Journal articles on the topic 'Protective clothing – Juvenile literature'

Background: Topical sunscreens have been used for many years on exposed areas (i.e., hands, face) to protect the skin from the damaging effects of ultraviolet radiation. Most people do not use sunscreens on their bodies when they are wearing clothes. An average weight cotton T shirt gives only a sun protection factor (SPF) of 7. This is inadequate protection when out of doors. Therefore, clothing with adequate sunscreening properties should be worn. Objective: The purpose of this study is to identify the factors in clothing fabrics that contribute to or detract from blocking ultraviolet radiation and to recommend criteria for establishing a standard for sunprotective clothing. Method: The study involves a review of the dermatologic and textile literature to identify various factors in fabrics that contribute to blocking ultraviolet radiation through textiles. Conclusion: For fabrics, the term ultraviolet protection factor (UPF) is used as the measure of ultraviolet radiation penetration through the fabric. The UPF of a fabric depends upon fiber content and weave, fabric colour, finishing processes, and the presence of additives. The performance of a fabric depends upon stretching, shrinkage, hydration, laundering, and wear of the fabric over time. Based upon these criteria the minimum CDA standard UPF for clothing should be 40 to 50+.

PurposeBench scale and flame manikin tests are two typical methods to evaluate thermal protective performance (TPP) of fire protective clothing. However, flame manikin test is limited to be widely used for its complication and high cost. The purpose of this paper is to develop a method to evaluate the thermal performance of protective clothing from the bench scale test results and garment parameters, which predicts the body burn injuries without conducting flame manikin tests.Design/methodology/approachBench scale and flame manikin tests’ data were collected from the previous research literature and then statistical analysis was performed to quantitatively investigate the correlations between the two test methods. Equations were established to predict the TPP values accounting for the effects of entrapped air gap and thermal shrinkage. Fitting analysis was conducted to analyze the relationship between the predicted TPP values and total burn injury. Finally, a method to predict total burn injury from the TPP values was proposed and validated.FindingsThe results showed that when the TPP value was predicted with the effects of air gap and thermal shrinkage considered, there was an approximate linear relationship between the predicted TPP values and total burn injury from the manikin test. Therefore, the prediction model of burn injury was developed based on the correlation analysis and verified with a generally good accuracy.Originality/valueThis paper presented a new prediction method to evaluate the thermal performance of protective clothing, which saved significant time and cost compared to the conventional methods. It can provide useful information for burn injury prediction of protective clothing.

Purpose The purpose of this paper is to identify the challenging barriers faced by female firefighters, which limit workplace entrance and performance. Design/methodology/approach Occupational barriers from both psychological and physiological viewpoints were explored based on previous literature and the reported experiences of female firefighters. Findings A comprehensive review of literature synthesizes previous studies pertaining to gender anthropometric differences, female firefighters’ experiences in the work environment and protective clothing issues. The physical capabilities of men and women in specific relation to performing firefighting activities are also examined. Issues of greatest concern are identified for personal protective clothing (PPC) and equipment, which have traditionally been designed for the male human form. This leads to a lack of protection, an increased risk of onsite injury, reduction in mobility and poorer comfort for female firefighters. Originality/value This review provides an original overview of the critical workplace challenges faced by female firefighters. The need for female-specific PPC and equipment is specifically addressed to retain the growing number of women entering the male-dominated firefighting profession.

AbstractGraphene is a new, advanced material with many possible applications in basic and clinical medicine, electronics and automation. Graphene compounds can be successfully used as an integral part of drug delivery systems, in the construction of transistors, polar processors, touch screens, solar cells and in the production of materials for the manufacture of personal protective equipment, i.e. products and equipment intended to protect the health and life of users. The literature review presented in this paper concerns physical and mechanical properties of composites containing graphene or its structure as well as methods of obtaining polymer, metallic and ceramic composites doped with graphene structures. Data analysis of the potential use of graphene and its composites in personal protective equipment such as monitoring sensors, clothing and security equipment such as ballistic armor, helmets and protective clothing were also reviewed and summarized.

Firefighters are exposed to high risk scenarios in which the prevention of extreme heat injuries is largely dependent on the effectiveness of their protective clothing. The following meta-study examines contemporary literature to determine the usefulness of phase change materials (PCM’s) in improving the effectiveness of the current firefighter protective clothing (FFPC) model in order to better protect firefighters. The time- temperature for multiple PCM’s in environments with low, medium and high heat fluxes (taken as 2.5-5 kW/m2 for 700 seconds, 10-15 kW/m2 for 300 seconds and 20-40 kW/m2for 30 seconds respectively) were compared in terms of the rate of temperature increase and final temperature. The study found that PCM I produced the best temperature reduction in a low flux, PCM K did so in a medium flux, and PCM B did so in a high flux. The study also found that overall the PCMs were most effective in a low flux, therefore further study should be directed towards creating PCMs that are more effective in high-flux environments. Keywords: Phase Change Material; Fire Fighter Protective Clothing; Heat Flux

Aim: The aim of the presented paper is to review the literature concerning the risks related to possible contamination with chemical substances of firefighter’s personal protective equipment (i.e. special clothing, special gloves, firefighter boots and balaclavas) during rescue operations. The authors focused on contamination resulting from the interaction of aromatic and aliphatic hydrocarbons, volatile organic compounds and phthalates. Introduction: During rescue operations, firefighters are exposed to chemicals which are inherent in fires in buildings and open spaces. The health hazards caused by chemicals accumulating on the surface of personal protective equipment, which can enter the firefighter’s body through the skin, posing a lethal threat, is becoming an increasingly recognized issue. Scientific research shows that chemicals generated during fires are harmful – a significant proportion of them has a confirmed carcinogenic and mutagenic effect. Methodology: The presented analysis of the issue of chemical contamination of personal protective equipment and the associated risks to the firefighter was prepared on the basis of a review of selected Polish and foreign literature. The main types of chemical pollutants with chemical substances and the determined levels of pollution were addressed in the paper, indicating the conditions under which they were obtained. Additionally, the properties of the most common groups of chemicals that contaminate personal protective equipment are described. The characteristics of firefighter’s personal protective equipment, with the particular focus on the materials used for special firefighter suit, are also presented. Conclusions: A review of relevant literature indicates that contamination of firefighter’s personal protective equipment were investigated mainly with respect to the presence of aromatic and aliphatic hydrocarbons, volatile organic compounds with a proven carcinogenic effect. Phthalates as substances posing a very high risk to fertility were less commonly studied. The high content of harmful chemicals in dirt present on the surface of the material of special clothing and on other personal protective equipment, as well as in the urine metabolites, indicates unequivocally the need for decontamination of personal protective equipment after every fire.

Purpose The purpose of this paper is to develop artificial neural networks (ANNs) allowing us to simulate the local thermal insulation of clothing protecting against cold on a basis of the characteristics of materials and design solutions used. Design/methodology/approach For this purpose, laboratory tests of thermal insulation of clothing protecting against cold as well as thermal resistance of textile systems used in the clothing were performed. These tests were conducted with a use of thermal manikin and so-called skin model, respectively. On a basis of results gathered, 12 ANNs were developed that correspond to each thermal manikin’s segment besides hands and feet which are not covered by protective clothing. Findings In order to obtain high level of simulations, optimization measures for the developed ANNs were introduced. Finally, conducted validation indicated a very high correlation (above 0.95) between theoretical and experimental results, as well as a low error of the simulations (max 8 percent). Originality/value The literature reports addressing the problem of modeling thermal insulation of clothing focus mainly on the impact of the degree of fit and the velocity of air movement on thermal insulation properties, whereas reports dedicated to modeling the impact of the construction of clothing protecting against cold as well as of diverse material systems used within one design of clothing on its thermal insulation are scarce.

Soldier loads continue to rise in response to new technological capabilities and emerging threats. However, literature addressing the extent to which load mass properties affects operational task performance and mission outcome is sparse. The objective of this preliminary study was to quantify the effect of PPE mass properties (weight, bulk and stiffness) on combat mobility, as measured using the standardized Load Effects Assessment Program (LEAP) course. Twenty-four soldiers completed the LEAP course in three clothing and individual equipment (CIE) configurations (UE: unencumbered; FFO: full fighting order (FFO) without body armour; and FFO+: FFO with body armour). Significant differences between clothing conditions were revealed for LEAP performance metrics (overall course time). Regression analysis revealed significant relationships between overall mobility performance and condition mass properties of weight, bulk, and stiffness. Outcomes will influence the design of future CIE and future research in this area.

Purpose – Clothing quality, performance, safety and health have become important considerations for consumer welfare. Properties of these aspects are encompassed on standards which regulates clothing products reaching consumers. The purpose of this paper is to categorize these aspects in a common platform by suggesting minimum requirements expected on readymade garments from which clothing standards compliance assessment is performed. Design/methodology/approach – With the aid of standard compliance assessment model, scored Standard Compliance Rate (SCR) values of the discussed properties of clothing standardization are synthesized from a standard compliance matrix, and the compliance of any clothing standards are assessed and assigned a “Standard Compliance Index/Level (SCI/SCL)” ranging from non compliance to full compliance at six levels. Findings – In reference to the standard compliance assessment model, 12 children and infant clothing standards, three from Kenya and nine from China, and eight protective clothing standards from Kenya, China, Britain and USA, two from each country, were assessed and the compliance level of each standard evaluated and results presented. The results of the study reveal the importance of every aspect of clothing standardization properties to fulfil the requirements of standard compliance assessment whereby, though they meet their role in developing Standard Compliance Index (SCI), they may have different impact depending with the context applied and the scope of every standard. Research limitations/implications – The selection of standardization parameters and characteristics, and the criteria for scoring some of the Standard Compliance Rating was subjective and may require mutual agreements between relevant bodies. Furthermore, this method can only be applied on clothing standards and not other textile testing standards. Practical implications – The proposed method can be applied when evaluating and comparing specific clothing standards between bodies or countries. Clothing SCI would be of primary importance as a guide on required clothing quality specifications to designers, manufacturers, standard regulators and consumer welfare bodies. Originality/value – This research reports the development of an original framework to assess compliance level of any clothing standard using standardization parameters and characteristics considered when determining the quality of a garment. It establishes a theoretical framework of clothing standards compliance assessment, which has not been reported in the literature to date.

