Laparoscopic Swenson procedure - An optimal approach for both primary and secondary pull-through for Hirschsprung's disease

Background/Purpose: Several pull-through procedures are available for the surgical management of Hirschsprung's disease (HD) in children. The authors have adopted a laparoscopic approach since 1995, including laparoscopic Swenson procedure (LSw), both for one-stage primary and 2-stage secondary procedures. The aim of this study was to examine the role of LSw in children with HD in both primary and secondary procedures. Methods: From January 1995 to December 2001, 42 children with biopsy-proven HD underwent laparoscopic pull-through procedure for HD. This group included 29 children who underwent LSw, a detailed analysis of which forms the basis of this report. Results: Sixteen children underwent a single-stage neonatal LSw; the median weight of this group at the time of surgery was 3.2 kg and the median age was 5 days. Secondary LSw was performed in the remaining 13 children, which included 3 children with total colonic HD who underwent laparoscopic total colectomy and LSw. The median operating time was 105 minutes (range, 66 to 175 minutes). The median time to commence full diet was 48 hours (range, 24 to 86 hours), and median time to return to normal play and activity was 72 hours (range, 48 hours to 5 days). There was no difference in operating time between primary and secondary pull-through procedures. There were no intraoperative complications, and no patient required open conversion. Postoperative ileus was noted in 3 children and enterocolitis in 2. The median hospital stay was 4 days (range, 2 to 6 days). Follow-up was between 6 months to 7 years with a median follow-up of 2.2 years. At follow-up, 2 children required laparoscopic antegrade continence enema procedure. A satisfactory continence was noted in 15 of the 19 children who were older than 3 years at the time of last follow-up. Conclusions: LSw seems to be a suitable procedure for laparoscopic management of HD in children. LSw is safe and effective, both for primary and secondary type of pull-through procedures, with good short-term results.

The campaign to save Croxteth comprehensive: an ethnographic study of a protest movement

This thesis is based on ethnographic research carried out on a Liverpool protest movement which occurred between November, 1980 and July,1983. The protest movement was waged by residents of the working class community of Croxteth Liverpool who wished to retain their state secondary school, Croxteth Comprehensive. The Liverpool City Council voted in favour of closing Croxteth Comprehensive in January, 1981 because of its declining roles. Residents began theIr campaign as soon as they became aware of intentions to close the school at the end of the previous year. The campaIgn itself went through a number of different phases, distinguishable accordIng to the groups of people involved, the strategy and tactics they employed, the ways in which they justified their campaign, and the goals they pursued. In July of 1982 the organisation which led the protest, the Croxteth Community Action Committee, took illegal possession of the school buildings and ran a pilot summer school project. In September of 1982 they opened the school doors for all secondary pupils on the council estate and began running classes, with the help of volunteer teachers. The school was run successfully in this way for the entire 1982/83 school year. By the end of this period the school was officially reinstated by a new Labour Party majorIty on the city council. This thesis presents a comprehensive account of the entire campaign, from its beginning to end. The campaign is analysed in a number of ways: by situating the closure itself in the economic and political conditions of Liverpool in the 1980s, by examining the relation of Croxteth Comprehensive to its community, by describing the conditions in which different groups of people contributed to the campaign and the changes it went through in its use of tactics, and through a close examination of the activities which took place inside the school during its year of occupation. A number of levels of analysis are used in the study. To explain the closure and the early forms of resistance which developed to oppose it, the structural location of the local government of Liverpool in the late 1970s and early 1980s is described. To explain the relationship of the school to its community, the formation of a group of activists and their leaders, and the resources available to the protestors for pursuing their aims, a single-group model of social action is used. To analyse the establishment of social routines and schooling practices within the school during its occupation, action-theoretica1 models are drawn upon., The chapters of literature review and concept analysis with which this thesis begins link these different levels theoretIcalIy through a model of actIon and its conditions. The theoretical framework employed is reviewed in the last chapter. It is one which could be used to study any social movement, and has applications to other social phenomena as well. Lastly various issues within the sociology of education are examined in light of the events which took place in Croxteth Comprehensive, especially the theory of community education.

An Examination of Stock Performance: The Three Top-Performing Lodging Firms August 1987 - January 1990

A study published in the Fall 1988 issue of the FIU Hospitality Review revealed that the top three lodging stock performers during the period July 1982 to January 1988 were Prime Motor Inns, Inc., Marriott Corporation, and Hilton Hotels Corporation. The author has completed a follow-up study in an attempt to determine how selected lodging firms have fared since the summer rally of 1987 (which preceded the stock crash of October 19, 1987) until more recent times.

