3,953 research outputs found
A review and survey of policies utilized for interventional pain procedures: a need for consensus
No full textLynn Kohan,1 Reza Salajegheh,1 Robin J Hamill-Ruth,1 Sandeep Yerra,1 John Butz,2 1Department of Anesthesiology, University of Virginia, Charlottesville, VA, 2West River Anesthesiology Consultants, Rapid City, SD, USA Background: Other than the newly published anticoagulation guidelines, there are currently few recommendations to assist pain medicine physicians in determining the safety parameters to follow when performing interventional pain procedures. Little information exists regarding policies for oral intake, cumulative steroid dose limits, driving restrictions with and without sedation, and routine medication use for interventional procedures.Methods: A 16-question survey was developed on common policies currently in use for interventional pain procedures. The questionnaire was distributed through the ­American Society of Regional Anesthesia and Pain Medicine and American Academy of Pain Medicine. We sought to statistically analyze the range of policies being used by pain medicine physicians and to determine if there are any commonly accepted standards.Results: A total of 337 physicians out of 4037 members responded to our survey with a response rate of 8.4%. A total of 82% of these respondents used a sedative agent while performing an interventional pain procedure. The majority of respondents required drivers after procedures, except after trigger points. A total of 47% indicated that they have an nil per os (NPO) policy for procedures without sedation. A total of 98% reported that they had an anticoagulation policy before an interventional procedure. A total of 17% indicated that the interval between steroid doses was <2 weeks, while 53% indicated that they waited 2–4 weeks between steroid doses.Conclusion: Our study has clearly demonstrated a wide variation in the current practice among physicians regarding sedation, NPO status, steroid administration, and the need for designated drivers. There was much higher endorsement of policies regarding anticoagulation. There is an obvious need for evidence-based guidelines for these aspects of interventional pain care to improve patient safety and minimize the risk of adverse events. Keywords: interventional pain procedures policies, steroids in pain procedures, driver policy in interventional pain procedures, NSAIDs and anticoagulants in interventional pain procedure
O passado no presente : releituras da modernidade
No full textCom o intuito de representar a produção do grupo de pesquisa homônimo, o livro traz análises críticas de obras da literatura mundial. Organizada por Maria Elizabeth Chaves de Mello e Maria Ruth Machado Fellows, a coletânea reúne, assim, trabalhos que contribuem para a formação de reflexões em torno de conceitos importantes para o melhor entendimento da literatura e cultura de hoje, tais como modernidade, ficção e memória. Os ensaios são: - "Memória e esquecimento" (Roger Chartier); - "Memória, fictício e imaginário no olhar de Francis de Castelnau sobre o Brasil" (Maria Elizabeth Chaves de Mello e Maria Ruth Machado Fellows);
- "Bug-Jargal, do romance hugoano à ópera de Gama Malcher" (Junia Barreto); - "Deslocamentos de sentidos da Europa - eurofobia e eurofilia" (Antonio Marcos Moreira da Silva); - "Estratégias de afirmação da autonomia cultural das literaturas americanas no início do século XX: estudo comparativo dos casos do Quebec e do Brasil" (Nova Doyon); - "Le mon amour é a França / Vem brindar" (Stela Maria Sardinha Chagas de Moraes); - "A 'Gradiva' de Freud" (Solange Rebuzzi); - "Ilusão realista X realidade ficcional: jornalismo e literatura, as duas faces de uma mesma moeda" (Sandra Regina Guimarães); - "Dialogismo e polifonia - o jogo das vozes em 'Cartas persas'" (Maria Zuleide Pires Killer); - "Aspectos selecionados da leitura na internet" (Simone Bacellar Moreira); - "O olhar estrangeiro: o papel da memória no texto literário" (Alessandra Fontes Carvalho da Rocha); - "A arte do inacabado em Ionesco e Picasso" (Kamila de Oliveira Carvalho); - "Os valores de Ítalo Calvino e a tradução literária no terceiro milênio" (Maria da Conceição Vinciprova Fonseca); - "Os bondes no Rio de Janeiro, no olhar de Machado de Assis" (Darisa Leonora de Matos Gravina
Reformulating the rj-McMC Algorithm for 3D Inversion of Passive Seismic Data for Near-Surface Characterization
No full textGeophysical subsurface characterization techniques could, due to their non-invasive nature, play a crucial role in the design and subsequent construction of infrastructure in urban & industrial environ- ments. Geo-data specialist company Fugro sees potential in upgrading their current ambient-seismic- noise-tomography workflow, to make use of state-of-the-art inversion schemes with the main goal of increasing the quality and accuracy of the initial-site characterization delivered to clients. In this thesis I explore the feasibility of utilizing the reverse-jump Markov chain Monte Carlo (rj-McMC) algorithm for the inversion of ambient seismic noise for characterization in urban & industrial environments. Specif- ically, testing the potential of scaling down this inversion algorithm to fit in a small scale, near-surface framework. To achieve this, I first carried out analyses to