Narratives of Violence: The Relationship of Masculinity and Ableism

As powerful ideologies, masculinity and ableism inculcate a set of norms, values, and behaviours within particular social structures and social actors. To understand the social meanings and operations of ideologies, I will be using a form of dialectical analysis to understand masculinity as contingent on its social relations and conditions. The theoretical analysis will examine how these two social constructions are intertwined and rely on each other to maintain power and influence. I will use Gramsci’s theory of hegemony to argue that both ableism and masculinity are hegemonic ideologies that act both on personal and structural levels. In describing masculinity, I will argue that the common and popular socialization of the masculine gender is connected with patriarchy and that it operates to benefit and supplement patriarchal dominance. I will articulate how ableism plays out to define a certain kind of masculinity and also to uphold ableist social structures in Canadian society. The project will be organized into four different sections: (1) methodology; (2) systemic violence through class structures; (3) boys physical violence; and (4) the implications for community organizing. The section on class structures will examine the masculinity-ableism relationship through the mechanisms of capitalism and neoliberalism (Harvey, 2007). Using a historical materialist analysis, I will reveal how the capitalist neoliberal state of Canada influences the formation of oppressive gender identities (Bannerji, 2000; Gorman, 2005; Razack, 2002). I will argue that capitalism operates as systemic violence that influences societal relations (Crow, 1996). This section is essential for a comprehensive analysis of the complexities of the formation of gender-identity oppression. An investigation of the social structures of capitalism will provide an analysis of masculinity-ableism that shows the materialist functions of oppressive ideologies (Gleeson, 1997; Mills, 2000). This analysis of capitalism will be used to understand the class relations that are imbedded in the masculinity-ableism relationship. Additionally, in analyzing my standpoint and lived experiences I will investigate how masculinity-abliesm is articulated by people of different classes in interpersonal relationships (Barker, 2010; Peterson, 2005). Though masculinity and ableism operate through social structures that produce various forms of violence, I will specifically analyze physical violence to explore the connection between masculinity and ableism. The section on boys physical violence will provide a theoretical framework of early identity constructions and how physical violence manifests for boys (Connell, 1994; hooks, 2004; Kaufman, 2007). The boys physical violence section I will utilize popular media examples of children’s literature and film, which will identify how such identities are constructed discursively from a young age (Ostrander, 2008; Nodelman, 2001). The literature and film that I will be examining will be ones that are related to my own history of socialization, such as, The Beauty and The Beast, Superman, and Peter Rabbit (Nodelman, 2001; hooks, 2004). Lastly, my final section will examine how masculinity-ableism is addressed within community organizing and activist culture. As the goal and intention of this paper is to provide a theoretical analysis that advances our understanding of oppressive societal relations, an examination of the implications of the work for concrete social justice activism is essentialYork University, CUPE 390

Systematic review of aortic valve preservation and repair.

Aortic valve repair has emerged as a feasible alternative to replacement in the surgical treatment of selected patients with aortic valve (AV) pathology. In order to provide a synopsis of the current literature, we preformed a systematic review with a focus on valve-related events following AV repair

Aortic valve preservation and repair in acute Type A aortic dissection

OBJECTIVES: Repair and preservation of the aortic valve in Type A aortic dissection (AAD) remains controversial. We performed a meta-analysis of outcomes for aortic valve (AV) repair and preservation in AAD focusing on long-term valve-related events. METHODS: Structured searches were performed in Embase (1980-2013) and PubMed (1966-2013) for studies reporting AV repair or preservation in AAD. Early mortality and linearized rates for late mortality and valve-related events were derived. Outcome data were pooled with an inverse-variance-weighted random-effects model. RESULTS: Of 5325 screened articles, 19 observational studies met the eligibility criteria consisting of 2402 patients with a median follow-up of 4.1 [range: 3.1-12.6 years, total 13 733 patient-years (pt-yr)]. The cohort was principally male (median = 68.1%, range: 39-89) with a median age of 59 (range: 55-68) years and Marfan's syndrome was present in 2.5%. AV resuspension was performed in 95% of the patients and the remainder underwent valve-sparing root replacement (reimplantation = 2.5% and remodelling = 2.5%). Pooled early mortality rate was 18.7% [95% confidence interval (95% CI): 12.2-26.2%], and linearized late mortality rate was 4.7%/pt-yr (95% CI: 3.4-6.3). Linearized rate for AV reintervention was 2.1%/pt-yr (95% CI: 1.0-3.6), recurrent aortic insufficiency (>2+) was 0.9%/pt-yr (95% CI: 0.3-2.2) and endocarditis was 0.2%/pt-yr (95% CI: 0.1-0.5). The composite rate of thromboembolism and bleeding was 1.4%/pt-yr (95% CI: 0.7-2.2). CONCLUSIONS: Patients surviving an AAD have a limited long-term survival. Preservation and repair of the aortic valve is associated with a moderate risk of reoperation, but a low risk of thromboembolism, bleeding and endocarditis