Compilation of planktonic foraminiferal census counts from the Southern Hemisphere Oceans

We present an improved database of planktonic foraminiferal census counts from the Southern Hemisphere Oceans (SHO) from 15°S to 64°S. The SHO database combines 3 existing databases. Using this SHO database, we investigated dissolution biases that might affect faunal census counts. We suggest a depth/[DCO3]2- threshold of ~3800 m/[DCO3]2- = ~-10 to -5 µmol/kg for the Pacific and Indian Oceans, and ~4000 m/[DCO3]2- = ~0 to 10 µmol/kg for the Atlantic Ocean, under which core-top assemblages can be affected by dissolution and are less reliable for paleo-sea surface temperature (SST) reconstructions. We removed all core-tops beyond these thresholds from the SHO database. This database has 598 core-tops and is able to reconstruct past SST variations from 2° to 25.5°C, with a root mean square error of 1.00°C, for annual temperatures. To inspect dissolution affects SST reconstruction quality, we tested the data base with two "leave-one-out" tests, with and without the deep core-tops. We used this database to reconstruct Summer SST (SSST) over the last 20 ka, using the Modern Analog Technique method, on the Southeast Pacific core MD07-3100. This was compared to the SSST reconstructed using the 3 databases used to compile the SHO database. Thus showing that the reconstruction using the SHO database is more reliable, as its dissimilarity values are the lowest. The most important aspect here is the importance of a bias-free, geographic-rich, database. We leave this dataset open-ended to future additions; the new core-tops must be carefully selected, with their chronological frameworks, and evidence of dissolution assessed.

A completely kinematostatically decoupled XY compliant parallel manipulator through new topology structure

This paper deals with a completely kinematostaticaly decoupled XY compliant parallel manipulator (CPM) composed of exactly-constrained compliant modules. A new 4-PP XY translational parallel mechanism (TPM) with a new topology structure is firstly proposed where each two P (P: prismatic) joints on the base in two non-adjacent legs are rigidly connected. A novel 4-PP XY CPM is then obtained by replacing each traditional P join on the base in the 4-PP XY TPM with a compound basic parallelogram module (CBPM) and replacing each traditional P joint on the motion stage with a basic parallelogram module (BPM). Approximate analytical model is derived with comparison to the FEA (finite element analysis) model and experiment for a case study. The proposed novel XY CPM has a compact configuration with good dynamics, and is able to well constrain the parasitic rotation and the cross-axis coupling of the motion stage. The cross-axis motion of the input stage can be completely eliminated, and the lost motion between the input stage and the motion stage is significantly reduced.

Continuously measured 222Rn activity concentrations (daily means) in near surface air at Neumayer Station in the period 1995 through 2011

We report on continuously measured 222Rn activity concentrations in near-surface air at Neumayer Station in the period 1995-2011. This 17-year record showed no long-term trend and has overall mean ± standard deviation of (0.019 ± 0.012) Bq/m**3. A distinct and persistent seasonality could be distinguished with maximum values of (0.028 ± 0.013) Bq/m**3 from January to March and minimum values of (0.015 ± 0.009) Bq/m**3 from May to October. Elevated 222Rn activity concentrations were typically associated with air mass transport from the Antarctic Plateau. Our results do not support a relation between enhanced 222Rn activity concentrations at Neumayer and cyclonic activity or long-range transport from South America. The impact of oceanic 222Rn emissions could not be properly assessed but we tentatively identified regional sea ice extent (SIE) variability as a significant driver of the annual 222Rn cycle.

Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

Cooperative or collaborative learning: Is there a difference in university students’ perceptions?

The hypothesis that the same educational objective, raised as cooperative or collaborative learning in university teaching does not affect students’ perceptions of the learning model, leads this study. It analyses the reflections of two students groups of engineering that shared the same educational goals implemented through two different methodological active learning strategies: Simulation as cooperative learning strategy and Problem-based Learning as a collaborative one. The different number of participants per group (eighty-five and sixty-five, respectively) as well as the use of two active learning strategies, either collaborative or cooperative, did not show differences in the results from a qualitative perspective.