evaluate the appropriate Rayleigh wave frequency range, after which realistic noise hyperparameters, suited for this reduced scale problem, were obtained. Because of the potential exploitation of in-situ borehole measurements, I reformulated the Bayesian prior within the rj-McMC algorithm to implement these constraining shear wave velocity values appropriately. I conducted extensive synthetic experiments to gain insight into the behavior of this adapted algorithm, from which it was concluded that the inherent dynamic discretization partially prevents these constraints from being implemented to their full extent. Nevertheless, promising results lead me to conclude that the use of the rj-McMC algorithm for application in near-surface urban & industrial environments is feasible.Applied Geophysics | IDEA Leagu
Projeto político pedagógico: uma experiência instituinte em São Gonçalo-RJ
No full textWith this research, we tried to recognize why, when and how the actions developed in the
process of the construction of Pedagogical Political Project of the Network of Schools of São
Gonçalo-RJ (2003-2004), took collective dimensions, making prevail movements where these
schools and their teachers increased their autonomy, including, creation and solidarity. Thus,
sought is mapping collisions, struggles and creating statements that were happening during
the movement that filled the schools in that period, and the limitations, the locks and the
contradictions that accompanied them. It took as a reference for theoretical discussions,
elaborations of Walter Benjamin, Paulo Freire and Célia Linhares, which improved
experiences that do not separate from a multiplicity of voices and feelings produced by the
subject in their stories. For this, appealed to the narratives, tool for expression of experience
in the process of remembering, seeking the path of women and men as natural events and
plurals in experiments that emerged within the meaning of Benjamin, a living memory of the
unfinished stories process of teaching. The tapping occurred during the process of discussion
of Political Pedagogical Projects in search of dialogical relationship of past demands that
claimed the entrelacement of other stories to education of the city, from the own experience of
the Network, to recreate collective actions.Com a presente pesquisa procurou-se reconhecer por que, quando e como as ações
desenvolvidas no processo de construção dos Projetos Políticos Pedagógico das escolas da
Rede Municipal de Ensino de São Gonçalo-RJ (2003-2004), assumiram dimensões
instituintes, fazendo prevalecer movimentos em que essas escolas e seus educadores
ampliaram seus exercícios de autonomia, includência, criação e solidariedade. Assim, buscouse
cartografar embates, lutas e afirmações criadoras que foram acontecendo no decorrer dos
movimentos que impregnaram as escolas no referido período, bem como, os cerceamentos, as
travas e as contradições que também lhes acompanharam. Tomou-se como referência, para as
teorizações, elaborações de Walter Benjamin, Paulo Freire e Célia Linhares, que valorizaram
experiências que não se descolam de uma multiplicidade de vozes e sentidos produzidos pelos
sujeitos em suas histórias. Para tanto, recorreu-se às narrativas, ferramenta para expressão das
experiências, no processo de rememoração, resgatando a trajetória de mulheres e homens,
como manifestações singulares e plurais em que pulsaram experiências, na acepção de
Benjamin; uma memória viva de histórias inacabadas no processo de construção pedagógica.
As escutas ocorreram durante o processo de discussão dos Projetos Políticos Pedagógicos, na
procura da relação dialógica de exigências passadas que reivindicaram a tessitura de outras
histórias para educação da cidade, partindo da própria experiência da Rede, para recriar ações
coletivas
Clowns, Fools, and Killers: An Exploration of Horror, Comedy, and Madness Through the Roles of Murderer 2 and Sir Richard Ratcliffe in William Shakespeare\u27s Richard III
No full textThis document is a thesis submitted in partial fulfillment of the Master of Fine Arts degree in Theatre Arts with a Concentration in Musical Theatre. It is a detailed account of author RJ Magee’s artistic and scholarly process in creating the roles of Murderer 2 and Sir Richard Ratcliffe in William Shakespeare’s Richard III. The production was performed as part of Minnesota State University, Mankato’s mainstage season in October of 2022. In five chapters, this thesis chronicles the actor’s process: a preproduction analysis, a historical and critical perspective, a rehearsal and performance journal, a post-production analysis, and a process development analysis. Appendices and works cited are included
Aspiration lung disease in children with severe neurodisability
No full textBackground: Children with severe neurodisability (ND) commonly suffer with respiratory disease and this is the leading cause of premature death. The nature of this respiratory disease is however, poorly understood. The underlying aetiology is often multifactorial, but aspiration (direct or reflux) is likely to play a key role. Unfortunately, diagnostic tests for reflux or direct aspiration are limited. There is a clinical need for high quality research on children with severe ND to define underlying mechanisms of respiratory disease and guide management.
