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Статті в журналах з теми "Continuous and deep sedation"
1
Yokomichi, Naosuke, Takuhiro Yamaguchi, Isseki Maeda, Masanori Mori, Kengo Imai, Akemi Shirado Naito, Takashi Yamaguchi, et al. "Effect of continuous deep sedation on survival in the last days of life of cancer patients: A multicenter prospective cohort study." Palliative Medicine 36, no. 1 (January 2022): 189–99. http://dx.doi.org/10.1177/02692163211057754.
Повний текст джерелаАнотація:
Background: Continuous deep sedation is ethically controversial with respect to whether it shortens a patient’s life. Aim: To examine whether continuous deep sedation shortens patient survival from the day of Palliative Performance Scale decline to 20 (PPS20). Design: A part of a multicenter prospective cohort study (EASED study). Setting/participants: We recruited consecutive adult patients with advanced cancer admitted to 23 participating palliative care units in 2017 in Japan. We compared survival from PPS20 between those who did and did not receive continuous deep sedation. Continuous deep sedation was defined as the continuous administration of sedative medication with the intention to keep a patient continuously unconscious to alleviate otherwise uncontrollable symptoms, but the dose of sedatives was adjusted to achieve adequate symptom relief for each patient. The propensity score-weighting method was used to control for potential confounders, and five sensitivity analyses were performed. Results: A total of 1926 patients were enrolled. Patients discharged alive were excluded, and we analyzed 1625 patients of whom 156 (9.6%) received continuous deep sedation. Median survival from PPS20 of 1625 patients was 81 h (95% CI: 77–88). The RASS scores decreased to ⩽−4 was 66% at 24 h. Continuous deep sedation was not associated with a significant survival risk (adjusted hazard ratio: 1.06, 95% CI: 0.85–1.33). All sensitivity analyses, including continuous deep sedation defined as the RASS score was ⩽−4 achieved the essentially the same results. Conclusions: Continuous deep sedation with careful dose adjustment was not associated with shorter survival in the last days of life in patients with advanced cancer.
2
Twycross, Robert. "Reflections on palliative sedation." Palliative Care: Research and Treatment 12 (January 2019): 117822421882351. http://dx.doi.org/10.1177/1178224218823511.
Повний текст джерелаАнотація:
‘Palliation sedation’ is a widely used term to describe the intentional administration of sedatives to reduce a dying person’s consciousness to relieve intolerable suffering from refractory symptoms. Research studies generally focus on either ‘continuous sedation until death’ or ‘continuous deep sedation’. It is not always clear whether instances of secondary sedation (i.e. caused by specific symptom management) have been excluded. Continuous deep sedation is controversial because it ends a person’s ‘biographical life’ (the ability to interact meaningfully with other people) and shortens ‘biological life’. Ethically, continuous deep sedation is an exceptional last resort measure. Studies suggest that continuous deep sedation has become ‘normalized’ in some countries and some palliative care services. Of concern is the dissonance between guidelines and practice. At the extreme, there are reports of continuous deep sedation which are best described as non-voluntary (unrequested) euthanasia. Other major concerns relate to its use for solely non-physical (existential) reasons, the under-diagnosis of delirium and its mistreatment, and not appreciating that unresponsiveness is not the same as unconsciousness (unawareness). Ideally, a multiprofessional palliative care team should be involved before proceeding to continuous deep sedation. Good palliative care greatly reduces the need for continuous deep sedation.
3
Rady, Mohamed Y., and Joseph L. Verheijde. "Uniformly defining continuous deep sedation." Lancet Oncology 17, no. 3 (March 2016): e89. http://dx.doi.org/10.1016/s1470-2045(15)00585-9.
Повний текст джерела
4
Ortega Pacheco, Yesid José. "Continuous deep sedation and euthanasia." Atención Primaria 55, no. 3 (March 2023): 102568. http://dx.doi.org/10.1016/j.aprim.2023.102568.
Повний текст джерела
5
Morita, Tatsuya, Isseki Maeda, Masanori Mori, Kengo Imai, and Satoru Tsuneto. "Uniform definition of continuous-deep sedation." Lancet Oncology 17, no. 6 (June 2016): e222. http://dx.doi.org/10.1016/s1470-2045(16)30115-2.
Повний текст джерела
6
Morita, Tatsuya, Tatsuo Akechi, Yuriko Sugawara, Satoshi Chihara, and Yosuke Uchitomi. "Practices and Attitudes of Japanese Oncologists and Palliative Care Physicians Concerning Terminal Sedation: A Nationwide Survey." Journal of Clinical Oncology 20, no. 3 (February 1, 2002): 758–64. http://dx.doi.org/10.1200/jco.2002.20.3.758.
