Women undergoing endovascular thoracoabdominal aortic aneurysm repair differ significantly from their male counterparts preoperatively and postoperatively

OBJECTIVE: A rational approach to the management of aortic aneurysm disease relies on weighing the risk of aneurysm rupture against the complications and durability of operative repair. In men, seminal studies of infrarenal aortic aneurysm disease and its endovascular management can provide a reasoned argument for the timing and modality of surgery, which is then extrapolated to the management of thoracoabdominal aortic aneurysms (TAAAs). In contrast, there is less appreciation for the natural history of TAAA disease in women and its response to therapy. METHODS: We used a retrospective cohort design of women, all men, and matched men, fit for complex endovascular thoracoabdominal aneurysm repair at two large aortic centers. We controlled for preoperative anatomic and comorbidity differences, and assessed technical success, postoperative renal dysfunction, spinal ischemia, and early mortality. Women and matched men were reassessed at follow-up for long-term durability and survival. RESULTS: Assessing women and all men undergoing complex endovascular aortic reconstruction, we demonstrate that these groups are dissimilar before the intervention with respect to comorbidities, aneurysm extent, and aneurysm size; women have a higher proportion of proximal Crawford extent 1, 2, and 3 aneurysms. Matching men and women for demographic and anatomic differences, we find persistent elevated perioperative mortality in women (16%) undergoing endovascular thoracoabdominal aneurysm repair compared with matched men (6%); however, at the 3-year follow-up, both groups have the same survival. Furthermore, women demonstrate more favorable anatomic responses to aneurysm exclusion, with good durability and greater aneurysm sac regression at follow-up, compared with matched men. CONCLUSIONS: Women and unmatched men with TAAA disease differ preoperatively with respect to aneurysm extent and comorbidities. Controlling for these differences, after complex endovascular aneurysm repair, there is increased early mortality in women compared with matched men. These observations argue for a careful risk stratification of women undergoing endovascular thoracoabdominal aneurysm treatment, balanced with women's good long-term survival and durability of endovascular aneurysm repair

No measure for culture? Value in the new economy

This paper explores articulations of the value of investment in culture and the arts through a critical discourse analysis of policy documents, reports and academic commentary since 1997. It argues that in this period, discourses around the value of culture have moved from a focus on the direct economic contributions of the culture industries to their indirect economic benefits. These indirect benefits are discussed here under three main headings: creativity and innovation, employability, and social inclusion. These are in turn analysed in terms of three forms of capital: human, social and cultural. The paper concludes with an analysis of this discursive shift through the lens of autonomist Marxist concerns with the labour of social reproduction. It is our argument that, in contemporary policy discourses on culture and the arts, the government in the UK is increasingly concerned with the use of culture to form the social in the image of capital. As such, we must turn our attention beyond the walls of the factory in order to understand the contemporary capitalist production of value and resistance to it. </jats:p

Understanding Video Game Developers as an Occupational Community

The video game industry has rapidly expanded over the last four decades; yet there is limited research about the workers who make video games. In examining these workers, this article responds to calls for renewed attention to the role of the occupation in understanding project-based workers in boundaryless careers. Specifically, this article uses secondary analysis of online sources to demonstrate that video game developers can be understood as a unique social group called an occupational community (OC). Once this classification has been made, the concept of OC can be used in future research to understand video game workers in terms of identity formation, competency development, career advancement and support, collective action, as well as adherence to and deviance from organizational and industry norms

Time invaders:conceptualizing performative game time

This chapter characterizes framing devices and other game elements as unstable signifiers, evaluating performances according to how they generate diachronic or synchronic effects by acting on those signifiers. Videogames make use of computers’ capabilities to present a very large set of these signifiers and thus generate highly complex forms of temporal experience. Because neither diachrony (exemplified by player performance) nor synchrony (computer-coded rule structures) can complete their respective operations and always leave a differential margin, videogames can be understood as diachrono-synchronic systems.Performative multiplicities of various sizes can be analyzed in terms of how they draw together or separate performances, creating a comparative methodology for describing temporal experience in videogames. One of the key synchronic effects is the Game Over, which has a high-level effect on all performances of a game. Considered as a synchronic horizon of experience, the Game Over provides a concept capable of addressing the heterogeneous and composite set of videogame elements in terms of how players interpret unstable signifiers. This includes narrative, which can be rigorously defined in terms of its synchronizing effect on a game’s performative multiplicity

Precarious, Always-On and Flexible: A Case Study of Academics as Information Workers

The higher education landscape has changed in the last decades. The neoliberal restructuring of universities has led to transformations such as reducing public expenditure, allocating resources based on competition and quasi-market disciplines. These structural transformations have also an effect on the working conditions, practices and relations of subjects within universities. Questions that need to be addressed: How do different working contexts and conditions in the academia shape feelings of autonomy, flexibility and reputation on the one hand and precariousness, overwork and dissatisfaction on the other? What are the broader political realities and potentials in terms of solidarity, participation and democracy at universities? I address these questions based on a theoretical analysis and qualitative interviews with precariously employed academics

