the controlled conditions of clinical trials. The results to date show an overall incidence of both in-hospital and post-discharge complications of approximately 7% in THA patients and 8% in TKA patients. The most common in-hospital complications in THA patients are fractures (0.6%) and deep-vein thrombosis (DVT) (0.6%), whereas in TKA patients DVT (1.4%) and cardiac events (0.8%) are most common. The most common post-discharge complications in both THA and TKA patients are reoperation due to bleeding, wound necrosis, wound infection, or other causes; and DVT. Bleeding complications were less common than other adverse events in both groups (in-hospital rates of 0.48% and 0.83%, respectively). Functional outcomes improved after surgery in both groups, as expected. Younger patients and patients who had been discharged directly to their homes seemed to have the greatest improvement in functional outcome after surgery
A Comparison of Intrauterine and Cervical Artificial Insemination Catheters on Farrowing Rate and Litter Size in Artificially Mated Sows
The objectives of this study were to determine the effects of artificial insemination (AI) catheter type on litter size and farrowing rate. No performance difference was found between sows artificially inseminated using intrauterine or intracervical methods. Since intrauterine catheters typically are more expensive, there is an economic advantage for the more commonly used intracervical method of artificial insemination in the present study
Computational Fluid Dynamics (CFD) Applied to a Glass Vaporization Chamber for Introduction of Micro- or Nano-Size Samples into Lab-Based ICPs and to a CFD-Derived (and Rapidly Prototyped Via 3D Printing) Smaller-Size Chamber for Portable Microplasmas
Computational fluid dynamics (CFD) is used extensively in many industries ranging from aerospace engineering to automobile design. We applied CFDs to simulate flows inside vaporization chambers designed for micro- or nano-sample introduction into conventional, lab-based inductively coupled plasmas (ICPs). Simulation results were confirmed using smoke visualization experiments (akin to those used in wind tunnels) and were verified experimentally using an ICP-optical emission spectrometry (ICP-OES) system with a fast-response photomultiplier tube (PMT) detector, an ICP-OES system with a slower-response charge injection device (CID) detector, and an ICP-mass spectrometry (ICP-MS) system. A pressure pulse (defined as a momentary decrease of the optical emission intensity of ICP background) was not observed when employing widely used ICPs either with a CID detector or with ICP-MS. Overall, the simulations proved to be highly beneficial, for example, detection limits improved by as much as five times. Using CFD simulations as a guide, a rapidly prototyped, 3D-printed and smaller-size vaporization chamber (a scaled-down version of that used with ICPs) is being evaluated for potential use with a portable, battery-operated microplasma. Details are provided in this chapter
Lessons learned from the global orthopaedic registry: study design, current practice patterns, and future directions
The previous articles in this supplement have recounted, in detail, a number of the findings of the Global Orthopaedic Registry (GLORY) and placed them within the context of current knowl-edge regarding anticoagulation in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). Furthermore, because of the multinational nature of GLORY, we have been able to provide a preliminary view of some of the geographical differences in orthopedic practices that occur
Differences in Complication Rates Between Roux-en-Y Gastric Bypass and Longitudinal Sleeve Gastrectomy
Introduction: Sleeve Gastrectomy (SG) has surpassed Roux-en-Y Gastric Bypass (RYGB) as the most commonly performed bariatric operation. Though the beneficial effect of SG on Type 2 Diabetes Mellitus is less than that of RYGB, it is perceived to have a lower complication rate. The purpose of this study was to quantify the complication rates between of SG and RYGB in a severely obese diabetic population.
Methods: This was a retrospective cohort study that included all diabetic patients undergoing RYGB and SG at an academic medical center from January 1, 2011 to July 1, 2015. Patients were followed at 6 week, 6 month, 1 year, 2 year, and 3 year postoperatively. Outpatient and emergency visits were identified in the EMR system. Continuous data was analyzed using Student T tests and discrete data was analyzed using Fisher’s Exact Test. We defined early complications as those occurring within 30 days postoperatively, and late complications as those after 30 days.
