Master plans and urban change: the case of Sheffield city centre

This paper critically examines the character, development and implementation of master plans as vehicles of urban change. The case of Sheffield’s city centre master planning is used to analyze how the city was reimagined from the early 1990s to the mid-2010s, and how the economic, cultural, social and political dimensions of urban regeneration were addressed. The paper argues that, in comparison to the post-war, welfare-state master plans, the master plans of the neoliberal period had a narrower spatial and thematic focus, linking place qualities to economic considerations, to be delivered through real estate investment. As such, social considerations were marginalized and, when a major economic crisis occurred, the new generation master plans’ lack of flexibility and vulnerability to economic fluctuations became apparent, much the same as their predecessors. This shows how master plans can be effective instruments for mobilizing investment and coordinating development around a selective spatial vision in periods of economic growth, but their utility is severely curtailed in economic downturns, when their coordinative potential is much diminished. They run the risk of becoming top-down technical devices to coordinate speculative real estate investment, without durable connections to the local economic and social capacities and needs

Sign Identification of Nonlinear Refractive Index of Colloidal Nanoparticles by Moiré Deflectometry Technique

In this paper, a visual rapid technique is presented for the sign identification of nonlinear refractive index of colloidal nanoparticles based on non-scanning Moiré deflectometry technique. In this method two lasers are used, one as a pump laser beam which causes thermal nonlinear effects in the sample and the second one is used as a probe beam laser which allows us to monitor these effects by Moiré deflectometry technique. The gradient of the nonlinear refractive index produced by the interaction of the pump laser, generates a cylindrical lens in the sample. The concave and convex lenses are produced as a result of negative and positive nonlinear refractive index respectively. Geometrical and experimental investigations show the Moiré fringes are deflected in two different directions by these lenses. By observing the shape of deflected moiré fringes, we can determine the sign of nonlinear refractive index and there will be no need for calibration or complicated calculations. This technique was applied for identification of nonlinear refractive index of Au and Tio_2 colloidal nanoparticles, under 47 mW second harmonic of Nd:YAG laser illumination. The sign of nonlinear refractive index of colloidal Au and Tio_2 nanoparticles were observed to be negative and positive respectively

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Towards a Deleuzoguattarian methodology for urban design

© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. The philosophy of Gilles Deleuze and Felix Guattari (Deleuzoguattarian) is now widely thought to be apropos for today’s world. This paper proposes Deleuzoguattarian philosophy as a new methodology for urban design research and practice. First, existing methodologies in the field of urban design are examined and their strengths and limitations outlined in relation to current urban problems. A reading of Deleuzoguattarian philosophy from an urban design perspective is then provided in order to propose a new methodology for research and practice. This reading mainly concentrates on the ontology and epistemology offered by the philosophy, aspects that have been neglected in the literature. The concept of territorialization as a complementary concept to assemblage theory is highlighted in order to illustrate the characteristics of the ontology and epistemology. Finally, normative goals are discussed. It is concluded that Deleuzoguattarian philosophy is not only an ethical response to modernism but is an epistemological need

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

Community planning and urban design in contested places. Some insights from Belfast

Although social conflict due to the presence of different groups divided by cultural, religious or ethnic issues plagues many contemporary cities, community and participatory planning methods still pay little attention to segregation in contested spaces as a specific matter of concern. This paper aims to contribute to filling this gap through the development of a novel tool to be implemented during community planning processes in contested cities, particularly in (visual) mapping processes. The pilot area for developing the lexicon has been selected within the city of Belfast, which has been struggling for years with problems related to inter-religious sectarian conflicts. The material effects on the urban structure of the long process of defensive planning during the socalled Troubles and within the post-conflicts peace programmes have been investigated by analysing urban artefacts including edges, borders, barriers, doors, visual control points. The paper suggests that a simple, recognizable lexicon may contribute to honing community planning methods in contested places by integrating the traditional methodology of visual mapping with a tailored taxonomy of elements of urban conflict, which may be used at many stages of the planning process, including developing a visual map, design and planning, and developing and implementing an action plan

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Social exclusion of older persons: a scoping review and conceptual framework

As a concept, social exclusion has considerable potential to explain and respond to disadvantage in later life. However, in the context of ageing populations, the construct remains ambiguous. A disjointed evidence-base, spread across disparate disciplines, compounds the challenge of developing a coherent understanding of exclusion in older age. This article addresses this research deficit by presenting the findings of a two-stage scoping review encompassing seven separate reviews of the international literature pertaining to old-age social exclusion. Stage one involved a review of conceptual frameworks on old-age exclusion, identifying conceptual understandings and key domains of later-life exclusion. Stage two involved scoping reviews on each domain (six in all). Stage one identified six conceptual frameworks on old-age exclusion and six common domains across these frameworks: neighbourhood and community; services, amenities and mobility; social relations; material and financial resources; socio-cultural aspects; and civic participation. International literature concentrated on the first four domains, but indicated a general lack of research knowledge and of theoretical development. Drawing on all seven scoping reviews and a knowledge synthesis, the article presents a new definition and conceptual framework relating to old-age exclusion