Congenital arterio-venous fistulae and other vascular anomalies

The object of this thesis is to present an extensive survey of some rare congenital vascular anomalies, with special reference to arterio- venous fistulae. Interest was first aroused in those cases which showed a marked hypertrophy of a limb, along with numerous angiomata and varicose veins. Investigations revealed that these features had been described both in the presence and in the absence of arteriovenous fistulae, and, further, that arterio -venous fistulae could be found in the absence of hypertrophy or angiomata. Illustrating many of the varied and bizarre manifestations, a series of twelve cases has been examined and will now be reported, the presence of arterio -venous fistulae being found in nine cases, but not in the other three. These cases will, there - fore, be described in considerable detail, along with brief reports on two other cases which have come to my notice.Though the lesions under review are congenital, there has been much difference of opinion as to the underlying pathology, a haemangioma, indicating a true tumour, being maintained by some, and an actual maldevelopment of the vascular system being supported by others. Such opposing views are shown by the varied and confused nomenclature, the following being examples of names which might be applied to my own series of cases, and which have been freely used in the past : - arterio- venous aneurysm, anastomoses or fistulae; cirsoid or racemose aneurysm; aneurysm by anastomosis; aneurysmal varix; many varieties of haemangioma or naevus, such as cavernous, pulsating, plexiform, arterial or venous; haemangioma of bone or 'muscle; angiosarcoma; phlebarteriectasis; phiebec Itasis; cavernoma; haemangiectatic hypertrophy; hems hypertrophy; generalised angiomatosis

Doctor of Philosophy

dissertationPrimary breast carcinoma is the most common type of cancer among women and radiodermatitis a frequent complication of treatment. The study aims were to examine the feasibility of measurements of radiodermatitis and gain a better understanding of quality of life (QOL) among 40 women with grade 0-III breast carcinoma receiving radiotherapy at a community cancer center. Study design feasibility, clinician-measured breast length, and multiple assessments of breast radiodermatitis were explored in a pilot study. Maximum radiodermatitis score significantly correlated with breast length (p =.04), and with the following breast areas: upper inner quadrant (p=.04), upper lateral quadrant (p=.02), and lower lateral quadrant (p=.02), inframammary fold (p=.001). Clinician-measured breast lengths and participant-reported bra cup sizes were discordant estimates of breast size. Change in skin-related and global QOL between baseline and at week 5 on radiotherapy was measured using the Dermatology Life Quality Index (DLQI) and the Quality of Life Instrument-Breast Cancer Patient Version. The relationship between, and factors associated with, skin-related and global QOL were examined. In general, skinrelated and global QOL were highly correlated. Skin-related QOL changed profoundly (M=.40, SD=1.19; versus M=3.88, SD=3.55, t(-6.32), p<.001) while global QOL did not change (M=296.90, SD=74.18; versus M=292.55, SD=72.23, t(60), p=.55) between baseline and five weeks on radiotherapy. We initiated the validation of the DLQI when used to measure skin-related QOL in breast radiodermatitis. Thirty-one (78%) participants provided narrative feedback on how the experience represented by each DLQI item impacted her life. Agreement between DLQI ratings and coded narratives ranged from 71% to 98%. Aside from work and study, the DLQI subscales demonstrated good internal consistency, α =.84. Content analysis was implemented to describe 28 participants' narrative response to an open-ended question about the most important DLQI item. Analysis of 60 narratives led to the identification of six themes: perspectives on having radiodermatitis, sensations caused by radiodermatitis, knowledge and preparation for radiotherapy, prevention of radiodermatitis, emotions induced by skin changes, and physical appearance of the breast skin. Results suggest radiodermatitis has a significant impact on skin-related QOL; breast length measurements and multiple assessments of radiodermatitis may improve breast cancer research in this area

Childhood physical abuse and delusional content.

This review will consider the literature regarding the prevalence and impact of childhood physical abuse, and the potential link to the formation of delusions later in life. Childhood physical abuse is linked to a number of psychological difficulties both within childhood and later in the life cycle. As psychological models have increasingly been applied to psychosis (and delusional beliefs in particular) the role of early experience has increasingly been considered central. Given the high prevalence of past abusive experiences in individuals with psychosis, and the potentially far reaching effects of this abuse and resulting posttraumatic stress symptoms, further research is recommended to consider the role of abuse in order to improve clinical practice with these individuals

Hydrogen jet-fire: Accident investigation and implementation of safety measures for the design of a downstream oil plant