Among the many diseases, the harm of infectious diseases is undoubtedly the first in terms of the scope of the disease and the threat to humans. In addition, most infectious diseases were regarded as terminal illnesses in the early stage of the outbreak. For example, smallpox and plague in history have even chosen to isolate patients and abandon them to prevent the spread of infectious diseases due to the lack of protection and treatment methods. Therefore, in the treatment of infectious diseases, epidemic prevention is very important. Based on this, this article discusses the research of special medical clothing design for epidemic prevention based on mathematical model analysis, hoping to provide strong help and support for epidemic prevention. First of all, this article understands the application status of mathematical models in the medical field and clothing design industry through literature research. Then, according to the functional requirements of antiepidemic medical special clothing in terms of protection from virus invasion and infection by other contact methods, this article established an antiepidemic clothing quality evaluation index system. Then, this article designs a simulation penetration test of pathogenic bacteria to test the protective function of the antiepidemic clothing and uses mathematical models to analyze the molecular structure and physical properties of the antiepidemic clothing materials. Finally, this article builds an analytic hierarchy model for the quality evaluation of epidemic prevention clothing based on the principle of analytic hierarchy process, analyzes the simulated experimental data and predicts the service life of the epidemic prevention clothing according to the performance degradation so that medical staff can replace it in time. The experimental results show that with the aid of mathematical model analysis, the quality of the epidemic prevention clothing is higher than the previous antiepidemic clothing design in terms of epidemic prevention performance, and in addition to the disposable epidemic prevention clothing, the multiple-use epidemic prevention clothing is not serious in the epidemic. Under these circumstances, it can maintain the antiepidemic performance for more than 2 months.

ABSTRACTIn actinic cheilitis, the current view is that the keratinocytes have undergone transformation forming a field of epithelium with the potential for neoplastic transformation. Clinical features include diffuse and poorly demarcated atrophic, erosive or keratotic plaques that may affect some parts of, or the entire vermilion border. Fair-complexioned people, those with albinism and people with eversion of the lip are all subject to actinic cheilitis. Prophylactic measures against all forms of sunlight-induced lesions must include limitation of exposure to the sun during peak sunlight hours, the use of appropriate protective clothing, and the use of a sunscreen cream. In this article, a case of albinism is used to illustrate the nature of actinic cheilitis, its clinical features and its treatment. (Eur J Dent 2011;5:101-106)

Waste fires and firefighters’ exposure to toxic agentsIn Poland in recent years more and more waste have been set on fire, thus intervening firefighters are at increased risk of suffering intoxication from fumes. Based on current literature and legal regulations review, characteristics of relevant toxic substances, associated health hazards and preventive measures were analyzed. In order to prevent negative health effects it is crucial not only to equip firefighters with adequate personal protective equipment and clothing but also to introduce obligatory monitoring their proper usage based on biologic markers of intoxication.

Metabolic energy costs were determined on sixteen male firefighters ascending a stairmill in an unladen and a laden condition at a vertical velocity of 12.2 m/min. In the unladen condition they wore shorts and tennis shoes, while lagen they wore full protective clothing, including a SCBA, and carried a hose pack. Mean mass of the load was 39.2 kg. Caloric costs were compared with selected equations from the literature. All of the equations overpredicted for the unladen condition. One continued to overpredict, one underestimated, and a third was very close for the cost for the laden condition. An equation derived from data for eight of the subjects, yielded better predictions for the remaining eight, under both conditions, than any of the equations from the literature. Limitations and the need for further research are discussed.

Organophosphate (OP) compounds, a family of highly hazardous chemical compounds included in nerve agents and pesticides, have been linked to more than 250,000 annual deaths connected to various chronic diseases. However, a solid-state sensing system that is able to be integrated into a clothing system is rare in the literature. This study aims to develop a nanofiber-based solid-state polymeric material as a soft sensor to detect OP compounds present in the environment. Esters of polydiacetylene were synthesized and incorporated into a cellulose acetate nanocomposite fibrous assembly developed with an electrospinning technique, which was then hydrolyzed to generate more hydroxyl groups for OP binding. Scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FT-IR), Instron® tensile tester, contact angle analyzer, and UV–Vis spectroscopy were employed for characterizations. Upon hydrolysis, polydiacetylene esters in the cellulosic fiber matrix were found unaffected by hydrolysis treatment, which made the composites suitable for OP sensing. Furthermore, the nanofibrous (NF) composites exhibited tensile properties suitable to be used as a textile material. Finally, the NF composites exhibited colorimetric sensing of OP, which is visible to the naked eye. This research is a landmark study toward the development of OP sensing in a protective clothing system.

This article uses the concepts of risk and resiliency to frame our understanding of how having a learning disability affects nonacademic outcomes such as emotional adjustment, family functioning, adolescent problems of school dropout, substance abuse and juvenile delinquency, and adult adaptation. The presence of a learning disability is viewed as a risk factor that, in and of itself, does not predict positive or negative outcomes. Rather, other risk and protective factors, as highlighted in the literature, interact with the presence of a learning disability to facilitate or impede adjustment. These risk and protective factors may be internal characteristics of the individual or external characteristics of the family, school and community environments. Implications for the development of proactive interventions and areas for future research are discussed.

AbstractThe incidence of skin cancer is increasing by epidemic proportions. Basal cell cancer remains the most common skin neoplasm, and simple excision is generally curative. On the other hand, aggressive local growth and metastasis are common features of malignant melanoma, which accounts for 75% of all deaths associated with skin cancer. The primary cause of skin cancer is long exposure to solar ultraviolet radiation (UV-R) crossed with the amount of skin pigmentation and family genetics. It is believed that in childhood and adolescence, 80% of UV-R gets absorbed while in the remaining, 20 % gets absorbed later in the lifetime. This suggests that proper and early photoprotection may reduce the risk of subsequent occurrence of skin cancer. Reducing the exposure time to sunlight, using sunscreens and protective textiles are the three ways of UV protection. Most people think that all the clothing will protect them, but it does not provide full sun screening properties. Literature sources claim that only 1/3 of the spring and summer collections tested give off proper UV protection. This is very important during the summer months, when UV index is the highest. Fabric UV protection ability highly depends on large number of factors such as type of fiber, fabric surface, construction, porosity, density, moisture content, type and concentration of dyestuff, fluorescent whitening agents, UV-B protective agents (UV absorbers), as well as nanoparticles, if applied. For all of these reasons, in the present paper, the results of UV protecting ability according to AS/NZS 4399:1996 will be discussed to show that standard clothing materials are not always adequate to prevent effect of UV-R to the human skin; and to suggest the possibilities for its improvement for this purpose enhancing light conversion and scattering. Additionally, the discrepancy in UV protection was investigated in distilled water as well as Adriatic Sea water.

ABSTRACTLabia minora hypertrophy is a relatively uncommon surgical entity being popularised in the realm of vulvovaginal plastic surgeries. Apart from the unaesthetic appearance of the hypertrophied minora, these cases are also associated with itching, hygiene problem, pain while sitting down, sports activities, difficulty in wearing tight clothing, bleeding and discomfort while or after sexual intercourse, social embarrassment, insecurity and psychological diminution of confidence and self-esteem. In a country like India, due to sociocultural reasons, patients hesitate to consult a doctor for such deformities. Most of the patients suffer in silence for years. Although common in the west, very few surgeons in the country perform this simple and rewarding surgery. Here, we are presenting a case of premenarchal juvenile labia minora hypertrophy (JLMH) in an 8-year-old child. Labial hypertrophy in this age group is uncommon. We were unable to find hypertrophy of labia minora in the eight-year-old child on English literature search.

Purpose Recent research finds that youth who identify as transgender or gender-expansive are disproportionately incarcerated in juvenile justice systems and are treated differently from their non-trans peers (Himmelstein and Brückner, 2011; Hunt and Moodie-Mills, 2012; Irvine, 2010; Mitchum and Moodie-Mills, 2014). Juvenile justice systems have paid little attention to this group of young people in terms of their unique service needs and risk factors. Using qualitative methods, the researchers analyze in-depth interviews and focus group findings from formerly incarcerated trans youth in juvenile justice settings to better understand their experiences. This paper aims to examine the challenges for young people, and, as well as considered recommendations for juvenile justice professionals to study toward making changes in policies, practices and programs that are needed to support young people who are transgender or gender expansive. Design/methodology/approach Using qualitative, case examples and descriptive analysis, this paper describes the experiences of trans youth in juvenile justice settings and studies toward developing models of promoting trans-affirming approaches to enhance juvenile justice institutions for trans and gender-expansive youth placed in them. The paper describes the evolution of an approach used by the authors, in New York state juvenile justice settings to increase a trans-affirming perspective as a central role in the organization’s strategy and design, and the methods it is using to institutionalize this critical change. Findings culled from the focus groups and in-depth interviews with 15 former residents of juvenile justice settings and several (3) key staff members from the juvenile justice system, focusing on policies, practices and training models are useful tools for assessing progress and recommending actions to increase the affirming nature of such systems. At its conclusion, this chapter will provide clear outcomes and implications for the development of policies, practices and programs with trans and gender expansive youth in juvenile justice systems. Findings Finding are conceptualized in six thematic categories, namely, privacy, access to health and mental health care, the difference between sexual orientation and gender identity, name and pronoun use, clothing, appearance and mannerism, and housing issues. Research limitations/implications This study is limited as it focuses on formerly incarcerated youth in the New York City area. Practical implications The following implications for practice stemming from this study are as follows: juvenile justice professionals (including judges, defense attorneys, prosecutors, probation officers and detention staff) must treat – and ensure others treat – all trans and gender-expansive youth with fairness, dignity and respect, including prohibiting any attempts to ridicule or change a youth’s gender identity or expression. Having written nondiscrimination and anti-harassment policy is also essential. These policies can address issues such as prohibiting harassment of youth or staff who are trans or gender expansive, requiring the use of respectful and inclusive language and determining how gender rules (e.g. usage of “male or “female” bathrooms, gender-based room assignments) will be addressed for transgender and gender-nonconforming youth. Programs should also provide clients and staff with training and helpful written materials. Juvenile justice professionals must promote the well-being of transgender youth by allowing them to express their gender identity through choice of clothing, name, hair-style and other means of expression and by ensuring that they have access to appropriate medical care if necessary. Juvenile justice professionals must receive training and resources regarding the unique societal, familial and developmental challenges confronting trans youth and the relevance of these issues to court proceedings. Training must be designed to address the specific professional responsibilities of the audience (i.e. judges, defense attorneys, prosecutors, probation officers and detention staff). Juvenile justice professionals must develop individualized, developmentally appropriate responses to the behavior of each trans youth, tailored to address the specific circumstances of his or her or their life. Social implications Providing trans-affirming services to youth in juvenile justice settings is a matter of equity and should be the goal strived for by all systems that care for these young people. Helping trans and gender-expansive youth reenter and reintegrate into society should be a primary goal. There are many organizations and systems that stand ready to assist juvenile justice systems and facilities in supporting trans and gender expansive youth in their custody and helping them to rehabilitate, heal and reenter a society that welcomes their participation and where they can thrive and not just survive. Originality/value The paper is original in that it examines the lived experiences of trans and gender-expansive youth in juvenile justice systems. An area, which has not been fully explored in the professional literature.

