154 research outputs found
Learning for work from the past, in the present, and into the future?
No full textIn this contribution, the complex interdependencies of the concepts of work and learning and, implicitly, also the concept of knowledge are discussed theoretically from three different but complementary perspectives. The urgency for this exercise lies in the author\u27s belief that learning for work is a topic which cannot be approached in a one-dimensional linear manner. The reason for this lies in the observation that, although in general free will seems to be illusionary in learning for work, we nevertheless acknowledge the individual with their own will, which gives (future) workers some control over changing themselves, their own working life, and the context around their work for the better (Van Dellen & Heidekamp, 2015). The question in this study is whether learning for work is driven by the individual, the actual knowledge aspect of the work, or the more general contextual features of the actual (learning for work) situation. The three different and complementary perspectives that will be discussed concern firstly the idea of the transformative mind (Stetsenko, 2017) using Vygotsky\u27s view of development and learning. The second perspective follows theoretical ideas about transformative learning that concern the complex process of individuals as they develop a more critical world view (Laros, Fuhr, & Taylor, 2017). Finally, the third perspective confronts the learning for work conceptual framework based on Ford\u27s (1992) motivational theory and the philosophical essay about responsibility by Verplaetse (2012) contextualized and operationalized in a study by Van Dellen and Heidekamp (2015). The most practical consequence of all of this theorizing lies in the outcome that learning for work is always something transitional and future-directed. This consequence means a great deal for our ideas about learning and development and the role of education, training, and development both vocationally and professionally. The article ends with a discussion of these consequences
Sublingual sufentanil (Zalviso) patient-controlled analgesia after total knee arthroplasty: a retrospective comparison with oxycodone with or without dexamethasone
No full textDavid E van Veen,1 Christiaan CWM Verhelst,2 Roelof T van Dellen,3 JSHA Koopman4 1Erasmus University Rotterdam, Rotterdam, The Netherlands; 2Department of Orthopedic Surgery, Maasstad Hospital, Rotterdam, The Netherlands; 3Department of Hospital Pharmacy, Maasstad Hospital, Rotterdam, The Netherlands; 4Department of Anesthesiology, Maasstad Hospital, Rotterdam, The Netherlands Abstract: Postoperative pain is a major problem, especially in orthopedic surgery. Our data suggest suboptimal pain management after total knee arthroplasty. This study evaluated a sufentanil sublingual tablet system (Zalviso) to optimize postoperative pain treatment. This retrospective, single-center, cohort study was conducted between January 2017 and September 2017. Zalviso as standard treatment was compared with a cohort receiving oxycodone (Oxy) immediate release and Oxy extended release and another receiving Oxy immediate release, Oxy extended release, and dexamethasone (Dexa + Oxy). The primary end point, pain intensity, was assessed on a numeric rating scale (NRS). Highest, lowest, and number of NRS scores >7 were collected. Secondary end points included length of hospital stay, nausea, and mobilization on the day of surgery. Patients receiving Dexa + Oxy had a lower lowest-pain intensity on day 0 (median 0, IQR 0–0) when compared to patients receiving Oxy (median 2, IQR 0–3; P<0.0001) or Zalviso (median 2, IQR 0–4; P<0.0001). No differences were observed on day 1 or 2. No differences were observed in highest pain score or number of patients reporting NRS scores > 7. Patients treated with Dexa + Oxy or Zalviso were discharged earlier compared to patients treated with Oxy (P<0.001). Patients treated with Zalviso experienced more nausea compared to other groups on day 0 and day 1 (P<0.001). Patients treated with Dexa + Oxy had a higher percentage of mobilization on the day of surgery compared to Oxy and Zalviso (P<0.001). In conclusion, Zalviso did not improve postoperative pain management in patients undergoing total knee arthroplasty and increased nausea. Keywords: total knee arthroplasty, postoperative pain, multimodal treatment, acute pain, Zalviso, sublingual sufentanil tablet system, opioid, sufentanil, sublingual formulatio
Hand-assisted laparoscopic donor nephrectomy in patients with aberrant inferior vena caval anatomy.