Is Aortic Valve Repair Reproducible? Analysis of the Learning Curve for Aortic Valve Repair

BACKGROUND: Aortic valve (AV) preservation and repair, although effective, is performed in a limited number of centres. Lack of wider application might be due to challenges in dissemination of tacit surgical knowledge. We examined the learning curve in 2 centres that initiated dedicated programs in AV repair. METHODS: Prospectively collected data on the first 100 (cohort A) and 150 consecutive patients (cohort B) who underwent AV repair surgery were analyzed. Safety end points included mortality, myocardial infarction or stroke, early AV repeat surgery, re-exploration for bleeding, or pacemaker implantation. Efficiency was assessed according to aortic crossclamp and cardiopulmonary bypass times. Efficacy parameters included residual aortic insufficiency or stenosis. Indices of case complexity included presence of severe aortic insufficiency, nontrileaflet AV, and associated cardiac procedures. Each cohort was divided into 3 equal tertiles (T1, T2, and T3). RESULTS: Early mortality was ≤ 1% in both cohorts. In cohort A, a total of 12 safety events occurred with a significant reduction in incidence over the tertiles (18%, 15%, and 3%, in T1, T2, and T3, respectively; P = 0.05). In cohort B, 20 safety events occurred in 18 patients with a trend toward reduction of incidence over tertiles (20%, 12%, and 8%, in T1, T2, and T3, respectively; P = 0.14). aortic crossclamp and cardiopulmonary bypass times decreased significantly after T2 in cohort A and T1 in cohort B (P < 0.01). Intraoperative procedural efficacy was similar across tertiles in both cohorts. CONCLUSIONS: Procedural safety and efficiency improves with experience whereas efficacy is consistent over time. AV repair is reproducible and appears to have a learning curve of approximately 40-60 cases.Introduction : La préservation et la réparation de la valve aortique (VA), bien qu'efficace, est réalisée dans un nombre limité de centres. Le manque d'application plus large pourrait être dû à des défis en matière de diffusion des connaissances tacites en chirurgie. Nous avons examiné la courbe d'apprentissage dans les deux centres qui ont initié des programmes dédiés à la réparation de la VA. Méthodes : Les données recueillies de façon prospective sur les 100 premiers patients qui ont subi une chirurgie de réparation de VA (cohorte A) et les 150 suivants (cohorte B) ont été analysées. Les points limites de sécurité incluent la mortalité, l’infarctus du myocarde ou l’accident vasculaire cérébral, la reprise précoce d’une chirurgie de la VA, le ré-examen pour saignement, ou l’implantation d'un stimulateur cardiaque. L'efficience a été évaluée en fonction du temps de clampage de l’aorte et la durée du pontage cardiopulmonaire. Les paramètres d’efficacité inclurent une insuffisance aortique résiduelle ou une sténose. Les indices de complexité des cas inclurent l’existence d'une insuffisance aortique sévère, d’une VA non trifoliée, et des procédures cardiaques associées. Chaque cohorte a été divisée en trois terciles égaux (T1, T2 et T3). Résultats : La mortalité précoce était ≤ 1 % dans les deux cohortes. Dans la cohorte A, un total de 12 événements touchant la sûreté ont eu lieu avec une réduction significative de l'incidence sur les terciles (18 %, 15 % et 3 %, pour T1, T2, et T3, respectivement, P = 0,05). Dans la cohorte B, 20 événements liés à la sûreté sont survenus chez 18 patients avec une tendance à la réduction de l'incidence à travers les terciles (20 %, 12 % et 8 %, en T1, T2 et T3, respectivement; P = 0,14). La durée du clampage aortique et le temps de circulation extracorporelle ont diminué de façon significative après le T2 pour la cohorte A et le T1 pour la cohorte B (P < 0,01). L’efficacité de la procédure per-opératoire était similaire entre les terciles pour les deux cohortes. Conclusions : La sécurité et l'efficience des procédures s’améliorent avec l'expérience alors que l'efficacité est constante dans le temps. La restauration de la VA est reproductible et semble correspondre à une courbe d'apprentissage d'environ 40-60 cas