Results: A total of 96 patients underwent RYGB and 89 underwent SG. The groups were concurrent and similar with regards to preoperative demographic factors such as age, gender, Hgb-A1c, HOMA2 parameters, excess body weight, BMI, and diabetic medication use. In terms of early complications, the rate of hemorrhage requiring transfusion was higher in the SG group compared to RYGB (10.1% vs. 3.1%, p=0.073). Postoperative length of stay was lower in the SG group (m=1.7 d vs. m=2 d, p=0.02), but the early readmission rate was also higher in the SG group (7.9% vs. 2.1%, p=0.09). For late postoperative complications, there were 4 anastomotic ulcer perforations and one case of internal hernia in the RYGB group. There were 6 late postoperative reoperations in the RYGB group (6% vs. 0%, p=0.03). In addition, 13 patients underwent 16 total upper endoscopies in the RYGB group (13.5% vs. 0%, p=0.0002). The cumulative rate of early and late interventions was higher in the RYGB group (20% vs. 3.4%, p=0.0005).
Conclusions: While the rate of early postoperative complication is similar between SG and RYGB, the need for late intervention is higher after RYGB. The cumulative need for reintervention (early and late) is higher after RYGB. This may explain the shift from Roux-en-Y Gastric Bypass to Sleeve Gastrectomy as the most commonly performed bariatric intervention
Risk Factors for High Early Mortality in Patients on Antiretroviral Treatment in a Rural District of Malawi.
OBJECTIVES: Among adults started on antiretroviral treatment (ART) in a rural district hospital (a) to determine the cumulative proportion of deaths that occur within 3 and 6 months of starting ART, and (b) to identify risk factors that may be associated with such mortality. DESIGN AND SETTING: A cross-sectional analytical study set in Thyolo district, Malawi. METHODS: Over a 2-year period (April 2003 to April 2005) mortality within the first 3 and 6 months of starting ART was determined and risk factors were examined. RESULTS: A total of 1507 individuals (517 men and 990 women), whose median age was 35 years were included in the study. There were a total of 190 (12.6%) deaths on ART of which 116 (61%) occurred within the first 3 months (very early mortality) and 150 (79%) during the first 6 months of initiating ART. Significant risk factors associated with such mortality included WHO stage IV disease, a baseline CD4 cell count under 50 cells/mul and increasing grades of malnutrition. A linear trend in mortality was observed with increasing grades of malnutrition (chi for trend = 96.1, P </= 0.001) and decreasing CD4 cell counts (chi for trend = 72.4, P </= 0.001). Individuals who were severely malnourished [body mass index (BMI) < 16.0 kg/m] had a six times higher risk of dying in the first 3 months than those with a normal nutritional status. CONCLUSIONS: Among individuals starting ART, the BMI and clinical staging could be important screening tools for use to identify and target individuals who, despite ART, are still at a high risk of early death
Comparison of Diabetic Remission Rates following Roux en-Y Gastric Bypass and Longitudinal Sleeve Gastrectomy
Introduction: Bariatric surgery is being increasingly investigated as treatment for Type II Diabetes Mellitus (T2DM). As Sleeve Gastrectomy (SG) surpasses Roux-en-Y Gastric Bypass (RYGB) as the new standard in bariatric surgery, it is still unknown if its efficacy in achieving remission is comparable to RYGB. This study compared diabetic remission rates between SG and RYGB in order to identify the predictive factors for remission and the mechanisms of achieving remission.
Methods: This was a retrospective cohort study comparing all diabetic patients undergoing RYGB and SG at an academic medical center from 1/1/11-7/1/15. Patients were followed preoperatively and at 6 week, 6 month, and 1, 2, and 3 year intervals. We defined diabetic remission as HbA1c under 7 without insulin or hypoglycemic use and excess body weight (EBW) as percent over ideal body weight. Data were analyzed using Cox analysis, Fisher’s Exact Tests, and Student T Tests.