Of Marx and Makers: an Historical Perspective on Generative Justice

In Marxist frameworks “distributive justice” depends on extracting value through a centralized state. Many new social movements—peer to peer economy, maker activism, community agriculture, queer ecology, etc.—take the opposite approach, keeping value in its unalienated form and allowing it to freely circulate from the bottom up. Unlike Marxism, there is no general theory for bottom-up, unalienated value circulation. This paper examines the concept of “generative justice” through an historical contrast between Marx’s writings and the indigenous cultures that he drew upon. Marx erroneously concluded that while indigenous cultures had unalienated forms of production, only centralized value extraction could allow the productivity needed for a high quality of life. To the contrary, indigenous cultures now provide a robust model for the “gift economy” that underpins open source technological production, agroecology, and restorative approaches to civil rights. Expanding Marx’s concept of unalienated labor value to include unalienated ecological (nonhuman) value, as well as the domain of freedom in speech, sexual orientation, spirituality and other forms of “expressive” value, we arrive at an historically informed perspective for generative justice. 

El surgimiento de HTML5; un nuevo paradigma en los estándares Web

Gracias al crecimiento, expansión y popularización de la World Wide Web, su desarrollo tecnológico tiene una creciente importancia en la sociedad. La simbiosis que protagonizan estos dos entornos ha propiciado una mayor influencia social en las innovaciones de la plataforma y un enfoque mucho más práctico. Nuestro objetivo en este artículo es describir, caracterizar y analizar el surgimiento y difusión del nuevo estándar de hipertexto que rige la Web; HTML5. Al mismo tiempo exploramos este proceso a la luz de varias teorías que aúnan tecnología y sociedad. Dedicamos especial atención a los usuarios de la World Wide Web y al uso genérico que realizan de los Medios Sociales o "Social Media". Sugerimos que el desarrollo de los estándares web está influenciado por el uso cotidiano de este nuevo tipo de tecnologías y aplicaciones. 

A Strategy for Maternity Care in Northern Ireland 2012-2018

DHSSPS has carried out a review of policy on maternity service provision in Northern Ireland. The review focused on the best available evidence for the care and treatment of mothers-to-be; quality, safety and service sustainability; wider workforce issues; and professional roles and responsibilities. As a result, a draft strategy was developed, which was the subject of a public consultation from 28 September 2011 to 23 January 2012. Following an analysis of the responses to the consultation, the final strategy, A Strategy for Maternity Care in Northern Ireland 2012-2018, was published on 2 July 2012. The Strategy is outcomes focused. The six outcomes are:- give every baby and family the best start in life; effective communication and high-quality maternity care; healthier women at the start of pregnancy (preconception care); effective, locally accessible, antenatal care and a positive experience for prospective parents; safe labour and birth (intrapartum) care with improved experiences for mothers and babies; and appropriate advice, and support for parents and baby after birth The strategy aims to provide women and their partners, HSC staff, commissioners and policy makers with a clear pathway for maternity care in Northern Ireland from pre conceptual care through to postnatal care. Within the document, twenty two objectives have been identified which link to the six outcomes identified above. The HSC Board and Public Health Agency will co-lead on implementation. An action plan will be developed to take account of the outcomes and objectives listed in the document. The Department will receive an annual report on progress towards implementation.

Iowa Crop Progress & Condition, July 3, 2016

Report produced by the The Department of Agriculture and Land Stewardship, Climatology Bureau. Weather report released by the USDA National Agricultural Statistical Service. The report is released weekly from April through October. Formally titled: Iowa Crop and Weather Report

Iowa Crop Progress & Condition, July 11, 2016

Report produced by the The Department of Agriculture and Land Stewardship, Climatology Bureau. Weather report released by the USDA National Agricultural Statistical Service. The report is released weekly from April through October. Formally titled: Iowa Crop and Weather Report

Iowa Crop Progress & Condition, July 17, 2016

Report produced by the The Department of Agriculture and Land Stewardship, Climatology Bureau. Weather report released by the USDA National Agricultural Statistical Service. The report is released weekly from April through October. Formally titled: Iowa Crop and Weather Report

Iowa Crop Progress & Condition, July 25, 2016

Report produced by the The Department of Agriculture and Land Stewardship, Climatology Bureau. Weather report released by the USDA National Agricultural Statistical Service. The report is released weekly from April through October. Formally titled: Iowa Crop and Weather Report