The New ‘Hidden Abode’: Reflections on Value and Labour in the New Economy

In a pivotal section of Capital, volume 1, Marx (1976: 279) notes that, in order to understand the capitalist production of value, we must descend into the ‘hidden abode of production’: the site of the labour process conducted within an employment relationship. In this paper we argue that by remaining wedded to an analysis of labour that is confined to the employment relationship, Labour Process Theory (LPT) has missed a fundamental shift in the location of value production in contemporary capitalism. We examine this shift through the work of Autonomist Marxists like Hardt and Negri, Lazaratto and Arvidsson, who offer theoretical leverage to prize open a new ‘hidden abode’ outside employment, for example in the ‘production of organization’ and in consumption. Although they can open up this new ‘hidden abode’, without LPT's fine-grained analysis of control/resistance, indeterminacy and structured antagonism, these theorists risk succumbing to empirically naive claims about the ‘new economy’. Through developing an expanded conception of a ‘new hidden abode’ of production, the paper demarcates an analytical space in which both LPT and Autonomist Marxism can expand and develop their understanding of labour and value production in today's economy. </jats:p

Extra-Activism: Counter-Mapping and Data Justice

Neither big data, nor data justice are particularly new. Data collection, in the form of land surveys and mapping, was key to successive projects of European imperialist and then capitalist extraction of natural resources. Geo-spatial instruments have been used since the fifteenth century to highlight potential sites of mineral, oil, and gas extraction, and inscribe European economic, cultural and political control across indigenous territories. Although indigenous groups consistently challenged maintained their territorial sovereignty, and resisted corporate and state surveillance practices, they were largely unable to withstand the combined onslaught of surveyors, armed personnel, missionaries and government bureaucrats. This article examines the use of counter-mapping by indigenous nations in Canada, one of the globe’s hubs of extractivism, as part of the exercise of indigenous territorial sovereignty. After a brief review of the colonial period, I then compare the use of counter-mapping during two cycles of indigenous mobilization. During the 1970s, counter-mapping projects were part of a larger repertoire of negotiations with the state over land claims, and served to re-inscribe first nation’s long-standing history of economic, social and cultural relations in their territories, and contribute to new collective imaginaries and identities. In the current cycle of contests over extractivism and indigenous sovereignty, the use, scope and geographic scale of counter-mapping has shifted; maps are used as part of larger trans-media campaigns of Indigenous sovereignty. During both cycles, counter-mapping as data justice required fusion within larger projects of redistributive, transformative and restorative justice

Online Games

When we agreed to edit the theme on online games for this Encyclopedia our first question was, “What is meant by online games?” Scholars of games distinguish between nondigital games (such as board games) and digital games, rather than between online and offline games. With networked consoles and smartphones it is becoming harder and harder to find players in the wealthy industrialized countries who play “offline” digital games. Most games developers now include some element of online activity in their game and the question is:What is the degree to which the gameplay experience occurs online? Is online gameplay more a multiplayer than an individual experience? If we move beyond the technological meaning of “being online” we should, as Newman (2002) argued, be concerned with varying degrees of participation during gameplay

For a political economy of massive open online courses

In understanding the changes that are impacting the global higher education sector, developing a critique of the relationships between technology and technological innovation, new managerialism and financialisation, and the impact of the secular crisis of global capitalism is critical. Moreover, it is important to critique these changes historically and geographically, in order to understand how political economics shapes the space in which higher education policy and practice are recalibrated for capital accumulation and profitability. This article will argue that educational innovations such as Massive Open Online Courses (MOOCs) might usefully be examined in light of the relationships between technological and organisational innovation; the historical tendency of the rate of profit to fall that is affecting competing educational providers; the disciplinary role of the State in shaping an educational space for further capital accumulation; and the subsumption of open networks to the neo-liberal project of accumulation and profitability. Such an analysis then enables a critique of the claims that are made for open networks in delivering new forms of sociability that transcend structures of power and domination. As a result of this political economic critique, the article will situate the emergence of MOOCs inside and against Capital’s drive to subsume labour practices inside technologically mediated forms of coercion, command, and control. It will argue that the ways in which MOOCs and the services that are derived from them are then valorised might offer a glimpse of how the neoliberal educational project is disciplining academic labour and how it might be resisted

The Discourse of Digital Dispossession: Paid Modifications and Community Crisis on Steam

This article is a chronicle and analysis of a community crisis in digital space that took place on Valve Corporation’s digital distribution platform, Steam. When Valve and Bethesda (publisher and developer of Skyrim) decided to allow mods to be sold by mod makers themselves, there ensued a community revolt against the commodification of leisure and play. I put this crisis of play and work in dialogue with Harvey’s concept of “accumulation by dispossession,” firmly placing it within a longer history of disruptive capital accumulation strategies. I then conduct a discourse analysis of community members on reddit, as they make sense of and come to terms with this process of dispossession. Arising in the discourse was not class consciousness per se, but instead a pervasive feeling of helplessness and frustration as games, play, and leisure began to feel like work