640 research outputs found
Effects of fentanyl and S(+)-ketamine on cerebral hemodynamics, gastrointestinal motility, and need of vasopressors in patients with intracranial pathologies - A pilot study
No full textIn neurosurgical patients, opioids are administered to prevent secondary cerebral damage. Complications often related to the administration of opioids are a decrease in blood pressure affording the use of vasopressors and intestinal atonia. One alternative approach to opioids is the application of S(+)ketamine. However, owing to a suspected elevation of intracranial pressure (ICP), the administration of S(+)-ketamine has questioned for a long time. The aim of the present study was to evaluate ICP, gastrointestinal motility, and catecholamine consumption in neurosurgical patients undergoing 2 different protocols of anesthesia using fentanyl or S(+)-ketamine. Twenty-four patients sustaining traumatic brain injury or aneurysmal subarachnoid hemorrhage received methohexitone plus either fentanyl or S(+)-ketamine to establish a comparable level of sedation. To reach an adequate cerebral perfusion pressure (CPP), the norepinephrine dosage was adapted successively. Enteral nutrition and gastrointestinal stimulation were started directly after admission on the critical care unit. ICP, CPP, and norepinephrine dosage were recorded over 5 days and also the time intervals to full enteral nutrition and first defecation. There was no difference regarding ICP, CPP, and the time period until full enteral nutrition or first defecation between both groups. Patients who underwent analgesia with S(+)ketamine showed a trend to a lower demand of norepinephrine compared with the fentanyl group. Our results indicate that S(+)-ketamine does not increase ICP and that its use in neurosurgical patients should not be discouraged on the basis of ICP-related concerns
Effects of hypervolemia and hypertension on regional cerebral blood flow, intracranial pressure, and brain tissue oxygenation after subarachnoid hemorrhage
No full textObjective: Hypertensive, hypervolemic, hemodilution therapy (triple-H therapy) is a generally accepted treatment for cerebral vasospasm after subarachnoid hemorrhage. However, the particular role of the three components of triple-H therapy remains controversial. The aim of the study was to investigate the influence of the three arms of triple-H therapy on regional cerebral blood flow and brain tissue oxygenation. Design: Animal research and clinical intervention study. Setting: Surgical intensive care unit of a university hospital. Subjects and Patients: Experiments were carried out in five healthy pigs, followed by a clinical investigation of ten patients with subarachnoid hemorrhage. Interventions: First, we investigated the effect of the three components of triple-H therapy under physiologic conditions in an experimental pig model. In the next step we applied the same study protocol to patients following aneurysmal subarachnoid hemorrhage. Mean arterial pressure, intracranial pressure, cerebral perfusion pressure, cardiac output, regional cerebral blood flow, and brain tissue oxygenation were continuously recorded. Intrathoracic blood volume and central venous pressure were measured intermittently. Vasopressors and/or colloids and crystalloids were administered to stepwise establish the three components of triple-H therapy. Measurements and Main Results: In the animals, neither induced hypertension nor hypervolemia had an effect on intracranial pressure, brain tissue oxygenation, or regional cerebral blood flow. In the patient population, induction of hypertension (mean arterial pressure 143 +/- 10 mm Hg) resulted in a significant (P <.05) increase of regional cerebral blood flow and brain tissue oxygenation at all observation time points. In contrast, hypervolemia/hemodilution (intrathoracic blood volume index 1123 :L 152 mL/m(2)) induced only a slight increase of regional cerebral blood flow while brain tissue oxygenation did not improve. Finally, triple-H therapy failed to improve regional cerebral blood flow more than hypertension alone and was characterized by the drawback that the hypervolemia/hemodilution component reversed the effect of induced hypertension on brain tissue oxygenation. Conclusions: Vasopressor-induced elevation of mean arterial pressure caused a significant increase of regional cerebral blood flow and brain tissue oxygenation in all patients with subarachnoid hemorrhage. Volume expansion resulted in a slight effect on regional cerebral blood flow only but reversed the effect on brain tissue oxygenation. In view of the questionable benefit of hypervolemia on regional cerebral blood flow and the negative consequences on brain tissue oxygenation together with the increased risk of complications, hypervolemic therapy as a part of triple-H therapy should be applied with utmost caution
Whose story is it anyway? The ethics of narration and the narration of ethics in Summertime and Die Sneeuslaper
