2,248 research outputs found
Hiskett (Mervyn) : The Development of Islam in West Africa
No full textCuoq Joseph. Hiskett (Mervyn) : The Development of Islam in West Africa. In: Revue française d'histoire d'outre-mer, tome 74, n°274, 1er trimestre 1987. pp. 111-112
Milieueffectrapportage Zandmotor Delflandse kust (projectnota/MER)
No full textMilieueffectrapportage met bijlagen (morfologische berekeningen, slib, natuur, zandwinning, aanleg, luchtkwaliteit, geluid) alsmede de startnotitie.Zandmoto
Intravascular catheter sepsis
Get PDFIntravascular devices are an integral component of modern-day medical practice. They are used to administer intravenous fluids, medications, blood products and parenteral nutrition. In addition, they serve as a valuable monitor of the haemodynamic status of critically ill patients
Central venous catheter-related infection
No full textIntroduction and Background: Central venous catheters (CVCs) are extensively used worldwide. Mechanical, infectious and thrombotic complications are well described with their use and may be associated with prolonged hospitalisation, increased medical costs and mortality.
CVCs account for an estimated 90% of all catheter-related bloodstream infections (CRBSI) and a host of risk factors for CVC-related infections have been documented. These include, most importantly, the duration of catheterisation. The duration of use of CVCs remains controversial and the length of time such devices can safely be left in place has not been fully and objectively addressed in the critically ill patient. Over the past few years, antimicrobial impregnated catheters have been introduced in an attempt to limit catheter-related infection (CRI) and increase the time that CVCs can safely be left in situ. Recent meta-analyses concluded that antimicrobial-impregnated CVCs appear to be effective in reducing CRI.
Materials and Methods: This was a prospective randomised double-blind study performed in the adult multidisciplinary Intensive Care Unit (ICU) at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) over a four year period. The study entailed a comparison of standard triple-lumen versus antimicrobial impregnated CVCs on the rate of CRI. The aim was to determine whether the duration of catheter insertion time could safely be increased from the standard practice of seven days at the CMJAH adult multidisciplinary ICU to 14 days, to assess the influence of the antimicrobial impregnated catheter on the incidence of CRI, and to elucidate the epidemiology and risks of CRI.
Results: One hundred and eighteen critically ill patients were included in the study which spanned 34 951.5 catheter hours (3.99 catheter years). Sixty-two patients received a standard triple-lumen catheter and 56, a chlorhexidine-silver sulfadiazine (CSS) impregnated triple-lumen catheter. The mean duration of placement for the full sample of
118 CVCs was 12.3 days (range, 1-14). No statistically significant difference in CRI rates between the two types of catheters could be demonstrated. The most common source of primary CRBSI was skin, followed by hub and infusate. The site of CVC insertion (internal jugular versus subclavian vein) and the use of parenteral nutrition were not noted to be risk factors for catheter infection. There was no clinical evidence of catheter-related thrombosis in either of the study groups.
Conclusion: This study was unable to demonstrate that antimicrobial catheters provided any significant benefit over standard catheters, which it is felt, can safely be left in place for up to 14 days with appropriate infection control measures. The most common source of CRI was the skin. The administration of parenteral nutrition and the site of catheter insertion (internal jugular vein versus subclavian vein) were not noted to be risk factors for CRI. There was no clinical evidence of thrombotic complications in either of the study groups. This study offers direction for the use of CVCs in critically ill patients and addresses many of the controversies that exist
Worst Case Scenario and Stakeholder Group Decision: A 5-6 Meter Sea Level Rise in the Rhone Delta, France
Get PDFRisk policy and public attitudes appear disconnected from research predicting warmer climate partially due to human activity. To step out of this stalled situation, a worst case scenario of a 5-6m sea level rise (SLR) induced by the collapse of the WAIS and occurring during the period 2030-2130 is constructed and applied to the Rhone delta. Physical and socio-economic scenarios developed with data from the Rhone delta context are developed and submitted to stakeholders for a day-long workshop. Group process analysis shows a high level of trust and cooperation mobilized to face the 5-6m SLR issue, despite potentially diverging interests. Two sets of recommendations stem from the scenario workshop. A conservative "wait and see" option is decided when the risk of the WAIS collapse is announced in 2030. After WAIS collapse generates an effective 1m SLR rise by 2050, decisions are taken for total retreat and rendering of the Rhone delta to its hydrological function. The transposition of these results into present times policy decisions could be considered. The methodology developed here could be applied to other risk objects and situations, and serve for policy exercises and crisis prevention.Sea level rise, France, Camargue, scenario, extreme climate, stakeholder workshop
Fictions sur mer : place de la mer dans l'écriture minimaliste de Francis Dannemark
Get PDFThe sea and the beach play a very specific role in the minimalist scenes and fiction of the contemporary Belgian francophone writer Francis Dannemark. They represent both space undefinition and fantasmatic escape. Our critical approach will try to illustrate that in several Dannemark's novels unanimously considered as "minimalist" and "postmodern" by criticism. The author tries to illustrate the narrative technique present in these novels as well as the specific and ambiguous vision of Belgium emerging from them through the theme of the sea
Nutrition in the critically ill in resourcelimited settingslow and middleincome countries
No full textFictions-sur-mer : place de la mer dans l'écriture minimaliste de Francis Dannemark
Get PDFThe sea and the beach play a very specific role in the minimalist scenes and fiction of the contemporary Belgian francophone writer Francis Dannemark. They represent both space undefinition and fantasmatic escape. Our critical approach will try to illustrate that in several Dannemark’s novels unanimously considered as “minimalist” and “postmodern” by criticism. The author tries to illustrate the narrative technique present in these novels as well as the specific and ambiguous vision of Belgium emerging from them through the theme of the sea
Testing protoplanetary disc dispersal with radio emission
No full textWe consider continuum free–free radio emission from the upper atmosphere of protoplanetary discs as a probe of the ionized luminosity impinging upon the disc. Making use of previously computed hydrodynamic models of disc photoevaporation within the framework of extreme-ultraviolet (EUV) and X-ray irradiation, we use radiative transfer post-processing techniques to predict the expected free–free emission from protoplanetary discs. In general, the free–free luminosity scales roughly linearly with ionizing luminosity in both EUV- and X-ray-driven scenarios, where the emission dominates over the dust tail of the disc and is partial optically thin at cm wavelengths. We perform a test observation of GM Aur at 14–18?GHz and detect an excess of radio emission above the dust tail to a very high level of confidence. The observed flux density and spectral index are consistent with free–free emission from the ionized disc in either the EUV- or the X-ray-driven scenario. Finally, we suggest a possible route to testing the EUV- and X-ray-driven dispersal model of protoplanetary discs, by combining observed free–free flux densities with measurements of mass-accretion rates. On the point of disc dispersal one would expect to find an M?2? scaling with free–free flux in the case of EUV-driven disc dispersal or an ?* scaling in the case of X-ray-driven disc dispersa
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