No full textOBJECTIVES Hand-assisted laparoscopic donor nephrectomy has become an established technique for live-donor organ retrieval. In most cases, the left kidney is removed because of its more favorable anatomic relations, particularly with the major abdominal vessels. MATERIALS AND METHODS We present 2 cases of live donation in which a hand-assisted laparoscopic approach was used to remove the right kidney as indicated by the presence of aberrant vascular anatomy, 1 being situs inversus totalis, the other a left-sided inferior vena cava. RESULTS A 41-year-old woman and a 51-year-old man underwent assessment for live-kidney donation. During preoperative investigation, they underwent magnetic resonance imaging that demonstrated situs inversus totalis and a left-sided inferior vena cava. No contraindications to live donation were found during the investigation. In both cases, a right donor nephrectomy was performed owing to an anatomically longer right renal vein. Living donation proceeded without complication in both cases, and both patients had uneventful recoveries. CONCLUSIONS Abnormalities in vascular anatomy should not be considered an absolute contraindication to donation, even by the hand-assisted laparoscopic donor approach. The use of magnetic resonance scanning preoperatively allows detailed planning of the approach required
Management problems in aneurysmal subarachnoid haemorrhage.
No full textThesis (M.Med.)-University of Natal, Durban, 1988.A retrospective review was made of the case records, angiograms and computed tomography (CT) relating to a total of 263 patients with subarachnoid haemorrhage (SAH) due to ruptured berry aneurysms who were admitted to the Department of Neurosurgery, Wentworth Hospital during the four years 1983-1986. The part of the thesis concerning vasospasm (VS) includes two independent studies on calcium blocker Nimodipine (NO) in the prevention and treatment of VS done by the author. The aim of the thesis is to analyse the management problems of aneurysmal SAH, and investigate factors influencing outcome in order to establish the best possible management policy. The results are discussed and related to the recent data from literature. The main factors influencing outcome were: clinical condition of the patient, the timing of admission and surgery, hypertension and hyperglycaemia on admission, presence of vasospasm and related CT appearance of a thick layer of blood or clot in subarachnoid haemorrhage (CT-Fisher 3). The systemic administration of the calcium blocker nimodipine did not reverse or prevent delayed vasospasm and caused serious adverse effects i.e. hypotension and hyperglycaemia. The results of the thesis suggest a change in management policy and timing of surgery should depend. on clinical condition of the patient on admission (Hunt & Hess grading)(HH I/II grade (HH as possible regardless of timing of admission and results of radiological investigations (CT, angiography). Early surgery (1-3 days) should be the aim of the effort including referral, transport and hospital organisation. III grade (HH surgery should be performed soon after day 10 post-SAH. Particular attention should be paid to the careful preparation and selection of patients for angiography. IV/V grade (HH in specialised units as s000n as possible, preferably neurological or neurosurgical wards, and operated on as soon as their grade improves or, in selected (by surgeon, radiologist and anaesthetist) cases by delayed surgery ( after day 10 post-SAH)
The Trees and the Forest: Characterization of complex brain networks with minimum spanning trees
No full textIn recent years there has been a shift in focus from the study of local, mostly task-related activation to the exploration of the organization and functioning of large-scale structural and functional complex brain networks. Progress in the interdisciplinary field of modern network science has introduced many new concepts, analytical tools and models which allow a systematic interpretation of multivariate data obtained from structural and functional MRI, EEG and MEG. However, progress in this field has been hampered by the absence of a simple, unbiased method to represent the essential features of brain networks, and to compare these across different conditions, behavioural states and neuropsychiatric/neurological diseases. One promising solution to this problem is to represent brain networks by a minimum spanning tree (MST), a unique acyclic subgraph that connects all nodes and maximizes a property of interest such as synchronization between brain areas. We explain how the global and local properties of an MST can be characterized. We then review early and more recent applications of the MST to EEG and MEG in epilepsy, development, schizophrenia, brain tumours, multiple sclerosis and Parkinson's disease, and show how MST characterization performs compared to more conventional graph analysis. Finally, we illustrate how MST characterization allows representation of observed brain networks in a space of all possible tree configurations and discuss how this may simplify the construction of simple generative models of normal and abnormal brain network organization.Network Architectures & Services (NAS)Electrical Engineering, Mathematics and Computer Scienc
Comprehensive behavioral testing in the R6/2 mouse model of Huntington's disease shows no benefit from CoQ10 or minocycline
No full textPrevious studies of the effects of coenzyme Q10 and minocycline on mouse models of Huntington’s disease have produced conflicting results regarding their efficacy in behavioral tests. Using our recently published best practices for husbandry and testing for mouse models of Huntington’s disease, we report that neither coenzyme Q10 nor minocycline had significant beneficial effects on measures of motor function, general health (open field, rotarod, grip strength, rearing-climbing, body weight and survival) in the R6/2 mouse model. The higher doses of minocycline, on the contrary, reduced survival. We were thus unable to confirm the previously reported benefits for these two drugs, and we discuss potential reasons for these discrepancies, such as the effects of husbandry and nutrition
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