No full textIncludes bibliographical references.This dissertation analyses and compares the narrative strategies in J.M. Coetzee’s Summertime and Marlene van Niekerk’s Die sneeuslaper and considers the implications of these strategies for the authors’ exploration of the ethics of writing. Much has been written about the literary oeuvres of both Coetzee and Van Niekerk, including studies of the translations of Van Niekerk’s Afrikaans novels into English. There are few “interlingual” comparative studies of contemporary works in Afrikaans and English, however, and certainly none to my knowledge which compares the work of Coetzee and Van Niekerk. My contribution to the conversation about Coetzee’s and Van Niekerk’s work, but also to an increasingly multilingual and interconnected South African literary criticism, will be a comparison of one recent work by each of these two authors, written in English and Afrikaans respectively. I draw on the theories of Bakhtin, Barthes and Levinas to consider the ethical dimension of texts in which “double-voicedness”, a questioning not only of existence, but of the self is fore grounded in the content and narrative structure; where there is a shift in focus from the author to the reader (“the birth of the reader”) and “utterances” are made with the response of “the other” in mind
Exploring the potential of using bio briquette ash in building materials
No full textAs the population and urbanization increase, the demand for affordable housing and the environmental
impact of conventional materials have become more pronounced. This study seeks sustainable solutions
through the repurposing of waste products. This study examined the potential application of bio-briquette
ash derived from sanitary sludge in building-material production. Bio-briquette ashes were produced by
incinerating bio-briquette char in an open kitchen at temperatures ranging from 300°C to 450°C.The
chemical composition of bio-briquette ashes produced with different binders (cassava peels, wastepaper,
and no binder) was analyzed using X-ray fluorescence (XRF) and X-ray diffraction (XRD). The results
showed that the ashes contain substantial amounts of oxides, including SiO2, Fe2O3, Al2O3, and CaO,
which are comparable to other supplementary cementitious materials like rice husk ash, sugarcane
bagasse ash, and fly ash. The findings indicate that these bio-briquette ashes have low pozzolanic
properties, however, they have the potential to produce cement-based products after activating their
reactivity either by optimization of burning temperature, mechanical grinding or chemical activation to
improve strength, durability, and workability. Future studies will focus on optimizing the burning
temperature, mechanical grinding, or chemical activation of the bio-briquette ashes to enhance their
reactivity as well as utilizing bio-briquette ash in building materials production and evaluating their
performance in practical applications.The author would like to express gratitude to
the funder of this research project, the Vrilous
Project of Belgium, as well as Ardhi University for
sponsoring this study. Special thanks are
extended to Prof. Elke Knapen from Hasselt
University and Prof. Shadrack M. Sabai from
Ardhi University for their valuable support
throughout the research. Additional appreciation
goes to the project team members of the
Decent Housing Project, as well as the
management of Hasselt University in Belgium
and Ardhi University in Tanzania, for their
administrative assistance
Exploring the potential of using bio briquette ash in building materials
No full textAs the population and urbanization increase, the demand for affordable housing and the environmental
impact of conventional materials have become more pronounced. This study seeks sustainable solutions
through the repurposing of waste products. This study examined the potential application of bio-briquette
ash derived from sanitary sludge in building-material production. Bio-briquette ashes were produced by
incinerating bio-briquette char in an open kitchen at temperatures ranging from 300°C to 450°C.The
chemical composition of bio-briquette ashes produced with different binders (cassava peels, wastepaper,
and no binder) was analyzed using X-ray fluorescence (XRF) and X-ray diffraction (XRD). The results
showed that the ashes contain substantial amounts of oxides, including SiO2, Fe2O3, Al2O3, and CaO,
which are comparable to other supplementary cementitious materials like rice husk ash, sugarcane
bagasse ash, and fly ash. The findings indicate that these bio-briquette ashes have low pozzolanic
properties, however, they have the potential to produce cement-based products after activating their
reactivity either by optimization of burning temperature, mechanical grinding or chemical activation to
improve strength, durability, and workability. Future studies will focus on optimizing the burning
temperature, mechanical grinding, or chemical activation of the bio-briquette ashes to enhance their