Infectious diseases have accompanied mankind for centuries, and the effects of their dramatic course are felt on many levels of everyday life. The COVID-19 pandemic caused by SARS-CoV-2 virus infection carries a tremendous psychological burden for both those infected and health care workers. Particularly vulnerable to psychological strain are paramedics who have direct contact with and caring for patients infected with coronavirus. From a review of the literature, it is known that Emergency Medical Team members, as a result of the stress experienced during a pandemic, manifest symptoms such as depression, anxiety, and sleep disturbances. In order to limit the adverse impact of the pandemic on the mental condition of this professional group, it is necessary to create appropriate conditions for solitary rest, relaxation and satisfaction of basic needs such as: food, sleep and protective clothing. An important role is also played by unrestricted access to psychological support in the broad sense of the word and often also to psychiatric care.

The development of lightweight flexible materials for electromagnetic interference shielding has received increased attention in recent years, particularly for clothing or technical applications and especially in areas of aircraft, aerospace, automobiles and flexible electronics, such as portable electronics and wearable devices. There are many references in the literature concerning the development and investigation of electromagnetic shielding lightweight flexible materials, especially those that are textile based with different electrically conductive additives. However, little attention has been paid to the problems related to the performance of developed electromagnetic shielding materials for clothing in use, above all wet processing (washing and drying). The main aim of this paper is a description of the influence of washing/drying cycles on the fundamental properties of metal fiber-containing fabrics. Changes in electromagnetic shielding ability and electric conductivity after washing/drying cycles were studied and also other characteristics, such as pilling, changes in mass per unit area and thickness of conductive fabrics, were evaluated. For the purpose of this study, fabrics with different structures (knitted, woven) containing extremely thin stainless steel staple fibers incorporated to the yarn structure as the conductive filler were chosen. For quantification of the influence of the washing/drying cycles on the above-mentioned characteristics, regression methods and simple t-tests were used. Both knitted and woven fabrics withstood satisfactory repeated application of wet processing with respect to the main requirement – electromagnetic shielding ability; in addition, woven fabrics exceeded in higher electrical conductivity, higher shielding effectiveness and lower inclination to pilling and therefore can be used for the production of protective cloth.

The current topic of the reliability of bridge structures in modern conditions and the role of the structural layers of the roadway (road surface) in increasing and maintaining their operational reliability and durability are considered. The existing standard designs of road surface clothing and the materials used for their arrangement are considered. The analysis and systematization of information from Russian and foreign sources on the construction of the clothing of the driving road indicates the prospects and technical and operational advantages of using cast asphalt concrete mixtures in the upper layers of the bridge pavement. It is noted that an effective road surface made of this material is capable of resisting existing loads, taking into account the specifics of the operation of the asphalt concrete surface during the established service life, additionally performing the protective waterproofing function of the metal structures of the bridge structure. The analysis of the literature demonstrates that active scientific research on the development and creation of effective cast asphalt concrete mixtures is primarily associated with the production and modification of its bituminous part, as a medium capable of initiating "self-healing" of the composite, independently eliminating structural defects. The rich experience of various methods of modifying bituminous binders, accumulated over the past few decades, allows to predict the prospects for using cast asphalt concrete in the construction of the roadway of bridge structures, based on improved binders, in order to create new high-quality materials that can improve the quality of the bridge network in the country.

Abstract 2017-231 Health and safety (H&S) of on-site personnel is important to government and industry alike and applied throughout all response activities. Unconventional crude oil is transported throughout Canada by rail, road, marine and pipeline in increasing volumes. Environment and Climate Change Canada’s (ECCC) Emergencies Science and Technology (ESTS) has undertaken a three-year study that reviews H&S concerns and develop tools to address identified gaps for government personnel who are required to conduct their work in close proximity to unconventional diluted bitumen (dilbit) spills. The literature search study of H&S issues assessed the chemical composition of two dilbit crude oils Access Western Blend and Cold Lake Bitumen, their fate and behavior during a spill and potential exposure pathways for on-site responders. Overall, it was noted that the characteristics relevant to H&S of unconventional crude oils can differ from those typical of conventional crude oils primarily as a result of the small molecular weight, volatile compounds in the condensate portion of dilbit. Evaporation of the dilbit could result in the rapid transfer of 12 to 16% by weight of the mass to air within the initial 6 hours of a spill. Consequently, there is a potential inhalation and contact threat to initial responders under certain significant spill scenarios. Recommendations for air monitoring instrumentation, chemical protective clothing, medical monitoring and decontamination protocols were put forth. The literature search study was followed by work to (1) undertake a task hazard analysis for ECCC personnel then develop safe work procedures; and (2) to update training guidance documents for on-site safety planning, including protective equipment and other tools for use by ECCC staff.

Observations of great white sharks (Carcharodon carcharias) scavenging from cetacean carcasses are rare and have only been reported in the scientific literature for large (>3.5 m total length (TL)) individuals. Between 13 October and 25 November 2006, young of the year and juvenile great white sharks were observed scavenging from the carcass of a humpback whale (Megaptera novaeangliae) in Algoa Bay, South Africa. Although more than one shark scavenged from the carcass, simultaneous feeding was not observed. The sharks showed a clear preference for soft tissue at sites along the mouth of the carcass. Protective ocular rotation was rarely observed and none of the sharks exhibited palatoquadrate protrusion while feeding. These observations provide a new insight into the foraging behaviour of young of the year and juvenile great white sharks. The prevalence of small great white sharks (1.5 m TL) and the absence of any individuals greater than 3.65 m TL suggest that Algoa Bay may function as a nursery area for great white sharks in South Africa. This information is crucial not only to improve our understanding of great white shark biology, but also for their long-term management and conservation in South Africa.

The many new airborne viral pathogens such as coronavirus (Covid-19), the novel variant (SARS-CoV-2), acute respiratory distress syndrome (ARDS), severe acute respiratory syndrome (SARS), and Middle East respiratory distress syndrome (MERS), have brought about a whole new avalanche of problems. These airborne pathogens are all highly contagious and transmissible, especially in the dental setting where the procedures and machinery used may generate enormous amounts of aerosol spray. This is an ideal vector for air/ droplet spread. Most dentists have implemented screening procedures to determine if their patients are well enough to be treated, and have begun wearing a full gamut of personal protective clothing (PPE). Nonetheless, a concern that has received limited attention in the literature is the “contagious clinician” who continues to work and who may pose a risk of infecting their patients. This paper explores both the patient’s rights to quality care in a safe and healthy environment, as well as the clinician’s rights to determine for themselves if they are mentally and physically competent to practice. It also poses questions about whether health care practitioners can be mandated to be inoculated against potentially life-threatening and highly infectious agents.

Introduction There is a growing literature demonstrating the benefits of engaging knowledge-users throughout the research process. We engaged a multi-stakeholder team to undertake a hackathon as part of an integrated knowledge translation (iKT) process to develop nonpharmacological interventions to enhance the economic lives of people with systemic lupus erythematosus (SLE). The aims of this research were to (1) increase understanding of the economic challenges of living with SLE through stakeholder engagement at a research hackathon; (2) investigate possible interventions to improve the economic lives of individuals affected by SLE in Canada; and (3) document the outcomes of the Waterlupus hackathon. Methods Waterlupus was held at the University of Waterloo in May 2019, attended by lupus advocacy organization representatives, researchers, physicians, individuals with lived experience and students. We conducted participant observation with participants’ understanding and consent; notes from the hackathon were qualitatively analyzed to document hackathon outcomes. Results At the conclusion of the 28­hour hackathon event, five teams pitched nonpharmacological interventions to address the economic challenges of living with SLE. The winning team’s pitch focussed on increasing accessibility of affordable sun-protective clothing. Other Waterlupus outcomes include increased awareness of SLE among participants, and professional and informal networking opportunities. Conclusion This paper contributes to a limited literature on health hackathons. The successful outcomes of Waterlupus emphasize the value of hackathons as an iKT tool. Research about how knowledge-users perceive hackathons is an important next step.

Australian young people from rural areas, particularly Aboriginal young people, are overrepresented in the juvenile justice system. Apart from broad evidence regarding the entrenched social disadvantages experienced by young people in rural communities, the literature is limited in describing why this might be case. Due to these social disadvantages, it is hypothesised that young offenders from rural communities will have higher levels of offending risk factors, as measured by the Youth Level of Service/Case Management Inventory—Australian Adaption (YLS/CMI-AA). A total of 6,750 archival records were analysed, showing that significantly more Aboriginal young offenders live in rural areas. Contrary to the hypothesis, urban young offenders had significantly higher risk scores than rural young offenders. These findings suggest that there may be particular ecological factors that are not assessed in the current risk assessment instrument or that rural young people have a range of protective factors that may insulate against the broader context of social disadvantage.

The literature has shown that delinquent adolescents report high rates of childhood adversity and family dysfunction. However, it is important to know both the degree of adversity among delinquent adolescents in comparison with other high-risk samples and the contribution of each single form of adversity to this comparison. The purpose of this study was to evaluate childhood adversity, psychopathology, and risk behaviors among 4 high-risk groups, including incarcerated delinquent youths. The participants were 120 male youths between 13 and 19 years old (M = 16.18, SD = 1.26), including 30 youths who were arrested and held in detention centers as a consequence of violent crimes; 30 youths who were identified by Child Protective Services (CPS) and remained with their families; 30 youths who were identified by CPS, removed from their homes, and placed in child and youth residential care; and 30 youths who were randomly selected from schools. The incarcerated youths reported significantly more adversity, global psychopathology, and global index of risk behaviors. When considering each risk behavior, the incarcerated youths reported higher percentages of alcohol abuse, drug use, early smoking initiation, physical assault, carrying weapons, early initiation of sexual intercourse, sexual intercourse under the influence of drugs, and sexual intercourse without condom use. The logistic regression analyses showed that only emotional neglect was significantly associated with delinquency. This study suggests that delinquent youths are exposed to a great magnitude of adversities in childhood, with emotional neglect as an independent risk factor for delinquency. In addition, these youths have higher rates of psychopathology and risk behaviors compared to other high-risk samples.