As amply known, hydrogen plays a very significant role in the process industry exerting a vital functionality in oil refineries, namely for secondary level refining units such hydro-treating and hydrocracking sections. This paper starts from a statistical analysis on hydrogen accidents and a thorough investigation on the sequence and causes of an accident involving a hydrogen leakage in a downstream oil industry. We present some key features of the accident and comment some practical implications for setting up risk reduction options at the plant level. The applicative phase of the paper states the main prevention strategies and suggest possible mitigation measures for hydrogen leaks events, discussing some practical solutions applied in the design of a large refinery. The experience and lessons learned gained from the event investigation and the comparison of the accident with the predictions of the safety report leads to the formulation of proposals and design modifications aiming at preventing or at least minimizing the consequences

Pink Concrete

(From Reader Report Reflection) - I started this course believing I was not a writer. I knew that I loved to write, I knew that it was innate to how I perceived the world. I had written a novel previously, it was an outpouring, uncontrollable imagination spew. I was often scared and doubted myself throughout writing it, but I took comfort in my reading. I picked up all the classics, modern and old, rewriting the words into notebooks alongside my own, retracing the sounds, the rhythms, the symbols and their little links, the pauses. I collected pieces rereading them with reverence, my fingers curling over the lines sunken into the page. I didn’t understand what I was doing, it felt natural to hide in the skirts of other writers peering behind the curtain to see how they built the illusion. And yet, even after finishing my novel I still didn’t think I was a writer; it was a hobby, it was something extra to me, a backpack I could take off and on. I denied what was innate, and said it was not that important to me. I applied for this Master’s in Creative Writing (MACW)7 course because I wanted external validation on my first novel and an application was probably the only way, I was going to get someone to read it. It is sad and stunted that I needed this external validation to believe I could try, to believe that I could learn to control this compulsion, to believe that I could become a writer. In our first course contact week,8 lecturers and supervisors kept saying again again that we were already writers, that this is what we are. I was scared of this, that they would find out I was not really meant to be here. Writing, taking those solitary thoughts that are too much for my skull and making them real, something tangible; this is how I move through my existence. I take pieces of myself and paste them to the page, otherwise the thoughts build up like snow around a car until you are suffocating in an icebox. And by removing this part of myself to just a hobby, a silly backpack that I can pick up and put down, was just me running away. This MACW course gave me the tools to tap into what I am, that I have a why that I must write to and that I have an audience for this why. By sharing pieces of myself, I make them real again, something I can study, tracing their edges, their dark underbelly, the light hillocks. I sat with my fear for two years slowly, piece by piece, cracking it open. I learnt to love my voice and believe in it without needing external validation, without needing the gold star of acceptance, because I accept and love what I am trying to build with my writing.Thesis (MACW) -- Faculty of Arts, School of Languages and Literatures, 202

Childhood abuse and the content of delusions

Original article can be found at: http://www.sciencedirect.com/science/journal/01452134 Copyright Elsevier Ltd.We aimed to investigate possible associations between histories of childhood abuse and the content of delusions for individuals with psychotic disorders. 39 participants with a psychotic disorder including one or more delusional beliefs successfully completed structured interviews about childhood trauma, delusional beliefs and associated anomalous perceptual experiences including hallucinations. The presence of hallucinations was predicted by greater physical abuse. Greater abuse in general was associated with delusions involving ‘special abilities’ (grandiosity) and, at trend levels, with those involving ‘defective self’. Though preliminary, these results suggest that further investigation is warranted. The presence and nature of abuse may be relevant to delusional presentations and should form an essential part of clinical assessment of psychotic disorder.Peer reviewe

Humiliated consciousness in Ronnie Govender’s The Lahnee’s pleasure and Ben Okri’s In Arcadia

Ronnie Govender entitled both his major play (Johannesburg: Ravan Press, 1977) and his later novel (Johannesburg: Jacana, 2008) The Lahnee’s Pleasure, articulating that life was, and still is, a pleasure ground for a privileged minority in South Africa. Over a period of three decades, spanning both the periods before and after apartheid, his assessment of political conditions in the country of his birth remains as valid. Lao, in Ben Okri’s In Arcadia, reveals how much of life in Europe today remains a “fairground for the favoured” (London: Head of Zeus, 2014, 108) and how little pampered and privileged people such as Jim, the director of the film project in this novel, see or comprehend of what is so often a secret ordeal for a person of colour. Okri writes of conditions and perceptions in contemporary Britain, while Govender writes of South Africa up to the present time; yet despite the many differences in their social contexts, their delineation of conditions that surround a person of colour living in British or South African society shows that interracial equality and brotherhood are still distant ideals in both countries. Both writers, however, do hold out a measured degree of hope in their depiction of Wordsworthian figures of humble labour: Mothie in Govender’s novel and the train driver in Okri’s