reactivity as well as utilizing bio-briquette ash in building materials production and evaluating their
performance in practical applications.The author would like to express gratitude to
the funder of this research project, the Vrilous
Project of Belgium, as well as Ardhi University for
sponsoring this study. Special thanks are
extended to Prof. Elke Knapen from Hasselt
University and Prof. Shadrack M. Sabai from
Ardhi University for their valuable support
throughout the research. Additional appreciation
goes to the project team members of the
Decent Housing Project, as well as the
management of Hasselt University in Belgium
and Ardhi University in Tanzania, for their
administrative assistance
Identification of key measures to promote and enhance cycling for visiting National Parks: A case study of Peak District National Park, England
No full textIncreasing pressure of cars towards National Parks is alarming for both nature and tourists. This research identifies the potential measures that can promote and enhance cycling within and around National Parks. The methodological approach includes 1) a literature review to identify measures sucessfuly implemented in the past in different case studies, 2) development of a questionnaire based on these measures, for inquiry of experts involved in the planning process of the case study, Peak District National Park (PDNP), England and 3) use of Kendall's W coefficient of concordance to determine the consensus among experts, about the rank and order of these potentional measures. The experts are most in favor of a flexible entry fee based on the transport mode of the visitor, a mobility app as a route planner, and infrastructural development. The Kendall's W shows a varying agreement among experts from moderate to strong for different categories of measures. Management implications • The research identifies the need to consider cycling as an essential mode of mobility from the local and visitors' perspective. Cycling is an important, healthy activity that helps people to reach various destinations. • The research highlights important measures that can help managers to convince visitors to use a bicycle instead of another mode. • The research findings provide guidance and a framework to promote and enhance the concept of cycling for managers involved in the planning/policy-making of visitors' mobility within and around a national park. • Managers should divert their focus towards the promotion of active mobility. They should understand that promoting cycling tourism will help them to overcome the dominance by cars. • The research indicates practical steps in order to guide managers in the implementation of the proposed measures.The authors would like to thank a couple of researchers from the University of Derby, Buxton. First of all, a lot of thanks to Dr. Peter Wiltshier and Dr. Iride Azara, senior lecturer in tourism, for providing a platform to collect data and organizing interviews with concerned officials. The author would especially like to pay gratitude to Emma Pope, Ph.D. student, University of Derby, for her coordination during the data collection process. Lastly, a bundle of thanks to Michael Reardon, senior transport officer (DCC), for providing access to relevant data. The research work is part of doctoral research. The doctoral research is funded by the Higher Education Commission (HEC), Islamabad, Pakistan. The author would also like to thank the doctoral schools of
Hasselt University for the provision of a mobility grant
Collaborative housing processes: Paradigms in transition from a north South perspective
No full textBy way of introduction, this chapter explains the main differences and convergences in housing provision paradigms in European and Chilean cities. From housing as part of Welfare State models, both societies have seen the replacement of the right to housing by the financialization of housing. The chapter highlights a red thread in this book, namely the presence of “cultures of the collective” in the provision of housing, which responds to different traditions and contexts in cities in the global north and in the global south. However, despite these differences, both relate to the essential question on how urban dwellers decide on how they want to live.Housing Managemen
Writers, artists, mothers: Author figures in the short fiction of Mary Lavin
No full textThis paper traces the development figures of the author in the short fiction of the Irish writer Mary Lavin against the background of her anomalous position as woman, writer and mother in the conservative and patriarchal context of mid-century Ireland. Through a detailed reading of six stories, the paper shows how after staging a confident author figure in the early "A Story With A Pattern", Lavin dramatized the tension between her roles as mother and artist in a series of oppositional characters in stories such as "The Becker Wives", "Eterna" and "In a Café". Her artist figures, modelled after the Romantic conception of the author as exceptionally gifted outsiders, are thus unable to attain 'ordinary' lives as wives or mothers; while her alter ego in the so-called widow stories are mostly realised as 'just' wife, widow and mother. Only in two stories written at the end of her career does Lavin again stage an author figure who combines the roles of mother and writer, thus offering an alternative to the Romantic and predominantly masculine image of the author that has long dominated Irish literary culture.status: Publishe