Clinical scenario: A mother brought her infant to the hospital with bronchiolitis and incidentally asked if I would recommend the use of infant sleeping bags to protect against Sudden Infant Death Syndrome as several of her friends use them. Structured question: Can infant sleeping bags be recommended by medical professionals as protective against Sudden Infant Death Syndrome? Methods: A literature search was performed. Trials were included if they had an English version available and the papers examined the impact that sleeping bag use had on risk of SIDS or its risk factors. Cochrane Library search found eight trials, two of which were found to meet inclusion criteria. MEDLINE was searched using the search terms ((baby sleeping bag) OR infant sleeping bag) OR cotton sleeping sack. Forty-seven papers were found, two of which were found to meet the inclusion criteria, one of which had already been found in the Cochrane Library search. One further paper was found through searching citations of the papers included. Discussion: Sleeping bags are used in 48-95% of infants in the UK and advocated for by the Lullaby Trust for their safety in the prevention of SIDS. The case control studies included found that sleeping bags are as safe, if not safer than other bedding when examining SIDS as an outcome. For sleeping bags to be safe they must be well made and appropriately used, which includes the correct size, Tog, clothing and other bedding for bedroom temperature.

Green Tobacco Sickness (GTS) has been one of the unexplored areas of occupational health safety. The condition mainly affects the tobacco harvesters. The condition is prevalent in Asian and South American tobacco harvesters. Although transient, the condition can affect multiple organ systems. The objective of this review is to extensively discuss the background, epidemiology, clinical features and measures to counter the problem.A literature search of Medline with terms such as “green”, “tobacco” and “sickness” was done covering years 1970-2007. All studies, reviews and commentaries on health effects of farming green tobacco and preventing the disease were included.Green Tobacco Sickness is caused by the absorption of nicotine through the skin from wet tobacco plants who have direct contact with tobacco plants during cultivation and harvesting. The early symptoms often include headache and nausea followed by vomiting, weakness, pallor, dizziness, headaches, increased perspiration, chills, abdominal pain, diarrhoea, and increased salivation which may also progress to extreme conditions like prostration, shortness of breath, and occasional fluctuations in blood pressure or heart rate. The duration of the illness is usually between one and three days. The use of protective, water-resistant clothing, chemical-resistant gloves, plastic aprons and rainsuits with boots and socks has reduced the chances of contracting GTS.It is important to educate the tobacco workers and the employers about GTS in order to reduce its incidence. An international level awareness campaign has to be taken up and more stringent workers safety regulations have to be formulated.DOI: http://dx.doi.org/10.3126/ijosh.v2i1.4963 International Journal of Occupational Safety and Health, Vol. 2 No. 1 (2012) 11-14

In the last few decades, the thinning of the ozone layer due to increased atmospheric pollution has exacerbated the negative effects of excessive exposure to solar ultraviolet radiation (UVR), and skin cancer has become a major public health concern. In order to prevent skin damage, public health advice mainly focuses on the use of sunscreens, along with wearing protective clothing and avoiding sun exposure during peak hours. Sunscreens present on the market are topical formulations that contain a number of different synthetic, organic, and inorganic UVR filters with different absorbance profiles, which, when combined, provide broad UVR spectrum protection. However, increased evidence suggests that some of these compounds cause subtle damage to marine ecosystems. One alternative may be the use of natural products that are produced in a wide range of marine species and are mainly thought to act as a defense against UVR-mediated damage. However, their potential for human photoprotection is largely under-investigated. In this review, attention has been placed on the molecular strategies adopted by marine organisms to counteract UVR-induced negative effects and we provide a broad portrayal of the recent literature concerning marine-derived natural products having potential as natural sunscreens/photoprotectants for human skin. Their chemical structure, UVR absorption properties, and their pleiotropic role as bioactive molecules are discussed. Most studies strongly suggest that these natural products could be promising for use in biocompatible sunscreens and may represent an alternative eco-friendly approach to protect humans against UV-induced skin damage.

Clinical Scenario: Many American football players have died from exertional heatstroke, one of the leading causes of sudden death in athletes. These athletes are predisposed to exertional heatstroke, in part, because of their protective equipment. Few authors have systematically appraised the research to determine how much faster rectal temperature (Trec) increases when full American football uniforms generally consisting of a helmet, shoulder pads, jersey, pants with padding, socks, shoes, and underwear/compressions (PADS) are worn compared with no uniform so that clinicians can better plan and modify exercise sessions to prevent dangerous Trec (i.e., ≥40.5 °C). Clinical Question: How much faster does Trec increase when men wear a full American football uniform compared with workout clothing during exercise in the heat? Summary of Key Findings: The authors searched the literature for randomized controlled studies with PEDro scores >6 that compared Trec of males wearing PADS to a control uniform during exercise under controlled laboratory conditions. In all four studies, Trec increased faster when PADS were worn during exercise (PADS = 0.052 ± 0.007 °C/min and control = 0.039 ± 0.009 °C/min). The average effect size across studies was 1.4 ± 0.5. Clinical Bottom Line: PADS increase Trec significantly faster than lesser uniform ensembles. Clinicians should factor in equipment and alterations in exercise duration and rest break frequency to help prevent dangerous Trec in American football players. Strength of Recommendation: Given the large effect size and controlled experimental study designs, there is strong evidence that wearing PADS during exercise results in faster increases in body core temperature.

The commercial sexual exploitation of children (CSEC) and domestic minor sex trafficking (DMST) occur across the United States, violating the rights and health of far too many children and youth. Adequate prevention efforts should seek to understand the factors that make minors vulnerable to sexual exploitation in order to properly design programs to prevent victimization. This review presents the identified risk factors collected via a systematic literature review. Following full-text review, 15 studies were selected for inclusion by meeting the following criteria: original quantitative or qualitative research studies published in English from January 2010 to September 2017 with titles or abstracts that indicated a focus on the risk factors, vulnerabilities, or statistics of CSEC/DMST and a domestic focus on CSEC/DMST (for U.S.-based journals) with findings that did not combine associations between minors and adults in the study. Relevant risk factors and vulnerabilities found in this review include child abuse and maltreatment, caregiver strain, running away or being thrown away, substance use, peer influence, witnessing family violence or criminality, poverty or material need, difficulty in school, conflict with parents, poor mental health or view of self, involvement in child protective services, involvement in juvenile detention or delinquency, early substance use, and prior rape or adolescent sexual victimization.

Smallholder farmer and tribal communities are often characterised as marginalised and highly vulnerable to emerging zoonotic diseases due to their relatively poor access to healthcare, worse-off health outcomes, proximity to sources of disease risks, and their social and livelihood organisation. Yet, access to relevant and timely disease information that could strengthen their adaptive capacity remain challenging and poorly characterised in the empirical literature. This paper addresses this gap by exploring the role of disease information in shaping the adaptive capacity of smallholder farmer and tribal groups to Kyasanur Forest Disease (KFD), a tick-borne viral haemorrhagic fever. We carried out household surveys (n = 229) and in-depth interviews (n = 25) in two affected districts–Shimoga and Wayanad–in the Western Ghats region. Our findings suggest that, despite the generally limited awareness about KFD, access to disease information improved households’ propensity to implement adaptation strategies relative to households that had no access to it. Of the variety of adaptation strategies implemented, vaccination, avoiding forest visits, wearing of protective clothing and footwear, application of dimethyl phthalate (DMP) oil and income diversification were identified by respondents as important adaptive measures during the outbreak seasons. Even so, we identified significant differences between individuals in exposure to disease information and its contribution to substantive adaptive action. Households reported several barriers to implement adaptation strategies including, lack of disease information, low efficacy of existing vaccine, distrust, religio-cultural sentiments, and livelihood concerns. We also found that informal information sharing presented a promising avenue from a health extension perspective albeit with trade-offs with potential distortion of the messages through misinformation and/or reporting bias. Altogether, our findings stress the importance of contextualising disease information and implementing interventions in a participatory way that sufficiently addresses the social determinants of health in order to bolster households’ adaptive capacity to KFD and other neglected endemic zoonoses.

Abstract.The family, as a central role in the socialization of children and adolescents, has been considered a decisive factor in the development of juvenile delinquency. Since the end nineteenth century, the family and delinquent behavior has aroused the interest of specialists in humanities (education, psychology, psychiatry, social work, sociology, criminology). These professionals propose that the way to interact appropriately with significant adults and peer group is important for the development of child and adolescent. This article is a literature review, whose main purpose is to synthesize some of the studies, to understanding and explaining the factors that contribute to occurrence antisocial behavior in children and adolescent.Keywords: antisocial behavior; risk factors; protective factorsResumo.A família, como papel central na socialização das crianças e adolescentes, tem sido considerada um factor decisivo no desenvolvimento da delinquência juvenil. Desde o final do século XIX, a temática família e conduta delinquente tem despertado o interesse dos especialistas em ciências humanas (educação, psicologia, psiquiatria, serviço social, sociologia, criminologia). Estes profissionais indicam que a forma de interagir adequadamente com os adultos significativos e grupo de pares é relevante para o desenvolvimento da criança e do adolescente. Este artigo assenta na revisão da literatura, cujo objectivo consiste sintetizar alguns dos estudos realizados, para a compreensão e explicação dos factores que contribuem para a ocorrência de comportamento antissocial da criança e do adolescente.Palavras-chave: comportamento antissocial; factores de risco; factores de protecção

As the trend to look beautiful is growing, so does the number of patients seeking reconstructive and aesthetic facial surgery, which leads to the rapid development of this field. To date, there exists a large number of techniques to eliminate a scar deformity, but none of them guarantees the optimal cosmetic effect. The purpose of the study. The study aims to search for and analyze scientific sources related to the prevention of pathological scars in Ukraine and the world. Materials and methods of research. To study the research materials, the bibliosemantic and analytical methods have been applied to process literature data, as well as research materials posted on the Internet. Skin is the largest human organ whose total surface area ranges from 1.7 to 2.6 m2 and can vary depending on height and weight. It acts as the main protective barrier from the environment. Violation of this barrier after injury, burns, or surgical resection can lead to chronic wounds and scars that affect patients physically and emotionally. Therefore, a better understanding of the cellular and molecular mechanisms underlying wound healing can potentially improve the lives of such people, as well as stimulate the development of new prevention and treatment methods. All wounds, except for surgical ones, are initially considered to be infected. Microorganisms get into the wound along with the damaging object, soil, pieces of clothing, air, and during hand touching. Once in the wound, microorganisms can cause suppuration and complications such as erysipelas. The most dangerous way for the microorganisms to enter the wound is in the absence of air which can cause anaerobic infection (gas gangrene). Another dangerous wound complication is a tetanus infection. For its prevention, all contaminated wounds (especially, by soil) should be treated with anti-tetanus toxoid or anti-tetanus serum. Thus, wound healing is one of the most difficult processes in the human body. It includes spatial and temporal synchronization of different cell types with different roles in the phases of hemostasis, inflammation, growth, reepithelialization, and remodeling. With the development of technology, it became possible to detect the phenotypic and functional heterogeneity of cell types. Discovering the role of each of these cell types and their interaction with each other is important for understanding the mechanisms of wound regeneration. The scar (Cicatrix) is a secondary morphological element of the skin, which is formed when it is damaged, and especially when the reticular dermis is damaged. Laser therapy is used to prevent scarring, but the evidence for the effectiveness of laser treatment of surgical and hypertrophic scars, as well as keloids is somewhat insufficient, but generally suggests promising results. Multiple studies report a significant scar thickness improvement when applying the right program. Conclusion. Based on the bibliosemantic and analytical methods applied to process literature data, we believe that the study of intra- and postoperative prevention of pathological scars at different stages of their formation remains a topical issue and needs further study.

