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Kinship care is the long-term caring arrangement within the family constellation for children who cannot remain with their birth parents. Despite being the most prevalent alternative care arrangement for children worldwide, there are significant gaps in the knowledge about kinship care and few children's perspectives in kinship care research. This article focuses on how children's views, understood through theories of recognition, can assist understanding their lived experiences in kinship care. The recognition of kinship care has implications on how it is supported, regulated and financed. Insights were drawn from nineteen children in England using dialogical participation and critical realism methodologies, and methods such as child-led tours, photo-elicitation and visual methods. Analysis of the children's insights unsettles simplistic dichotomous recognition of kinship care, family, participation and childhood seen in most current UK social work policy and practice. The research also demonstrates that children's views are worthy of further inclusion in social work policy, practice and research, especially for kinship care. [ABSTRACT FROM AUTHOR]

In-line inspection tools cannot inspect most of the natural gas transmission pipelines and distribution mains due to restrictions in the pipelines that will not allow a tool equipped with current inspection technologies to pass. Remote field eddy current (RFEC) inspection is an excellent candidate for inspecting a pipeline with multiple diameters, valve and bore restrictions and tight or miter bends. The results of this paper show that the RFEC technique can inspect pipeline materials, and that all of the components needed for RFEC inspection can be made much smaller that the pipe diameter. RFEC inspection is commercially available for inspecting small diameter piping without restrictions, several hundred feet at a time. The prototype design described in this paper shows this technology will work in a free-swimming tool that can inspect miles pipeline at time and bypass restrictions. [DOI: 10.1115/1.1991878]

Magnetic Flux Leakage (MFL) is currently the standard method of gas pipeline inspection in spite of the fact that the accuracy of MFL is only about 10%. Ultrasonic inspection has much better accuracy and is not sensitive to permeability changes but normally requires a liquid couplant to get sufficient energy into the pipe wall. Reported here are the laboratory results of Gas Technology Institute's (GTI) effort to investigate newly developed transducers that use gas as the coupling media. The combination of transducers specifically designed for this application and high gain amplifiers produced signals strong enough to measure wall thickness in steel at pressures from 200 to 1000 PSIG. Investigations showed that both the sensitivity of the transducers and the gas-metal coupling are functions of pressure and, therefore, limit the useful pressure range. Tests were run in pulse-echo mode and pitch-catch mode to determine the advantages and limitations of each. The average ultrasonic wall thickness will be used to calibrate the MFL improving the accuracy of its measurements. [DOI: 10.1115/1.1991875]

A 50-year- old man was referred to the emergency department by his general practitioner with a tender right-sided irreducible inguinal hernia (previously reducible), right-sided testicular pain and scrotal swelling. Clinical examination revealed a non-reducible, tender right inguinal-scrotal hernia and swollen right scrotum. Blood tests showed raised inflammatory markers. The patient went on to have a CT scan which was reported to show an indirect right inguinal-scrotal hernia possibly containing terminal ileum and small bowel mesentery. The scan also showed increased infiltrate changes within the hernia sac suggesting incarceration with possible early strangulation but no obvious evidence of bowel obstruction. The patient was taken to the operating theatre and found to have a large right inguinal-scrotal hernia containing pus and a perforated necrotic appendix. He went to have an appendicectomy and sutured repair of the hernia. Postoperatively, the patient made a good recovery and was discharged 2 days postsurgery. [ABSTRACT FROM AUTHOR]

Background: Studies assessing the safety and effectiveness of Del Nido cardioplegia for adult cardiac surgery remain limited. We investigated early outcomes after coronary artery bypass grafting (CABG) using single-dose Del Nido cardioplegia vs. conventional multi-dose blood cardioplegia. Methods and Results: The 81 consecutive patients underwent isolated CABG performed by a single surgeon. The initial 27 patients received anterograde blood cardioplegia, while the subsequent 54 patients received anterograde Del Nido cardioplegia. There were no differences in the baseline characteristics of each group nor any differences in the 30-day incidences of myocardial infarction, all-cause death, and readmission following surgery. The use of Del Nido cardioplegia was associated with shorter cardiopulmonary bypass time (98 vs. 115 min, P=0.011), shorter cross-clamp time (74 vs. 87 min, P=0.006), and decreased need for intraoperative defibrillation (13.0% vs. 33.3%, P=0.030) compared with blood cardioplegia. To control for the difference in cross-clamp time, we performed propensity score matching with a logistical treatment model and confirmed that Del Nido cardioplegia provided similar outcomes as blood cardioplegia and also reduced the need for defibrillation independent of cross-clamp time., Conclusions: Compared with conventional blood cardioplegia, Del Nido cardioplegia provided excellent myocardial protection with reduced need for intraoperative defibrillation, shorter bypass and cross-clamp times, and comparable early clinical outcomes for adult patients undergoing CABG.

Direct thrombin inhibitors are heparin alternatives for anticoagulation during cardiopulmonary bypass in patients with heparin-induced thrombocytopenia. We report a case of a large thrombus forming in the venous reservoir while using bivalirudin. We suggest that blood stasis associated with the full venous reservoir maintained in this case led to formation of a large thrombus at the top of the venous canister. Furthermore, activated clotting times may not accurately reflect the magnitude of anticoagulation when using direct thrombin inhibitors.