‘Not at all afraid’: Queer Temporality and the School Detective Story

Kate Haffey has recently argued that if queer time can be seen as a turning away from narrative coherence, it suggests new possibilities for considering narrative structures more generally. Combining the narratively rigid structures of the school story and the detective novel, the four novels discussed in this article – Gladys Mitchell’s Laurels are Poison (1942), Josephine Tey’s Miss Pym Disposes (1946), Shirley Jackson’s Hangsaman (1951), and Joan Lindsay’s Picnic at Hanging Rock (1967) – disrupt conventional understandings of linear time. Depicting not only queer, or potentially queer, characters, but a queer phenomenological perspective, they challenge reader expectations with a focus on aporias and gaps, whether in terms of trauma (Jackson), the blurring of fact and fiction (Lindsay), or the prolonged delay of both crime and resolution (Tey). These novels draw attention to the insufficiency of texts to capture experience, and the inadequacy of textual authority. As such, they reveal the extent to which mid-twentieth-century women’s fiction was able to challenge the genres and narrative structures with which it was most closely associated.

Compensatory Mechanism for Miscarriage of Justice in Cases of Prolonged Delay: The Case of India

There have been several studies on the issue of justice delayed, but no rigid step has been taken in lieu of the victims who suffer as a result of such dawdling processes. Despite the existence of a vast number of provisions in our current legal system, current legal remedies do tend to create an ex gratia obligation but not a statutory obligation for the state to compensate the victims of miscarriage of justice. There is a persistent need for an explicit and detailed law on this subject. The idea underlying this research is to portray the need for a rigid compensatory mechanism for prolonged delays in judicial processes and decisions. Thereby construing a need for strong legislative action towards this issue and reflect upon the grey area in Indian Legal Framework.

ARROSIVE BLEEDING FROM THE APPENDICULAR ARTERY IN ACUTE DESTRUCTIVE APPENDICITIS

Summary. Objective of the study: to present to the surgical community a rather rare complication of severe destructive appendicitis – arrosive bleeding and the cause of its development. Material and methods. Published a rare clinical case from prac-tice — the development of perforation of the appendix and arrosive bleeding from the appendicular artery in a patient with acute gangrenous appendicitis. Results and its discussion. The atypical course of acute appendicitis of undulating nature under the mask of acute adnexitis and antibacterial therapy has led to a prolonged delay with surgery in the surgical department. Only the appendicular abscess, which spontaneously opened into the abdominal cavity, made it possible to diagnose acute appendicitis and determine indications for emergency surgery, during which arrosive bleeding was diagnosed. The favorable outcome of the disease is due to the local purulent-necrotic process and small hemoperitoneum. Findings. Timely diagnosis of acute appendicitis, with the involvement of additional research methods in unclear cases, and subsequent appendectomy, are the prevention of a rather rare complication — arrosive bleeding from the appendicular artery in the development of severe complicated forms of acute destructive appendicitis.

The Beginning of More Worries: Doctoral Candidates’ Untold Stories After Submission of Dissertation

The present study focused on this particular situation in which doctoral candidates become anxious, impatient, and disappointed while experiencing a prolonged delay in processing their dissertation during and after the submission. The researchers tend to explore doctoral candidates’ storied experiences they had while confronting such procedural barriers and delays. We undertook a narrative mode of inquiry to explore the events and storied experiences through interviewing doctoral candidates from public universities in the province of Punjab, Pakistan. Nine doctoral candidates were selected through snowball sampling with the criterion of including those participants who were waiting for their external reviews at least for more than 1 year. From the narratives, the emergent themes include supervisors’ mutual relationships, the pressure of paper publication, lack of administrative support, external evaluation and follow-up and stress of delayed evaluation. The study has implications for relaxing procedural formalities during and after submission of a doctoral dissertation to facilitate students in the timely attainment of their doctoral degrees.

Errors and сomplications in the treatment of children with anorectal malformations

Purpose. This manuscript aims to introduce errors and complications of diagnosis and treatment in children with anorectal malformations (ARM). Methods. A retrospective analysis of 63 children with ARM treated at a single tertiary Speransky childrens Hospital. Results. The patients ages ranged from 2 mo to 17 y. o. (median, 6 y. o.). The types of ARM included: rectourethral fistula 27%, rectoperineal fistula 17.5%, rectovestibular fistula 15.9%, rectobladderneck fistula 6.3%, no fistula 7.9%, cloaca 11.1%, cloaca with urogenital sinus and disorder of sex development 1.6%, pouch colon 1.6%, rectal stenosis 4.8%, anal duplication 3.2%, and rectovaginal fistula 3.2%. Of these patients, 76% underwent surgery earlier at another hospital (surgical treatment completed), 14% had stomas, and 10% did not have any prior procedures. The historical analysis showed diagnostic errors in 48% of children (untimely diagnosis, incorrect interpretation of the ARM variant, prolonged delay in anorectoplasty). Errors led to emergency procedures or changes in subsequent surgical treatment (further ostomy, excess bowel resection) in 22% of cases. After anorectoplasty (stenosis, mislocated anus/rectum, rectal prolapse), complications were detected in 56% of cases, whereas ostomy complications were observed in 5% of cases. Long-term problems after the surgical treatment (constipation, incontinence, and pseudoincontinence) were evident in 98% of children. Different surgical reconstructive techniques of the sphincter formation had been performed previously in 13% of patients. Moreover, they most often had spinal pathology as the cause of functional disorders. Only half of the childrens parents had information about bowel management, 38% did not follow the recommendations and usually had fecal impaction and pseudoincontinence. 45% of children/parents performed non-effective or irregular enemas and required corrective treatment. Conclusion. It is recommended that Russian pediatric surgeons treat children with ARM, according to Russian pediatric surgeons guidelines consistent with international protocols to avoid errors and complications.