Purpose: The article focuses on the production of polymer nanofibres from poly(lactic acid) using the electro-spinning method, i.e. the technique of forming fibres in an electrostatic field. The main aim of the publication was to analyse the influence of the distance between electrodes on the morphology of one-dimensional polymeric materials obtained. Design/methodology/approach: In the practical part of the study solutions of polylactide in acetone and a mixture of chloroform/dimethylformamide (DMF) were produced. After 72 hours of mixing, no homogeneous solutions were obtained, therefore a solution consisting of a polylactide dissolved in chloroform was prepared, to which dimethylformamide was added in order to dilute the mixture. The morphology of the nanostructures obtained was analysed by means of a scanning electron microscope (SEM) equipped with an X-ray energy dispersion spectrometer (EDS), which allowed to analyse the chemical composition of the nanofibres produced. The electro-spinning method used to obtain fibres is characterized by high versatility - it gives the possibility to produce fibres from a wide range of polymers. Electro-spinning is also an economic method, and spinned fibres have a wide application potential. Findings: Nanofibres obtained by electro-spinning from the previously produced solution, regardless of the distance between the nozzle and the collector (10 or 20 cm) did not show any significant discrepancies in the values of measured diameters. Fibres obtained at increased distance between electrodes (20 cm) are characterized by a smaller average diameter value, but the difference is small, fluctuating between 48-49 nm. In the case of the sample formed during electro-spinning at the distance of the nozzle - collector equal to 10 cm and the sample produced at the distance doubled, no defects in the structure of the obtained nanofibres were observed. The analysis of topographic images of surfaces produced in the course of nanostructures' work did not show any significant influence of the distance between the nozzle and collector on the diameter of fibres. No defects in the structure of one-dimensional polymer materials obtained allowed to state that the distance between the nozzle and the collector in the range of 10-20 cm is the optimal parameter of the electro-spinning process allowing to obtain smooth, untangled fibres. Practical implications: The fibrous polymer mats obtained during the electro-spinning process of polylactide can be used as protective clothing materials, as drug delivery systems, as tissue scaffolding and as filtration membranes. Originality/value: At present, there are few articles in the literature on the electrospinning process, due to the fact that it is a constantly developing matte for the production of nanofibres. Moreover, most of the research focuses on fibres obtained from nonbiodegradable polymers, which do not have the advantages of fibres obtained from polylactide.

Background. Personal protective equipment (PPE) is an item of clothing designed to protect healthcare workers (HCW) or others from infection. PPE includes gloves, masks, gowns, respirators, goggles, face shields, headgear, boot covers, rubber shoes, and more. Objective. To describe the evolution of medical devices for HCW protection. Materials and methods. Review of literature data on this issue. Results and discussion. Medical gloves are divided into sterile and non-sterile. The purpose of wearing non-sterile gloves is to prevent contamination of the hands of HCW with microorganisms. They should be worn when there is a risk of contact with blood or other body fluids, patient secretions, or contaminated equipment. Gloves do not protect against contamination and after their use it is still necessary to treat hands with antiseptic. Latex gloves have good elasticity and flexibility, are convenient and anatomically suitable for hands, have a good sensitivity to touch. However, they can cause allergies or skin irritation. Latex allergy is the most common cause of perioperative anaphylaxis in children. It is recommended to use powder-free gloves. Nitrile gloves for examination manufactured by “Yuria-Pharm” are characterized by high toughness, elongated cuff, and special texture facilitating holding the instruments. Surgical masks consist of three layers of thermoplastic polymer located between the layers of nonwoven fabric. They are designed to protect against pathogens (mainly bacteria) transmitted in large droplets (>5 μm). The Cochrane review did not show any convincing effect of wearing of surgical masks on reducing the risk of infectious complications during sterile surgical procedures. WHO recommends wearing surgical masks to prevent the transmission of coronavirus disease (COVID-19). N95 or FFP3 class respirators are recommended for aerosol-generating procedures (tracheal intubation, bronchoscopy) and for dangerous infections. N95 respirators are the standard for working with patients with COVID-19 in USA. They can be with a valve or without it. These respirators consist of thermoplastic polymer and nonwoven fabric and filter 95 % of particles sized ≥0.3 μm. They should tightly fit to the face and be tested for leaks before the contact with patient. A similar tactic should be used when wearing FFP3 respirator. Valve respirators are easier to use because the presence of a valve facilitates exhalation. The valve also increases comfort and prevents excessive accumulation of moisture under the respirator. Such respirators do not filter the exhaled air, so they do not protect others from infection. Another field of PPE application is its usage in hematocontact infections caused by hepatitis B/C virus and human immunodeficiency virus. The risk of HCW infection is associated with pricks, cuts, contact with the patient’s body fluids, and any invasive diagnostic or treatment procedures. The risk of patient’s infection is present in case of the improper instruments sterilization, use of non-sterile infusion solutions, transfusion of blood and its components, transplantation, and contact with biological fluids of the infected HCW. To reduce the risk of HCW infection, always wear gloves if there is a risk of contact with blood or other body fluids; never put the cap on the needle after using it; always keep a container for sharp objects on hand; carry out the necessary vaccinations; use PPE and safety needles, scalpels and syringes. Conclusions. 1. Wearing masks reduces the risk of COVID-19 transmission. 2. During aerosol-generating procedures it is necessary to use all available PPE. 3. When wearing a respirator, it is advisable to check its tightness. 4. The number of extra injections should be minimized.

Background:Since the beginning of the COVID-19 pandemic in our country, Turkey, more than two million people have been infected and more than 20,000 people have died. Although children infected less frequently and generally have a milder findings of COVID-19, the number of patients with a more severe clinical course as multisystem inflammatory syndrome in children (MIS-C) is increasing significantly. However, it has not been shown exactly how biological disease-modifying antirheumatic drug (bDMARD)s, which we frequently use in our pediatric rheumatology practice, and/or the underlying rheumatological diseases affect the clinical course of COVID-19.Objectives:Here, we aimed to reveal the outcome of COVID-19 infection in our patients with pediatric rheumatic disease and treated with bDMARDs.Methods:During the period between April 1, 2020 and December 1, 2020, the patients who received bDMARDs were evaluated at the regular outpatient clinic follow-up or by telemedicine with a maximum of 3 months interval. Clinical and demographic characteristics, COVID-19 data and outcome of these patients were retrospectively collected.Results:Out of the 436 patients treated with bDMARDs, 39 children were infected with COVID-19. The diagnosis was confirmed in 37 patients by RT-PCR (nasalpharyngeal swab) and in two by antibody test. Twenty-two (56.4%) patients were female (17 male, %43.6) and the median age of patients were 12.3 years (min-max: 1.2-20.9). The primary diagnosis of patients were as follows; 20 juvenile idiopathic arthritis (six were systemic subtype), 12 systemic autoinflammatory diseases, three vasculitis, three chronic recurrent multifocal osteomyelitis and one Sjögren’s syndrome. Prior to COVID-19 infection, 13 patients (33.3%) were using canakinumab, seven were infliximab (18%), five were adalimumab (12.8%), four were etanercept 10.2%), four were tocilizumab (10.2%), three were anakinra (7.7%), two were rituximab (5.1%), and one was tofacitinib (2.6%).Of the 39 patients, 21 had at least one COVID-19-related symptom, while 18 patients were asymptomatic. No laboratory or imaging tests was performed for asymptomatic patients and they were followed up without treatment at home isolation. Laboratory tests revealed that fourteen patients had elevated acute phase reactants, six had elevated D-dimer levels, three had lymphopenia (<1000/mm3), and three had hyperferritinemia.Hospitalization was required in 20 patients (51.3%) at median of 7-days (min-max: 3-17) and pediatric intensive care unit admission in one. Five patients developed MIS-C and one of these patients was followed up in the pediatric intensive care unit. Myocardial dysfunction was developed in this patient and he was died. The other four patients fully recovered with no remain morbidity.Conclusion:Considering the literature data and the results of our study, it is not possible to say that currently used bDMARDs worse the course of COVID-19 infection. In patients with underlying risk factors for hyperinflammation, as in one of our patients, COVID-19 may cause mortality regardless of the use of bDMARDs. Whether bDMARDs does not affect the severity of the disease, but it is still not true to say that these drugs are protective. Since cessation of bDMARDs for COVID-risk may cause exacerbation of the primary rheumatic disease, continuing with current treatments seems an appropriate approach.References:[1]FELDSTEIN LR, ROSE EB, HORWITZ SM, et al: Overcoming COVID-19 Investigators; CDC COVID-19 Response Team. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med 2020; 383: 334-46.[2]MICHELENA X, BORRELL H, LÓPEZ-CORBETO M, et al. Incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases treated with targeted biologic and synthetic disease-modifying anti-rheumatic drugs. Semin Arthritis Rheum 2020; 50: 564-70.Disclosure of Interests:None declared.

