35 research outputs found
20th century behaviour of Drygalski Ice Tongue, Ross Sea, Antarctica
No full textDrygalski Ice Tongue is the floating seaward extension of David Glacier, a large outlet glacier draining from Talos and Circe Domes of the East Antarctic ice sheet. Several explorers mapped and described Drygalski Ice Tongue in the early years of the 20th century and, although this information does not allow detailed interpretation of ice-tongue behaviour, it is clear that from 1900-12 it was a significant feature extending 65-75km from the coast. More detailed information has been compiled from aerial photographs and satellite images. In December 1956, the ice tongue was about 100km long. By December 1957, a major calving event had occurred and the outer 40km of the ice tongue had broken away. This is the only major 20th century calving event identified, and it may have occurred during a violent storm that affected the Ross Sea in mid-June 1957. By 1960, further minor ice loss had occucrred but, since that time, Drygalski Ice Tongue has maintained the same shape. -from Author
Patient selection for transcatheter aortic valve implantation (TAVI) in South Africa
No full textPatient selection is likely to be the most important determinant of a successful long term outcome of the TAVI procedure. It requires careful assessment of the indications for aortic valve replacement, clinical status of the patient, associated co-morbidities and, importantly, the cognitive function and motivation of the patient. This assessment must be made by a multi-disciplinary team consisting of at least a cardiologist, cardiac surgeon, anaesthetist and general physician. Careful imaging of the relevant anatomywith ultrasound and CT scanning is critical. Experience improves patient selection and ultimate outcome. Funding remains a challenge and many patients worthy of the procedure are denied because of costs
Insights into the Elder Care Conundrum through complementary use of SSM and TOC
No full textWhether a parent should move into an assisted care facility can be a difficult decision for families and one that is increasingly evident as the „baby-boomer‟ population ages. This paper explores decisions about how best to care for elderly family members and in particular, whether a parent should move (or be moved) into an assisted care facility (ACF). The problematic situation is described as based on personal experience of the first author initially. Two complementary lenses were then employed as problem structuring aids, providing critical insights into the dilemma facing family members. A Soft Systems Methodology (SSM) was used first, followed by the Evaporating Cloud (EC) method from the Theory of Constraints. This use of complementary lenses in multimethodological fashion allowed the elicitation, clarification and elaboration of assumptions underlying the issue of whether the parent should go into an ACF. As a result, multiple avenues for resolving the issue are surfaced, along with several opportunities for further research. This paper contributes to Community OR by this case study showing how the different frames can work to address the fraught situation in which families can find themselves, as they seek to safeguard their elderly parents by accessing ACF, while also endeavouring to maintain satisfactory family relationships. The paper makes a unique contribution, not just in terms of highlighting the elder care situation and suggesting ways forward, but also in terms of the multi-methodological use of SSM and TOC. Finally, it is significant that the case study arose from the use of SSM in the USA, where such „Soft OR‟ methods are rarely applied
Acute renal failure in the cardiac intensive care unit – A practical approach to management
No full textThe association between cardiovascular disease and acute renal failure (ARF) and acute-on-chronic renal failure is less well defined. In the cardiac intensive care unit (CICU), the presence of ARF imparts a significant mortality. The predominant aetiology of ARF in the CICU relates to hypotension, although other causes are certainly involved too, and both contrast nephropathy and cholesterol embolisation may be associated with percutaneous coronary intervention. Despite the availability of renal replacement therapies, preventative measures remain the most important element of management. Specific therapy includes management of the patient’s volume status, vasoactive medication and renal replacement therapy in the way of dialysis. In the setting of acute renal failure, both patient and renal outcome is improved with the early involvement of a nephrological service
Vagueness, Inconsistency and Less Respect for Charter Rights of Accused at the Supreme Court in 2012-2013
No full textThis paper suggests that several recent decisions of the Supreme Court show undue vagueness, inconsistency and less resolve to protect the Charter rights of accused. The rhetorical reliance on the language of Charter “values” of “equality, autonomy, liberty, privacy and human dignity” in R. v. Mabior is seen as increasingly unruly and leading to considerable inconsistency. Leaving the test of intervening cause largely untethered in R. v. Mabin is found to be unfortunate. It is suggested that complex and deeply divided rulings in R. v. Prokofiew have left comments on the accused’s silence at trial to the largely unfettered discretion of trial judges, the reby unnecessarily further diminishing the Charter right to silence. The new R. v. Nedelcu definition for section 13 use immunity protection revived the distinction between evidence that incriminates and evidence going to credibility. The author is of the view that Binnie J.’s decision for a unanimous Court in R. v. Henry had persuasively decided that this distinction is in practice too difficult to draw, and that this key determination should not have been overruled. The paper draws attention to the Court’s having avoided rather than considered Charter standards of moral involuntariness for defences declared in R. v. Ruzic and the Court’s previous Charter rulings on voluntariness intoxication in R. v. Daviault. Finally, the author finds rampant inconsistency in the Court’s approach to judicial notice. These concerns go to the legitimacy of the rule of law the Court often proudly invokes