Lactogenesis II Onset Following Prolonged Delay in a Mother With a Nonfunctioning Macroadenoma Treated With Cabergoline: A Case Study in Persistence

IntroductionThis is a case of a 31-year-old woman who experienced headaches and visual changes in her 15th week of pregnancy and was diagnosed with a macroadenoma.TreatmentShe started a dopamine agonist, a prolactin inhibitor, at that time to treat these symptoms and continued it for 2 weeks after the birth, a total of 13 weeks.Goal and OutcomeThe mother’s goal was to provide her own milk for her infant. She began to express milk the day of her infant’s birth but obtained only drops for the first 2 months. Using a breast pump and, later, hand expression, this mother was able to finally express more than drops per day. She achieved a full milk supply, 750 mL per day, 21 weeks following delivery, when 2–3 weeks is the average. She continued expressing milk achieving over 900 mL per day when the infant was 24 weeks old.ConclusionIn this case where cabergoline was discontinued after the birth, persistent pumping and hand expression was enough to initiate milk production. This case study reports this mother’s experience with continued expression despite no increasing volumes in the first 2 months. This confirms that with a diagnosis and treatment of this type, milk production is possible with persistent expression.

Motor neurone disease

Motor neurone disease describes a group of rare, fatal, neurodegenerative disorders. They are devastating conditions that cause the loss of upper and/or lower motor neurones, leading to a variety of progressive neurological symptoms that can develop over months to years. Due to the rarity of these conditions and the differing and often insidious symptoms there is typically a prolonged delay between presentation and diagnosis of between 15 and 18 months on average. There is often a short prognosis of 3 years, though this can vary significantly depending on the type of syndrome diagnosed. Primary care clinicians play a key role in both facilitating early diagnosis and subsequent management and co-ordination of care in the community.

Patient delay in the diagnosis of tuberculosis in Ethiopia: a systematic review and meta-analysis

Background Delay in the diagnosis of Tuberculosis (TB) remains a major challenge against achieving effective TB prevention and control. Though a number of studies with inconsistent findings were conducted in Ethiopia; unavailability of a nationwide study determining the median time of patient delays to TB diagnosis is an important research gap. Therefore, this study aimed to determine the pooled median time of the patient delay to TB diagnosis and its determinants in Ethiopia. Methods We followed PRISMA checklist to present this study. We searched from Google Scholar, PubMed, Science Direct, Web of Science, CINAHL, and Cochrane Library databases for studies. The comprehensive search for relevant studies was done by two of the authors (MA and LY) up to the 10th of October 2019. Risk of bias was assessed using the Newcastle-Ottawa scale adapted for observational studies. Data were pooled and a random effect meta-analysis model was fitted to provide the overall median time of patient delay and its determinants in Ethiopia. Furthermore, subgroup analyses were conducted to investigate how the median time of patient delay varies across different groups of studies. Results Twenty-four studies that satisfied the eligibility criteria were included. Our meta-analysis showed that the median time of the patient delay was 24.6 (95%CI: 20.8–28.4) days. Living in rural area (OR: 2.19, 95%CI: 1.51–3.18), and poor knowledge about TB (OR: 2.85, 95%CI: 1.49–5.47) were more likely to lead to prolonged delay. Patients who consult non-formal health providers (OR: 5.08, 95%CI: 1.56–16.59) had a prolonged delay in the diagnosis of TB. Moreover, the narrative review of this study showed that age, educational level, financial burden and distance travel to reach the nearest health facility were significantly associated with a patient delay in the diagnosis of TB. Conclusions In conclusion, patients are delayed more-than three weeks in the diagnosis of TB. Lack of awareness about TB, consulting non-formal health provider, and being in the rural area had increased patient delay to TB diagnosis. Increasing public awareness about TB, particularly in rural and disadvantaged areas could help to early diagnosis of TB.

The Effects of Social Stress on Memory: If, How and When

Physical stress, such as from the cold-pressor test, has been robustly associated with altered memory retrieval, but it is not yet clear whether the same happens following psychosocial stress. Studies using psychosocial stressors report mixed effects on memory, leading to uncertainty about the common cognitive impact of both forms of stress. The current study uses a stepped replication design, with four near-identical experiments, each differing by a single critical factor. In three experiments we induced psychosocial stress after participants encoded word stimuli, then assessed retrieval after a prolonged delay. These experiments found no group level influence of postencoding stress on recognition of neutral words or cued recall of word-pairs, but a small effect on recollection of semantically-related words. There was, however, some indication of positive relationships within the stress group between measures of stress (cortisol in experiment 1 and self-reported-anxiety in experiment 3) and recollection of single word stimuli. In the fourth experiment, we found that psychosocial stress immediately before retrieval did not influence word recognition. Overall, our findings demonstrate that psychosocial stress has a typically modest impact on memory, lower than previously claimed, but that individual differences in stress responsivity, particularly for tasks that tap recollection, may help to explain variability in previous findings.