AbstractProtective and sport clothing is governed by protection requirements, performance, and comfort of the user. The comfort and impact performance of protective and sport clothing are typically subjectively measured, and this is a multifactorial and dynamic process. The aim of this review paper is to review the contemporary methodologies and approaches for measuring ergonomic wear comfort, including objective and subjective techniques. Special emphasis is given to the discussion of different methods, such as objective techniques, subjective techniques, and a combination of techniques, as well as a new biomechanical approach called modeling of skin. Literature indicates that there are four main techniques to measure wear comfort: subjective evaluation, objective measurements, a combination of subjective and objective techniques, and computer modeling of human–textile interaction. In objective measurement methods, the repeatability of results is excellent, and quantified results are obtained, but in some cases, such quantified results are quite different from the real perception of human comfort. Studies indicate that subjective analysis of comfort is less reliable than objective analysis because human subjects vary among themselves. Therefore, it can be concluded that a combination of objective and subjective measuring techniques could be the valid approach to model the comfort of textile materials.

Purpose: This manuscript aimed to present a review of the literature pertaining to horse riding and other horse-related injuries. Method: A review of the literature was performed, searching for appropriate terms with regards to horse accidents, horse riding injuries and protective clothing for the horse riding context. The literature review search returned 151 relevant full-text articles, with 71 of these detailing the overall injury epidemiology of horse-related accidents. Most of these studies were conducted in the USA and used a retrospective review of hospital data methodology. Results: Of the 71 articles investigated, 60 suggested that those most frequently involved in horse-related accidents are young females and 97% of papers investigating injury mechanisms found the most commonly involved was a fall from horseback. It was suggested in multiple studies that these injury events mostly occurred in warm weather conditions, when the horse behaved in an unexpected manner. Injury type and location varied by the primary mechanism of injury; but frequently involved body regions were the head and upper extremities, and the most common injuries observed were fractures and soft tissue injuries. Neurological trauma was reported by all relevant studies to be the most frequent cause of fatality. Conclusion: Some improvements in horse-related accident numbers and outcomes have been observed with the development and introduction of protective devices such as helmets and vests. Yet despite the benefits of helmet and vest usage, there is evidence to suggest helmets do not perform as well as they could. Further work could investigate improvements in safety measures and risk factors associated with fatalities.

Introduction The use of personal watercrafts (PWCs) has increased in popularity, size and engine power over time. Hydrostatic injuries when the passenger falls into water and the pelvic floor is directly hurt by the water jet remain rarely reported in literature but potentially lethal. Perineal, gynaecological and rectosigmoid regions present significant points of anatomical weakness to the force vector of the water. Biomechanical aspects on water-associated injuries on PWC may include disruption of the perineal soft tissues, inefficient anal sphincter and hydrodynamic insufflation. Methods This is a study involving a literature review from 1972 to 2020 using suitable search terms to identify all hydrostatic PWC injuries following PRISMA guidelines. Data were extracted from suitable articles on mechanism of injury, injuries sustained, treatment and outcomes. Results Thirty-two patients with major perineal, gynaecological and/or digestive injuries due to hydrostatic PWC traumas were identified. Major risk factors were female gender (84.4%), young age (25.5 years), being a rear passenger and wearing a standard swimsuit (100%). The injuries were digestive tract only (81.3%), gynaecological only (46.9%) or combined (28.1%). The interdisciplinary surgical management must include a vaginal and anal exploration under general anaesthesia and an exploratory surgery. Vaginal repair (41.9%) may be associated with a transanal anorectal suturing for lacerations of the intraperitoneal rectum (40.6%). A defunctioning stoma was performed in 62.5% and consisted of a loop sigmoidostomy (43.5%) or Hartmann’s procedure (34.8%) depending on laceration complexity. Conclusions PWC-related hydrostatic injuries are still rare but associated with a mortality rate of 6.3% which rises to 25% if initial haemodynamic instability was present. Expert guidelines such as adding an automated engine shut-off switch for the rear passenger and wearing a protective and safety clothing should be more widely respected.

Juvenile-Onset Recurrent Respiratory Papillomatosis (JORRP) is a viral infection caused by Human papilloma virus 6, 11 which presents as hoarseness, shortness of breath and in severe form may present with acute airway obstruction because of papillomatous growth obstructing the larynx. Urgent surgical intervention may be needed to secure the airway. In the present situation of Coronavirus disease-2019 (COVID-19) pandemic, the case of JORRP with COVID-19 positive state is a challenging situation because any laryngeal or airway surgery is associated with high amount of aerosol generation. Air borne transmission is one of the major routes of transmission for SARS-Cov-2 virus which may result in spread of COVID-19 among to the health care provider. In this situation, it is better to avoid delay laryngeal surgery if the patient is not in acute airway obstruction requiring urgent surgical intervention. Otherwise, if the urgent surgery has to be done, then it should be done properly by following institutional guidelines to avoid the spread of the disease and to be done with all precautionary biosafety measures like use of personal protective equipment (PPE), N95 mask and proper donning and doffing.

ABSTRACT The purpose of this research was to determine biosecurity measures at the dental office after the appearance of coronavirus disease 2019 (COVID-19). A search was conducted in the main databases of the scientific literature using the words “COVID-19, coronavirus, SARS-Cov2, biosecurity, disinfection and dentistry.” We analyzed biosecurity and disinfection standards at the dental office and dental health personnel to date, and their adaptation to the needs and way of working of each. As a result, according to the information collected the following procedure was identified: a telephone appointment must be made and a questionnaire should be given before dental care; at arrival to the appointment, the temperature of the patient should be taken and proper cleaning and disinfection of the waiting room should be maintained. Panoramic radiography and CBCT are the auxiliary methods of choice. Absolute isolation and atraumatic restorative therapy techniques are a good alternative to decrease fluid exposure. The removal of protective clothing and accessories must follow a specific order and washing hands before and after is essential. In conclusion, the efficient biosecurity for dentists and patients in all dental care processes before, during, and immediately after the appointment reduces the risk of COVID-19 infection and allows healthy dental care environments.

Background Adverse health effects among agricultural workers due to chronic heat exposure have been characterized in the literature as not only due to high ambient temperatures but also due to intensive manual labor in hot and humid conditions. The aim of this study was to use biomonitoring equipment to examine the effectiveness of selected cooling devices at preventing agricultural workers from exceeding the core body temperature threshold of 38.0°C (Tc38) and attenuating heat-related illness symptoms. Methods A convenience sample of 84 agricultural workers in Florida was randomized to one of four groups: (a) no intervention, clothing as usual; (b) cooling bandana; (c) cooling vest; and (d) both the cooling bandana and cooling vest. Biomonitoring equipment worn by the participants included core body temperature monitor and an accelerometer to capture physical activity. Findings A total of 78 agricultural workers completed one intervention workday trial. Compared with the control group, the bandana group had lower odds of exceeding Tc38 (odds ratio [OR] = 0.7, 90% confidence interval [CI] = [0.2, 3.2]) and the vest group had higher odds of exceeding Tc38 (OR = 1.8, 90% CI = [0.4, 7.9]). The simultaneous use of cooling vest and bandana showed an effect little different from the control group (OR = 1.3, 90% CI = [0.3, 5.6]). Conclusion/Application to Practice This is the first field-based study to examine cooling intervention among agricultural workers in the United States using biomonitoring equipment. This study found that using a bandana while working in a hot agricultural environment has the potential to be protective against exceeding the recommended Tc38 threshold.

Abstract Background Systemic lupus erythematosus (SLE) is a systemic autoimmune/inflammatory disorder that can affect any organ system. An estimated 10- 20% of all patients with SLE develop clinical disease before the age of 16 years and are therefore classified as juvenile-onset SLE (JSLE). JSLE is characterised by more severe clinical manifestations, such as lupus nephritis, more complications and less favourable outcomes compared to adult-onset SLE. Chronic kidney disease (CKD) refers to a state of irreversible kidney damage and/or reduction of kidney function that is associated with progressive loss of function over time. Lupus nephritis does not always lead to CKD. However, when it does it is associated with increased morbidity and mortality. It is important to identify clinical and laboratory predictors of CKD development in JSLE patients, as a more aggressive treatment approach could be advocated for these patients. In this study we compared the baseline characteristics of JSLE patients with and without chronic kidney disease to ascertain if there are any significant differences between the two groups. Methods This is a single-centre retrospective study, who included patients reviewed in our young adult and adolescent clinics. All data were analysed descriptively. Mann-Whitney U or Chi-Square tests were performed to compare the characteristics between the patients with and without CKD. We used the Pearson’s (r) or Kendall’s τ (tau) correlation to examine if there is any association between the CKD and the baseline characteristics. Results We identified 44 JSLE patients, out of which 17 (39%) fulfilled the diagnostic criteria for CKD at their last clinical review. The stages of CKD varied from 2 to 5. All patients with CKD also had lupus nephritis, while 5/44 patients (11%) had lupus nephritis without CKD. There were statistical significant differences in the treatments used for patients with and without CKD. As expected, the highest dsDNAlevels were higher in patients with CKD (p = 0.03). There was also a positive moderate correlation (ρ = 0.32) between raised levels of dsDNAand the development of CKD (p = 0.008). We also found a negative moderate correlation (τ= -0.439) between the presence of RF and CKD (p = 0.04). Conclusion We found a negative moderate correlation between the presence of RF and CKD, which has also been reported in the literature before. Further research using a large JSLE cohort is suggested to explore further if RF exerts a protective effect against renal disease in SLE. dsDNA is a serological marker of lupus nephritis and it is reasonable that the highest dsDNA correlates with CKD. Conflicts of Interest The authors declare no conflicts of interest.

The sudden outbreak of COVID-19 pandemic has rattled the world and has severely compromised not only the public health system but has decelerated the global economy. In this backdrop, the article explores the dynamics of the institutional care of the out-of-home care (OHC) children, adolescents and children who are residing in alternative care homes, childcare institutes (CCIs), foster homes and who are in conflict with law like refugees or in juvenile correctional centres. The article attempts to highlight the risk factors and systematic barriers that CCIs and associated functionaries have been confronting in the aftermath of the COVID-19 pandemic worldwide. It would also catalogue the remedial, preventive and protective initiatives undertaken as best practices. The qualitative content analysis method is used to identify major themes related to the ongoing COVID-19 pandemic and institutional care of children. Critical evaluation of literature reviews, published newspaper reports and articles and documentation of webinar proceedings is performed for theoretical and thematic conceptualisation of this article. The fundamental barriers that surfaced include financial barriers, health and nutrition, social justice, educational barriers, safety issues, administrative barriers, management, rehabilitation and integration of children living in CCIs and the ones who are leaving the CCIs. The unprecedented challenges have exposed the emergency unpreparedness and lacunae in functioning of CCIs in diverse ways. This has necessitated the undeniable need for reframing the regulatory directives for protection of child rights; accounting for the newer structural reforms aiming for standard operating procedures (SOPs); compliance and accountability guidelines; upgrading training and capacity building of the caregivers; addressing issues of psycho-social, mental health and well-being of the children and caregivers; building resilient coping strategies and enhancing the dignity, flexibility, inclusivity and sustainability in the responsive policy formulation regarding overall childcare system. This entails a multi-sectoral, participatory and coordinated approach as envisaged in United Nations Convention on the Rights of the Child (UNCRC) where the concerned stakeholders, including government legislations, non-governmental organisations (NGOs), civil societies, grassroot organisations, individual CCIs and management staff, would ensure non-discriminatory measures protecting the best interests of the children.