Elke Mustamäe AS car wash cost-benefit analysis
No full textLõputöö eesmärgiks oli analüüsida Elke Mustamäe AS-i pesukorraldust ning leida lahendus efektiivsuse tõstmiseks. Peamised probleemid, mis paistsid koheselt silma, olid seotud töökoja sissesõidutee kasutamisena sekundaarse pesualana ning pesuteenuste jagamine SmartService OÜ teenusepakkujaga. Samuti oli vaja leida lahendus ettevõttesiseste pesuteenuste omakulude vähendamiseks. Lahenduste leidmisel oli abiks firma poolt autorile jagatud firmasisesed dokumendid laiendustööde planeeringuks, kuid mille otstarbeka kasutamise osas veel ideid ei olnud. Lõputöö käigus analüüsiti pesuteenuste mahtu ning nendega kaasnevaid kulutusi ettevõttele. Ülevaate saamiseks uuris autor kõikide pesuteenuse omamaksumust, et leida reaalne kasum või kahjum. Selgus, et kõik ettevõttes müüdavad teenused on võimelised tekitama kasumit, kuid ettevõttesiseste pesude kulutused ja töömahu jagamine SmartService OÜ teenusepakkujaga, on kokkuvõttes ettevõttele kahjumit teenivad faktorid. Teenuse sisseostmise puhul on tegemist puhtalt potentsiaalse kasumi ära andmisega teisele ettevõttele. Lõputöö lahendusena jõudis autor järeldusele, et SmartService OÜ teenuse kasutamine ei ole majanduslikult ettevõttele kasulik ning teenuse sisseostmine sellisel kujul tuleks lõpetada. Teenusest loobumine tooks ettevõtte pesuteenuste kahjumi väiksesse kasumisse. Kasumi suurendamiseks ja ettevõttesiseste kulutuste vähendamiseseks. pakkus autor välja automaatpesula soetamise, mis sobiks ideaalselt planeeritavasse laiendusse. Arvutuste käigus selgus, et masinapesu kombineerimisel käsipesuga demo-, rendi- ja keretööde autode pesemisel tooks ettevõtte, varem kahjumit teenivad pesuteenused, kasumisse. Sellega kaasneks ka suur ajaline kokkuhoid, mida saaks kasutada klientidele autopesu müümiseks letist. Kokkuvõttes oleks sellise lahendusega tagatud ka automaatpesuseadme tasuvus autori hinnangul kolme aastaga. Töökoja sissesõiduteel oleva pesula saaks koos tehnikaga kolida uude planeeritavasse laiendusse.The purpose of this graduation thesis was to analyze Elke Mustamäe car washing services and to raise the overall efficiency. The main problems, that stood out instantly, were related to using workshop driveway as a secondary workstation for cleaning cars and sharing washing workload with SmartService OÜ. Second objective was to reduce the expenses of washing cars, that does not produce any sort of income for the company. These types of cars are for example company´s own cars like rental or test drive cars or those, that are being worked on in body shop. To find solutions, the management helped the author by providing information about the future expansion plan, that involved building a new washing bay, although there was not a certain plan how to use it yet. During the graduation thesis, author analyzed the expenses related to each washing procedure to find out the actual profit of providing these types of services. It turned out, that all of them were capable to earn profit, but the cost of washing cars that will not make any income and sharing the profit with SmartService OÜ, is altogether creating financial a loss for the company. As a solution to the thesis, the author came in to the conclusion that using the service of SmartService OÜ is not economically beneficial for the company and the partnership in this form should be cancelled. As a result, ending the partnership would bring the loss of the company´s washing services to a small profit. In order to reduce internal costs, the author suggested the purchase of an automatic vehicle wash system, which would fit perfectly into the planned expansion. The calculations showed that combining machine washing with hand washing would bring down the costs of washing the company´s own and body shop cars. This would also result in a large time savings that could be used to offer washing services to clients. All in all, such a solution would also guarantee the profitability of the automatic washing system in approximately three years and eventually the financial loss is going to be turned into a profit. The washing bay which is currently located at workshop driveway could be moved into the planned expansion to make more room for other cars to maneuver in the workshop
Bij elke kaartschaal de juiste digitale geodata
No full textOTB ResearchOTB Research Institute for the Built Environmen
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