The changing face of the Constantia Valley a temporal study of land use change in a heritage landscape
No full textIncludes bibliographical references.The study of land use change and urban morphology requires a multi-layered approach. Case studies are needed to gain an understanding of the local factors that are driving land use change and forming urban landscapes. This study will provide a temporal perspective on land use change in the Constantia Valley, a high income suburb on the outskirts of Cape Town. It will contextualise the efforts to conserve its heritage and, furthermore, attempt to explain the factors underlying the observed changes in the urban form. This study, through the use of Geographic Information System (GIS) mapping and a series of interviews, examines how and why the urban form of the Constantia Valley has changed. Finally, based on the findings the possible future urban form of Constantia will be considered
The exegesis of Tabatabaei and the Hermeneutics of Hirsch: a comparative study
No full textThis thesis is a comparative study between Hermeneutics on the one hand and exegesis of the Holy Qur'an on the other. Its objective is to discover whether there are salient points of convergence between the two disciples, and whether issues germane to the Hermeneutical tradition in the West have been referred to and/or employed in Muslim works of Qur'an commentary. To this end, the works of one of the most prominent Shi'ite philosophers and exegetes. Allama Mohammad Hossein Tabataei, have been analysed and compared with the perspective and methodology of E D. Hirsch, one of the most important hermeneuticians in the Western World. Hirsch has been chosen since, in the opinion of the author, there is a considerable number of commonalities between the Hirschian approach to hermeneutics and the exegetical methodology of Tabatabaei and other Shi'ite Muslim interpreters of the Qur'an.. Hirsch, as an objectivist, along with a number of other Hermeneutical scholars, are critical of those who subscribe to philosophical Hermeneutics, such as Heideger and Gadimer. The same approach is taken in Tabatabaei's works, thus providing a strong rationale for an academic comparison of these two scholars. For this reason, this thesis attempts to study the theories of Tabatabaei and Hirsch in order to highlight the similarities and differences in their works. The central hypothesis is that while small differences in approach exist, there is much common ground, and that it is possible to use certain facets of Hirschian hermeneutics in the interpretation of the Qur'an, thus modernising some of the existing exegetical approaches employed by Shi'ite scholars.Since the aim of this thesis is to compare the interpretive works of Tabatabaei with those of Hirsch's, an introductory chapter has been dedicated to the study of the evolution of Shi'ite exegesis from the beginning to date. Tabatabaei's Al-Mizan has been chosen as the foremost work of Shi'ite exegesis in the modem period. Furthermore, a complete chapter has also been dedicated to Tabatabai's exegetical modus operandi as reflected in Al-Mizan, in order to arrive at a better understanding of his perspectives. This research arrives at the conclusion that philosophical Hermeneutics and Epistemology have opened new horizons on which we will always be dependent. Whatever interpretive theories with regards to the understanding of the text are accepted, or whatever the tendency as far as literary criticism is concerned, or whatever ideas are accepted in the arena of philosophy of human and social sciences, the discussion of the nature of understanding in general cannot be avoided. This does not mean that Hermeneutics is limited to these new theories. Rather, the opportunity always exists to introduce new interpretive theories in connection with the understanding of the text. It is indeed possible to study these discussions in detail in a separate sphere independent of the other branches of Islamic sciences and arrive at a number of stable principles in the interpretation of the text in Islamic research
Transcatheter aortic valve replacement in a patient with an anomalous origin of the right coronary artery
No full textFirst case of trans apical implantation of an aortic valve in a patient with dextrocardia
No full textAbstract We describe the clinical presentation and implantation procedure of the first transcatheter aortic valve implantation described in a patient with dextrocardia.</p
Intracoronary thrombus: Role in coronary occlusion complicating percutaneous transluminal coronary angioplasty
No full textAngiograms from 238 consecutive patients who underwent percutaneous transluminal coronary angioplasty at the Mayo Clinic were reviewed to determine the presence of Intracoronary thrombus before dilation. Patients with previously occluded vessels and those receiving streptokinase therapy were excluded. Intracoronary thrombus before dilation was present in 15 patients (6%); complete occlusion occurred in 11 (73%) of these during or immediately after dilation. None of these patients had angiographic evidence of major intimal dissection. In contrast, among the 223 patients in whom no intracoronary thrombus was present before dilation, complete occlusion occurred in 18 (8%) and in 12 was associated with major intimal dissection. The difference between the complete occlusion rates for patients with and without prior intracoronary thrombus was highly significant (73 versus 8%, respectively, p < 0.001).Therefore, the presence of Intracoronary thrombus identifies a group of patients who are at increased risk of developing complete occlusion during or after attempted coronary artery dilation
