Low-cycle fatigue of Type 347 stainless steel and Hastelloy alloy X in hydrogen gas and in air at elevated temperatures

An investigation was conducted to assess the low-cycle fatigue resistance of two alloys, Type 347 stainless steel and Hastelloy Alloy X, that were under consideration for use in nuclear-powered rocket vehicles. Constant-amplitude, strain-controlled fatigue tests were conducted under compressive strain cycling at a constant strain rate of 0.001/sec and at total axial strain ranges of 1.5, 3.0, and 5.0 %, in both laboratory-air and low-pressure hydrogen-gas environments at temperatures from 538 to 871 C. Specimens were obtained from three heats of Type 347 stainless steel bar and two heats of Hastelloy Alloy X. The tensile properties of each heat were determined at 21, 538, 649, and 760 C. The continuous cycling fatigue resistance was determined for each heat at temperatures of 538, 760, and 871 C. The Type 347 stainless steel exhibited equal or superior fatigue resistance to the Hastelloy Alloy X at all conditions of this study

Narratives from the road to social justice in PETE: teacher educator perspectives

Developing teacher education programmes founded upon principles of critical pedagogy and social justice has become increasingly difficult in the current neoliberal climate of higher education. In this article, we adopt a narrative approach to illuminate some of the dilemmas which advocates of education for social justice face and to reflect upon how pedagogy for inclusion in the field of physical education (PE) teacher education (PETE) is defined and practiced. As a professional group, teacher educators seem largely hesitant to expose themselves to the researcher's gaze, which is problematic if we expect preservice teachers to engage in messy, biographical reflexivity with regard to their own teaching practice. By engaging in self- and collective biographical story sharing about ‘our’ teacher educator struggles in England and Norway, we hope that the reader can identify ‘her/his’ struggles in the narratives about power and domination, and the spaces of opportunity in between

Outcomes comparison between hip fracture surgery and elective hip replacement. A propensity score-matched analysis on administrative data

Background: Increased life expectancy causes higher prevalence of chronic diseases and greater frailty among older persons. Osteoarthritis and hip fracture are the leading causes of disability among the older persons in high income countries. Recent studies showed that patients undergoing hip fracture surgery have an increased risk of mortality and developing complications. The aim of this study was to compare the occurrence of in-hospital mortality events, complications, and 30-hospital readmissions among patients undergoing hip fracture surgery (HFS) and elective hip replacement (EHR). Methods: The study considered all hospital admissions for HFS and EHR performed from 2006 to 2015 in Abruzzo region, Italy. Data were collected from hospital discharge records. To compare outcomes between HFS and EHR, a propensity score matching procedure was performed. Odds ratios with 95% confidence intervals for primary and secondary outcomes were computed using logistic regression models. Results: A total of 32,248 patients were selected: 23,075 underwent HFS and 9173 underwent EHR. After matching, 18,078 patients were included in the analyses (9039 patients who underwent HFS and 9039 patients who underwent HER). In the matched population, HFS patients showed an increased risk of in-hospital mortality (OR 2.03; 95% CI 1.58–2.61) and 30-day hospital readmission (OR 1.97; 95% CI 1.85–2.09). A sensitivity analysis performed on patients younger than 65 years of age confirmed these findings. Conclusions: In a cohort of Italian patients, hip fracture surgery was associated with a higher risk of in-hospital mortality and 30-day readmission when compared to elective hip replacement

Incidence of hip fracture and 30-day hospital readmissions in a region of central Italy from 2006 to 2015