Results: During the study, 96 patients underwent RYGB and 89 underwent SG. Preoperatively, patients from both groups had similar age, weight, gender, preoperative weight loss, HbA1c at onset and at surgery, oral hypoglycemic use, insulin use, and HOMA2 parameters. At one year postoperatively, patients who underwent RYGB showed a statistically greater postoperative EBW loss (62% vs. 36% p \u3c 0.0001). Kaplan Meier analysis showed a significantly higher rate of remission, (83% vs. 66%) in patients who underwent SG (p=0.02). After using Cox analysis to account for differences in delta BMI (p=0.04), EBW loss (p=0.04), preoperative HOMA2 parameters (p=0.008-0.011), and preoperative factors such as HbA1c and insulin use (p=0.001 for both), there was no change in RYGB’s impact on diabetic remission compared to SG.
Conclusion: Our results confirm that RYGB achieves a significantly greater rate of diabetic remission and a significantly higher weight loss than SG. Additionally, the difference in rate of diabetic remission is not explained by weight loss or preoperative predictors of less reversible diabetes (HOMA2 parameters, use of insulin). Identification of the factor(s) responsible for this differential effect on diabetes may afford opportunity for therapeutic intervention
The adverse effects of race, insurance status, and low income on the rate of amputation in patients presenting with lower extremity ischemia
ObjectivesA consequence of delay in the diagnosis of peripheral vascular disease limb loss. This study was undertaken to determine the correlation of low socioeconomic status and race on the severity of ischemic presentation and the subsequent amputation rate.MethodsData from the Nationwide Inpatient Sample (NIS) from 1998 to 2002 on patients from urban hospitals with the diagnosis of lower extremity ischemia were evaluated. The population was divided into two groups: the amputation group (AMP) and lower extremity revascularization group (LER). Comorbidities, age, gender, race, ischemic gangrene at presentation, insurance status (no/noncommercial or commercial), and income status at admission were determined. These variables were compared using multivariate logistic regression analyses of the data for risk adjustment.ResultsOf 691,833 patients presenting with lower extremity ischemia, 363,193 underwent revascularization (66.3%) or amputation (33.7%). Univariate analysis correlated a statistically significant (P < .0001) higher rate of amputation and multivariate analysis associated significantly higher odds of amputation with the following variables: nonwhites (1.91, 95% confidence interval [CI], 1.65, 2.20), low-income bracket (1.41, 95% CI, 1.18, 1.60), and Medicare & Medicaid (1.81, 95% CI, 1.66, 1.97). Adjusting for other variables of statistical significance, multivariate regression analysis showed a statistically significant risk for amputation based on the nonteaching status of the institution (odds ratio [OR], 1.17, 95% CI, 1.08, 1.30).ConclusionsPrimary amputation was performed with a higher frequency on patients with lower extremity ischemia who were nonwhite, low income, and without commercial insurance. The observed advanced ischemia among these economically disadvantaged patients suggests a delayed diagnosis of peripheral vascular disease, probably due to lack of access to adequate primary care or vascular surgery providers, or both. Better education of the general population and primary care providers to the symptoms and consequences of PVD may reduce the amputation rate in this group
The pediatric emergency department care experience: A quality measure
To develop and validate a measure of the quality of the pediatric emergency department care experience from the parent perspective. This was a multiphase study conducted at a tertiary-care pediatric health system using qualitative and quantitative methods. A list of candidate questions was developed to measure each of eight dimensions of family-centered pediatric emergency care described in a published framework. This list was evaluated and refined using the Question Appraisal System (QAS-99) followed by cognitive interviewing methods. Remaining questions were field tested using survey methods via telephone interviews with randomly selected parents. Composite scores to measure each of the eight dimensions of family-centered pediatric emergency care were calculated. Reliability was evaluated using measures of internal consistency. Construct validity was evaluated by measuring the association of each question and composite scores with overall satisfaction. A pool of 77 questions was reduced to 51 using QAS-99 criteria. Cognitive interviews with 19 parents resulted in a final list of 24 questions for field testing. With a response rate of 46%, 404 parents participated in the field test. Each individual question exhibited a significant positive association with overall satisfaction. Measures of internal consistency did not support the composite scores based on the initial eight dimensions. An exploratory factor analysis resulted in alternative composite measures that exhibited acceptable reliability and construct validity. This study has resulted in a measure that can be used to inform quality improvement work aimed at improving the pediatric emergency department care experience
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