Aims: In this study, the aims were to (i) characterise respiratory symptoms and their relationship with lower airway inflammation in children with severe ND, (ii) explore available bronchial lavage (BAL) biomarkers of reflux aspiration, assessing their validity and their relationship to clinical and airway inflammatory data, (iii) develop a novel assay for the accurate detection/quantification of pepsin in BAL, (iv) investigate the validity of an alpha-amylase assay in paediatric BAL and explore the relationship of alpha-amylase levels with lower airway inflammation and clinical symptoms, and (v) investigate the effects of pH alteration and pepsin exposure on airway epithelial cells (AEC).
Methods: Clinical data and BAL samples were collected from children with severe ND at times of stability and respiratory deterioration and also from healthy controls. BAL differential cell counts and cytokine measurements (ELISA) were performed. Lower airway microbial colonisation/infection was assessed. BAL pepsin measurement was attempted using a number of methods, and the feasibility of inhibitor affinity enrichment and LC-MRM-MS techniques to identify and quantify BAL pepsin was explored using SDS PAGE gel and mass spectrometry analysis. BAL alpha-amylase activity was measured using an ethylidene-pNP-G7 based assay. BEAS-2B cells were cultured in monolayer and the cytotoxic/inflammatory effects of pH alteration and pepsin exposure were explored through trypan blue staining and cytokine assays.
Results: Children with severe ND have burdensome chronic respiratory symptoms that impact on their quality of life and that of their families’. Symptoms may relate to lower airway inflammatory levels. A trend for greater airway
neutrophilia and respiratory symptoms was seen in those with lower airway microbial positivity. Available ‘in house’ pepsin ELISA assays were not robust but Western Blot results indicated a higher frequency of BAL pepsin positivity in ND patients with acute respiratory deterioration. Notably, positivity was also found in some healthy controls, highlighting the need for a quantitative assay. The use of an immobilized inhibitor (pepstatin agarose) to recover pepsin from paediatric BAL samples was shown to be feasible. Subsequent digestion of pepsin and detection by LC-MSMS with selective ion monitoring was demonstrated. Significantly increased BAL alpha-amylase levels were seen in Elective-ND patients compared to healthy controls and furthermore, significant correlations were observed with BAL lower airway inflammatory markers. BEAS-2B cells were sensitive to mild acidification, with up-regulation of TGF Beta-1, IL-6 and IL-8 mRNA expression. A corresponding rise in protein secretion was not necessarily seen and in some cases, was significantly down-regulated. No significant cytotoxicity or decrease in cell viability was observed in any condition.
Conclusions: In children with severe ND, chronic respiratory symptoms may be directly related to lower airway inflammation and bacterial colonization. Measurement and quantification of pepsin in BAL (as a marker of reflux aspiration) is difficult. However, an inhibitor affinity enhanced mass spectrometry based technique has potential as a ‘gold-standard’ method for identification and quantification of pepsin in BAL. BAL alpha-amylase activity shows promise as a biomarker of direct aspiration. Mild alterations in airway pH may directly contribute to the pathophysiology of inflammatory airway disease and specifically, reflux-aspiration related lung disease in this group. This requires further study as a potential novel therapeutic target
O patenteamento nas universidades brasileiras: o caso do CEFET/RJ
No full text8 p. : il.The universities produce always new technologies although researchers and institutions
have no profits from the economic results of their efforts in supporting such activities. This
is much caused by an absent patent policy, and weak commerce practices in Brazilian
academic environment. This article aims to present actions undertook in CEFET/RJ to
promote intellectual property culture diffusion and improve greater conscience about knowledge protection importance. As a natural consequence, systematic patentement
activity increase is expected
Introduction of complementary foods and the relationship to food allergy
No full textObjectives: To address questions regarding breastfeeding, complementary feeding, allergy development, and current infant-feeding recommendations. Methods: This was a nested, case-control within a cohort study in which mothers of 41 infants diagnosed with food allergy by the age of 2 years (according to double-blind, placebo-controlled food challenge) and their 82 age-matched controls kept prospective food diaries of how their infants were fed in the first year of life. Results: Infants who were diagnosed with food allergy by the time they were 2 years of age were introduced to solids earlier (?16 weeks of age) and were less likely to be receiving breast milk when cow’s milk protein was first introduced into their diet. Conclusions: This study supports the current American Academy of Pediatrics’ allergy prevention recommendations and the European Society of Pediatric Gastroenterology, Hepatology and Nutrition recommendations on complementary feeding to not introduce solids before 4 to 6 months of age. It also supports the American Academy of Pediatrics’ breastfeeding recommendations that breastfeeding should continue while solids are introduced into the diet and that breastfeeding should continue for 1 year, or longer, as mutually desired by mother and infant
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