Aim: Increased life expectancy causes a higher prevalence of chronic and degenerative diseases, and greater frailty among older people. Hip fracture is a common event for older people, and 1-year mortality after hip fracture is high. The present study was carried out in the Abruzzo region, Italy, over the years from 2006 to 2015, entailing as its main objectives the assessment of age and sex-specific trends in the incidence of hip fractures, with the subsequent hospital mortality. Causes of 30-day hospital readmissions were assessed. Methods: Data were collected from all hospital discharge records. Information on all 30-day readmissions was also retrieved. Results: Overall, 23 075 patients were admitted to hospital for hip fracture (mean age 81.0 ± 11.7 years,72.6% women). The overall hip fracture incidence remained constant over the study period, varying from 175.9 cases in 2006 to 179.3 cases per 100 000 in 2015. However, the incidence progressively increased from 40.0 to 51.0 among men, and from 61.6 to 80.9 among patients aged >85 years. The in-hospital mortality rate was 3.8%. Within 30 days from the hip fracture discharge, 10 526 patients (45.6%) had a second hospitalization, related to the condition of interest in >80% of the patients. Additionally, 414 (3.9%) patients died during the second hospitalization. Conclusions: Although women aged >65 years remain the category of patients at highest risk of hip fracture, an increasing trend is observed among men and patients aged >85 years. Hip fracture is frequently associated with early hospital readmission and is responsible for elevated in-hospital mortality

The revolving door phenomenon: Psychiatric hospitalization and risk of readmission among drug-addicted patients

Background. Substance use may influence the onset and course of psychiatric diseases. The “Revolving door” (RD) phenomenon, which indicates repeated hospitalizations of the same patients, has become a public health. Objectives. The aim of this study was detecting the risk factors associated to hospital readmission to psychiatric wards of drug-addicted patients. Methods. The study considered all the admissions performed between 2006 and 2015 in Abruzzo, Italy. Only the hospital discharge registry having code 304 (drug dependence) as diagnosis was taken into account. In addition, only the patients with a psychiatric DRG were included. Results. 325 patients performed 558 psychiatric admissions during the study period (1089 person-years). The analyses of the discharge registry showed “Psychoses” as the main DRG (73.2%). An amount of 119 patients experienced a second psychiatric admission. Psychiatric readmissions were independently predicted by Schizofrenia (HR=2.061) and Anxiety disorders (HR=0.326). Conclusions. Psychiatric hospitalization and readmission are frequent among drug-addicted patients. The subsequent RD phenomenon has become a public health issue, both for health and economic sides

Trend in Hospital Admissions of Drug Addicts and Associated Factors from 2006 to 2015: an Observational Study on the Hospitals' Discharge Registries from a Region of Central Italy

BACKGROUND: Several social, economic and political factors have contributed to the global spread of alcohol and other drugs. Drug addiction represents a huge expense for the society in terms of direct and indirect health and social consequences, as it is associated with numerous medical issues such as HIV, other infections and psychiatric disturbances. OBJECTIVES: The aim of this study was the assessment of the hospital admissions among drug addicted patients in Abruzzo Region, central Italy, from 2006 to 2015, in order to clarify the specific causes of hospitalization. METHODS: Data were collected from all hospital discharge records, taking into account only the hospital discharge registrations coded 304 (drug dependence). Multivariate logistic regression was performed to evaluate factors associated with main causes of the admission. RESULTS: Between 2006 and 2015, an amount of 2,159 drug-addicted subjects, aged 38.0±9.7 years, were admitted to hospital. Most of the admissions occurred in public hospitals (2,039, 94.4%), through the emergency room access (1,503, 69.6%) From an amount of 2,159 hospitalizations, 1,178 (54.6%) were first and 981 (45.4%) were subsequent admissions. The most frequent cause of hospitalization was "Psychosis" (419, 19.4%). The trend by range of age showed a progressive reduction in hospital admissions for patients aged < 45 y. Further, an increase in the hospitalization rate was estimated over recent years among drug addict subjects aged 25-45 years. Cannabis consumption was associated with mental disorder admissions (OR: 3.16, p<0.001), opioid consumption was associated with hepatic disorder admission (OR:2.16, p<0.001) and cardiovascular admissions (OR: 1,78, p<0.001), and cocaine was associated with cardiovascular admissions (OR:1,55, p:<0.001). CONCLUSIONS: Mental disorders result to be the leading cause of hospitalization among drug-addicts, principally associated with cannabis abuse. Opioid and cocaine abuse was associated with hepatic and cardiovascular disorders