IntroductionThe 2009 American film Trash Humpers, directed by Harmony Korine, was released at a time when the hipster had become a ubiquitous concept, entering into the common vernacular of numerous cultures throughout the world, and gaining significant press, social media and academic attention (see Žižek; Arsel and Thompson; Greif et al.; Stahl; Ouellette; Reeve; Schiermer; Maly and Varis). Trash Humpers emerged soon after the 2008 Global Financial Crisis triggered Occupy movements in numerous cities, aided by social media platforms, reported on by blogs such as Gawker, and stylized by multi-national youth-subculture brands such as Vice, American Apparel, Urban Outfitters and a plethora of localised variants.Korine’s film, which is made to resemble found VHS footage of old-aged vandals, epitomises the ironic, retro stylizations and “counterculture-meets-kitsch” aesthetics so familiar to hipster culture. As a creative stereotype from 1940s and ‘50s jazz and beatnik subcultures, the hipster re-emerged in the twenty-first century as a negative embodiment of alternative culture in the age of the Internet. As well as plumbing the recent past for things not yet incorporated into contemporary marketing mechanisms, the hipster also signifies the blurring of irony and authenticity. Such “outsiderness as insiderness” postures can be regarded as a continuation of the marginality-from-the-centre logic of cool capitalism that emerged after World War Two. Particularly between 2007 and 2015, the post-postmodern concept of the hipster was a resonant cultural trope in Western and non-Western cultures alike, coinciding with the normalisation of the new digital terrain and the establishment of mobile social media as an integral aspect of many people’s daily lives. While Korine’s 79-minute feature could be thought of as following in the schlocky footsteps of the likes of Rob Zombie’s The Devil’s Rejects (2006), it is decidedly more arthouse, and more attuned to the influence of contemporary alternative media brands and independent film history alike – as if the love child of Jack Smith’s Flaming Creatures (1963) and Vice Video, the latter having been labelled as “devil-may-care hipsterism” (Carr). Upon release, Trash Humpers was described by Gene McHugh as “a mildly hip take on Jackass”; by Mike D’Angelo as “an empty hipster pose”; and by Aaron Hillis as either “the work of an insincere hipster or an eccentric provocateur”. Lacking any semblance of a conventional plot, Trash Humpers essentially revolves around four elderly-looking protagonists – three men and a woman – who document themselves with a low-quality video camera as they go about behaving badly in the suburbs of Nashville, Tennessee, where Korine still lives. They cackle eerily to themselves as they try to stave off boredom, masturbating frantically on rubbish bins, defecating and drinking alcohol in public, fellating foliage, smashing televisions, playing ten-pin bowling, lighting firecrackers and telling gay “hate” jokes to camera with no punchlines. In one purposefully undramatic scene half-way through the film, the humpers are shown in the aftermath of an attack on a man wearing a French maid’s outfit; he lies dead in a pool of blood on their kitchen floor with a hammer at his feet. The humpers are consummate “bad” performers in every sense of the term, and they are joined by a range of other, apparently lower-class, misfits with whom they stage tap dance routines and repetitively sing nursery-rhyme-styled raps such as: “make it, make it, don’t break it; make it, make it, don’t fake it; make it, make it, don’t take it”, which acts as a surrogate theme song for the film. Korine sometimes depicts his main characters on crutches or in a wheelchair, and a baby doll is never too far away from the action, as a silent and Surrealist witness to their weird, sinister and sometimes very funny exploits. The film cuts from scene to scene as if edited on a video recorder, utilising in-house VHS titling sequences, audio glitches and video static to create the sense that one is engaging voyeuristically with a found video document rather than a scripted movie. Mainstream AlternativesAs a viewer of Trash Humpers, one has to try hard to suspend disbelief if one is to see the humpers as genuine geriatric peeping Toms rather than as hipsters in old-man masks trying to be rebellious. However, as Korine’s earlier films such as Gummo (1997) attest, he clearly delights in blurring the line between failure and transcendence, or, in this case, between pretentious art-school bravado and authentic redneck ennui. As noted in a review by Jeannette Catsoulis, writing for the New York Times: “Much of this is just so much juvenile posturing, but every so often the screen freezes into something approximating beauty: a blurry, spaced-out, yellow-green landscape, as alien as an ancient photograph”. Korine has made a career out of generating this wavering uncertainty in his work, polarising audiences with a mix of critical, cinema-verité styles and cynical exploitations. His work has consistently revelled in ethical ambiguities, creating environments where teenagers take Ritalin for kicks, kill cats, wage war with their families and engage in acts of sexual deviancy – all of which are depicted with a photographer’s eye for the uncanny.The elusive and contradictory aspects of Korine’s work – at once ugly and beautiful, abstract and commercial, pessimistic and nostalgic – are evident not just in films such as Gummo, Julien Donkey Boy (1999) and Mister Lonely (2007) but also in his screenplay for Kids (1995), his performance-like appearances on The Tonight Show with David Letterman (1993-2015) and in publications such as A Crackup at the Race Riots (1998) and Pass the Bitch Chicken (2001). As well as these outputs, Korine is also a painter who is represented by Gagosian Gallery – one of the world’s leading art galleries – and he has directed numerous music videos, documentaries and commercials throughout his career. More than just update of the traditional figure of the auteur, Korine, instead, resembles a contemporary media artist whose avant-garde and grotesque treatments of Americana permeate almost everything he does. Korine wrote the screenplay for Kids when he was just 19, and subsequently built his reputation on the paradoxical mainstreaming of alternative culture in the 1990s. This is exemplified by the establishment of music and film genres such “alternative” and “independent”; the popularity of the slacker ethos attributed to Generation X; the increased visibility of alternative press zines; the birth of grunge in fashion and music; and the coining of “cool hunting” – a bottom-up market research phenomenon that aimed to discover new trends in urban subcultures for the purpose of mass marketing. Key to “alternative culture”, and its related categories such as “indie” and “arthouse”, is the idea of evoking artistic authenticity while covertly maintaining a parasitic relationship with the mainstream. As Holly Kruse notes in her account of the indie music scenes of the 1990s, which gained tremendous popularity in the wake of grunge bands such as Nirvana: without dominant, mainstream musics against which to react, independent music cannot be independent. Its existence depends upon dominant music structures and practices against which to define itself. Indie music has therefore been continually engaged in an economic and ideological struggle in which its ‘outsider’ status is re-examined, re-defined, and re-articulated to sets of musical practices. (Kruse 149)Alternative culture follows a similar, highly contentious, logic, appearing as a nebulous, authentic and artistic “other” whose exponents risk being entirely defined by the mainstream markets they profess to oppose. Kids was directed by the artist cum indie-director Larry Clark, who discovered Korine riding his skateboard with a group of friends in New York’s Washington Square in the early 1990s, before commissioning him to write a script. The then subcultural community of skating – which gained prominence in the 1990s amidst the increased visibility of “alternative sports” – provides an important backdrop to the film, which documents a group of disaffected New York teenagers at a time of the Aids crisis in America. Korine has been active in promoting the DIY ethos, creativity and anti-authoritarian branding of skate culture since this time – an industry that, in its attempts to maintain a non-mainstream profile while also being highly branded, has become emblematic of the category of “alternative culture”. Korine has undertaken commercial projects with an array skate-wear brands, but he is particularly associated with Supreme, a so-called “guerrilla fashion” label originating in 1994 that credits Clark and other 1990s indie darlings, and Korine cohorts, Chloë Sevigny and Terry Richardson, as former models and collaborators (Williams). The company is well known for its designer skateboard decks, its collaborations with prominent contemporary visual artists, its hip-hop branding and “inscrutable” web videos. It is also well known for its limited runs of new clothing lines, which help to stoke demand through one-offs – blending street-wear accessibility with the restricted-market and anti-authoritarian sensibility of avant-garde art.Of course, “alternative culture” poses a notorious conundrum for analysis, involving highly subjective demarcations of “mainstream” from “subversive” culture, not to mention “genuine subversion” from mere “corporate alternatives”. As Pierre Bourdieu has argued, the roots of alternative culture lie in the Western tradition of the avant-garde and the “aesthetic gaze” that developed in the nineteenth century (Field 36). In analysing the modernist notion of advanced cultural practice – where art is presented as an alternative to bourgeois academic taste and to the common realm of cultural commodities – Bourdieu proposed a distinction between two types of “fields”, or logics of cultural production. Alternative culture follows what Bourdieu called “the field of restricted production”, which adheres to “art for art’s sake” ideals, where audiences are targeted as if like-minded peers (Field 50). In contrast, the “field of large-scale production” reflects the commercial imperatives of mainstream culture, in which goods are produced for the general public at large. The latter field of large-scale production tends to service pre-established markets, operating in response to public demand. Furthermore, whereas success in the field of restricted production is often indirect, and latent – involving artists who create niche markets without making any concessions to those markets – success in the field of large-scale production is typically more immediate and quantifiable (Field 39). Here we can see that central to the branding of “alternative culture” is the perceived refusal to conform to popular taste and the logic of capitalism more generally is. As Supreme founder James Jebbia stated about his brand in a rare interview: “The less known the better” (Williams). On this, Bourdieu states that, in the field of restricted production, the fundamental principles of all ordinary economies are inversed to create a “loser wins” scenario (Field 39). Profit and cultural esteem become detrimental attributes in this context, potentially tainting the integrity and marginalisation on which alternative products depend. As one ironic hipster t-shirt puts it: “Nothing is any good if other people like it” (Diesel Sweeties).Trash HipstersIn abandoning linear narrative for rough assemblages of vignettes – or “moments” – recorded with an unsteady handheld camera, Trash Humpers positions itself in ironic opposition to mainstream filmmaking, refusing the narrative arcs and unwritten rules of Hollywood film, save for its opening and closing credits. Given Korine’s much publicized appreciation of cinema pioneers, we can understand Trash Humpers as paying homage to independent and DIY film history, including Jack Smith’s Flaming Creatures, William Eggleston’s Stranded in Canton (1973), Andy Warhol’s and Paul Morrissey’s Lonesome Cowboys (1967) and Trash (1970), and John Waters’s Pink Flamingos (1972), all of which jubilantly embraced the “bad” aesthetic of home movies. Posed as fantasized substitutions for mainstream movie-making, such works were also underwritten by the legitimacy of camp as a form of counter-culture critique, blurring parody and documentary to give voice to an array of non-mainstream and counter-cultural identities. The employment of camp in postmodern culture became known not merely as an aesthetic subversion of cultural mores but also as “a gesture of self-legitimation” (Derrida 290), its “failed seriousness” regarded as a critical response to the specific historical problem of being a “culturally over-saturated” subject (Sontag 288).The significant difference between Korine’s film and those of his 1970s-era forbears is precisely the attention he pays to the formal aspects of his medium, revelling in analogue editing glitches to the point of fetishism, in some cases lasting as long as the scenes themselves. Consciously working out-of-step with the media of his day, Trash Humpers in imbued with nostalgia from its very beginning. Whereas Smith, Eggleston, Warhol, Morrissey and Waters blurred fantasy and documentary in ways that raised the social and political identities of their subjects, Korine seems much more interested in “trash” as an aesthetic trope. In following this interest, he rightfully pays homage to the tropes of queer cinema, however, he conveniently leaves behind their underlying commentaries about (hetero-) normative culture. A sequence where the trash humpers visit a whorehouse and amuse themselves by smoking cigars and slapping the ample bottoms of prostitutes in G-strings confirms the heterosexual tenor of the film, which is reiterated throughout by numerous deadpan gay jokes and slurs.Trash Humpers can be understood precisely in terms of Korine’s desire to maintain the aesthetic imperatives of alternative culture, where formal experimentation and the subverting of mainstream genres can provide a certain amount of freedom from explicated meaning, and, in particular, from socio-political commentary. Bourdieu rightly points out how the pleasures of the aesthetic gaze often manifest themselves curiously as form of “deferred pleasure” (353) or “pleasure without enjoyment” (495), which corresponds to Immanuel Kant’s notion of the disinterested nature of aesthetic judgement. Aesthetic dispositions posed in the negative – as in the avant-garde artists who mined primitive and ugly cultural stereotypes – typically use as reference points “facile” or “vulgar” (393) working-class tropes that refer negatively to sensuous pleasure as their major criterion of judgment. For Bourdieu, the pleasures provided by the aesthetic gaze in such instances are not sensual pleasures so much as the pleasures of social distinction – signifying the author’s distance from taste as a form of gratification. Here, it is easy to see how the orgiastic central characters in Trash Humpers might be employed by Korine for a similar end-result. As noted by Jeremiah Kipp in a review of the film: “You don't ‘like’ a movie like Trash Humpers, but I’m very happy such films exist”. Propelled by aesthetic, rather than by social, questions of value, those that “get” the obscure works of alternative culture have a tendency to legitimize them on the basis of the high-degree of formal analysis skills they require. For Bourdieu, this obscures the fact that one’s aesthetic “‘eye’ is a product of history reproduced by education” – a privileged mode of looking, estranged from those unfamiliar with the internal logic of decoding presupposed by the very notion of “aesthetic enjoyment” (2).The rhetorical priority of alternative culture is, in Bourdieu’s terms, the “autonomous” perfection of the form rather than the “heteronomous” attempt to monopolise on it (Field 40). However, such distinctions are, in actuality, more nuanced than Bourdieu sometimes assumed. This is especially true in the context of global digital culture, which makes explicit how the same cultural signs can have vastly different meanings and motivations across different social contexts. This has arguably resulted in the destabilisation of prescriptive analyses of cultural taste, and has contributed to recent “post-critical” advances, in which academics such as Bruno Latour and Rita Felski advocate for cultural analyses and practices that promote relationality and attachment rather than suspicious (critical) dispositions towards marginal and popular subjects alike. Latour’s call for a move away from the “sledge hammer” of critique applies as much to cultural practice as it does to written analysis. Rather than maintaining hierarchical oppositions between authentic versus inauthentic taste, Latour understands culture – and the material world more generally – as having agency alongside, and with, that of the social world.Hipsters with No AlternativeIf, as Karl Spracklen suggests, alternativism is thought of “as a political project of resistance to capitalism, with communicative oppositionality as its defining feature” (254), it is clear that there has been a progressive waning in relevance of the category of “alternative culture” in the age of the Internet, which coincides with the triumph of so-called “neoliberal individualism” (258). To this end, Korine has lost some of his artistic credibility over the course of the 2000s. If viewed negatively, icons of 1990s alternative culture such as Korine can be seen as merely exploiting Dada-like techniques of mimetic exacerbation and symbolic détournement for the purpose of alternative, “arty” branding rather than pertaining to a counter-hegemonic cultural movement (Foster 31). It is within this context of heightened scepticism surrounding alternative culture that the hipster stereotype emerged in cultures throughout the world, as if a contested symbol of the aesthetic gaze in an era of neoliberal identity politics. Whatever the psychological motivations underpinning one’s use of the term, to call someone a hipster is typically to point out that their distinctive alternative or “arty” status appears overstated; their creative decisions considered as if a type of bathos. For detractors of alternative cultural producers such as Korine, he is trying too hard to be different, using the stylised codes of “alternative” to conceal what is essentially his cultural and political immaturity. The hipster – who is rarely ever self-identified – re-emerged in the 2000s to operate as a scapegoat for inauthentic markers of alternative culture, associated with men and women who appear to embrace Realpolitik, sincerity and authentic expressions of identity while remaining tethered to irony, autonomous aesthetics and self-design. Perhaps the real irony of the hipster is the pervasiveness of irony in contemporary culture. R. J Magill Jnr. has argued that “a certain cultural bitterness legitimated through trenchant disbelief” (xi) has come to define the dominant mode of political engagement in many societies since the early 2000s, in response to mass digital information, twenty-four-hour news cycles, and the climate of suspicion produced by information about terrorism threats. He analyses the prominence of political irony in American TV shows including The Daily Show with Jon Stewart, The Simpsons, South Park, The Chappelle Show and The Colbert Report but he also notes its pervasiveness as a twenty-first-century worldview – a distancing that “paradoxically and secretly preserves the ideals of sincerity, honesty and authenticity by momentarily belying its own appearance” (x). Crucially, then, the utterance “hipster” has come to signify instances when irony and aesthetic distance are perceived to have been taken too far, generating the most disdain from those for whom irony, aesthetic discernment and cultural connoisseurship still provide much-needed moments of disconnection from capitalist cultures drowning in commercial hyperbole and grave news hype. Korine himself has acknowledged that Spring Breakers (2013) – his follow-up feature film to Trash Humpers – was created in response to the notion that “alternative culture”, once a legitimate challenge to mainstream taste, had lost its oppositional power with the decentralization of digital culture. He states that he made Spring Breakers at a moment “when there’s no such thing as high or low, it’s all been exploded. There is no underground or above-ground, there’s nothing that’s alternative. We’re at a point of post-everything, so it’s all about finding the spirit inside, and the logic, and making your own connections” (Hawker). In this context, we can understand Trash Humpers as the last of the Korine films to be branded with the authenticity of alternative culture. In Spring Breakers Korine moved from the gritty low-fi sensibility of his previous films and adopted a more digital, light-filled and pastel-coloured palette. Focussing more conventionally on plot than ever before, Spring Breakers follows four college girls who hold up a restaurant in order to fund their spring break vacation. Critic Michael Chaiken noted that the film marks a shift in Korine’s career, from the alternative stylings of the pre-Internet generation to “the cultural heirs [of] the doomed protagonists of Kids: nineties babies, who grew up with the Internet, whose sensibilities have been shaped by the sweeping technological changes that have taken place in the interval between the Clinton and Obama eras” (33).By the end of the 2000s, an entire generation came of age having not experienced a time when the obscure films, music or art of the past took more effort to track down. Having been a key participant in the branding of alternative culture, Korine is in a good position to recall a different, pre-YouTube time – when cultural discernment was still caught up in the authenticity of artistic identity, and when one’s cultural tastes could still operate with a certain amount of freedom from sociological scrutiny. Such ideas seem a long way away from today’s cultural environments, which have been shaped not only by digital media’s promotion of cultural interconnection and mass information, but also by social media’s emphasis on mobilization and ethical awareness. ConclusionI should reiterate here that is not Korine’s lack of seriousness, or irony, alone that marks Trash Humpers as a response to the scepticism surrounding alternative culture symbolised by the figure of the hipster. It is, rather, that Korine’s mock-documentary about juvenile geriatrics works too hard to obscure its implicit social commentary, appearing driven to condemn contemporary capitalism’s exploitations of youthfulness only to divert such “uncool” critical commentaries through unsubtle formal distractions, visual poetics and “bad boy” avant-garde signifiers of authenticity. Before being bludgeoned to death, the unnamed man in the French maid’s outfit recites a poem on a bridge amidst a barrage of fire crackers let off by a nearby humper in a wheelchair. Although easily overlooked, it could, in fact, be a pivotal scene in the film. Spoken with mock high-art pretentions, the final lines of the poem are: So what? Why, I ask, why? Why castigate these creatures whose angelic features are bumping and grinding on trash? Are they not spawned by our greed? Are they not our true seed? Are they not what we’ve bought for our cash? We’ve created this lot, of the ooze and the rot, deliberately and unabashed. Whose orgiastic elation and one mission in creation is to savagely fornicate TRASH!Here, the character’s warning of capitalist overabundance is drowned out by the (aesthetic) shocks of the fire crackers, just as the stereotypical hipster’s ethical ideals are drowned out by their aesthetic excess. The scene also functions as a metaphor for the humpers themselves, whose elderly masks – embodiments of nostalgia – temporarily suspend their real socio-political identities for the sake of role-play. It is in this sense that Trash Humpers is too enamoured with its own artifices – including its anonymous “boys club” mentality – to suggest anything other than the aesthetic distance that has come to mark the failings of the “alternative culture” category. In such instances, alternative taste appears as a rhetorical posture, with Korine asking us to gawk knowingly at the hedonistic and destructive pleasures pursued by the humpers while factoring in, and accepting, our likely disapproval.ReferencesArsel, Zeynep, and Craig J. Thompson. “Demythologizing Consumption Practices: How Consumers Protect Their Field-Dependent Identity Investments from Devaluing Marketplace Myths.” Journal of Consumer Research 37.5 (2011): 791-806.Bourdieu, Pierre. 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