Повний текст джерелаАнотація:
PURPOSE: To clarify the frequency of practice of sedation therapy for terminally ill cancer patients and to identify physicians’ attitudes toward sedation. METHODS: Questionnaires were mailed to 1,436 Japanese oncologists and palliative care physicians with a request to report their practice of and attitudes toward palliative sedation therapy. RESULTS: A total of 697 physicians returned questionnaires (response rate, 49.6%). Use of mild, intermittent-deep, or continuous-deep sedation for physical and psychologic distress was reported by 89% and 64%, 70% and 46%, and 66% and 38%, respectively. In vignettes in which physicians were asked whether they would use sedation for a patient with refractory dyspnea or with existential distress, 14% and 15%, respectively, chose continuous-deep sedation as a strong possibility. Those physicians less confident with psychologic care and with higher levels of professional burnout were more likely to choose continuous-deep sedation. In vignettes in which they were asked whether they use sedation for a patient with depression or delirium, 39% and 31%, respectively, considered psychiatric treatment to be a strong possibility, and 42% and 50% regarded continuous-deep sedation as a potential treatment option. Physicians less involved in caring for the terminally ill and less specialized in palliative medicine were significantly less likely to choose psychiatric treatment. CONCLUSION: Sedation is frequently used for severe physical and psychologic distress of cancer patients. Physicians’ clinical experiences with the terminally ill and their levels of professional burnout influence the decisions. Training and education for physicians in regard to end-of-life care and valid clinical guidelines for palliative sedation therapy are necessary.
7
Ziegler, Sarah, Margareta Schmid, Matthias Bopp, Georg Bosshard, and Milo Alan Puhan. "Using sedative substances until death: A mortality follow-back study on the role of healthcare settings." Palliative Medicine 33, no. 2 (December 5, 2018): 213–20. http://dx.doi.org/10.1177/0269216318815799.
Повний текст джерелаАнотація:
Background: In the last decade, the use of sedative substances to keep a patient in deep sedation until death increased fourfold in German-speaking Switzerland, where every third patient admitted to hospital, palliative care unit or hospice died continuously deeply sedated. Aim: To investigate sedation practices across healthcare settings and to identify their associations with conventional symptom control. Design: National mortality follow-back study in Switzerland between 2013 and 2014. Questionnaires on medical end-of-life decisions were sent to attending physicians of a continuous random sample of all registered deaths aged 1 year or older. Setting/participants: Of all sampled deaths, 3678 individuals who died non-suddenly and not through an external cause were included. Results: Across settings, continuous deep sedation appeared more likely in patients aged younger than 65 years (odds ratio range: 1.53–2.34) and as part of or after intensified alleviation of pain and symptoms (odds ratio range: 1.90–10.27). In hospitals, sedation was less likely for cancer patients (odds ratio: 0.7, 95% confidence interval: 0.5–1.0, p = 0.022). In nursing homes, sedation was more likely for people who were married (odds ratio: 1.8, 95% confidence interval 1.3–2.5, p = 0.001). Conclusion: In all settings, sedated patients have significantly more pain problems compared to patients not receiving sedation. Large differences between settings seem to indicate different patient populations, different levels of professionals’ palliative care experience and different availability of treatment options. Our study suggests that certain patient groups who may be as vulnerable to refractory pain and symptoms as others are less likely to receive continuous deep sedation until death when warranted.
8
Murray, Scott A., Kirsty Boyd, and Ira Byock. "Continuous deep sedation in patients nearing death." BMJ 336, no. 7648 (March 14, 2008): 781–82. http://dx.doi.org/10.1136/bmj.39511.514051.80.
Повний текст джерела
9
Rietjens, JAC, HM Buiting, HRW Pasman, PJ van der Maas, JJM van Delden, and A. van der Heide. "Deciding about continuous deep sedation: physicians’ perspectives." Palliative Medicine 23, no. 5 (March 20, 2009): 410–17. http://dx.doi.org/10.1177/0269216309104074.
Повний текст джерела
10
Imai, Kengo, Tatsuya Morita, Masanori Mori, Naosuke Yokomichi, Toshihiro Yamauchi, Satoru Miwa, Satoshi Inoue, et al. "Family experience of palliative sedation therapy: proportional vs. continuous deep sedation." Supportive Care in Cancer 30, no. 5 (January 18, 2022): 3903–15. http://dx.doi.org/10.1007/s00520-021-06745-1.
Повний текст джерелаДисертації з теми "Continuous and deep sedation"
1
Blondet, Vanessa. "Les pratiques sédatives en unités de soins palliatifs, entre travail du care et négociation." Thesis, Strasbourg, 2019. https://publication-theses.unistra.fr/restreint/theses_doctorat/2019/Blondet_Vanessa_2019_ED519.pdf.
Повний текст джерелаАнотація:
Quels sont les différentes formes de la sédation en unité de soins palliatifs ? Comment les sédations sont-elles négociées entre les soignants, le patient et ses proches ? Qu’est-ce que l’usage du Midazolam et sa négociation nous dit du travail en unité de soins palliatifs en France ? Cette thèse repose sur une enquête qualitative menée auprès de quatre structures de soins palliatifs différentes. Le travail s’appuie sur des observations directes et indirectes au sein des structures, le suivi des évolutions dans les doses de Midazolam pour 42 patients, ainsi que soixante entretiens semi-directifs. L'analyse des matériaux montre l’existence de huit usages du Midazolam, dont cinq pratiques sédatives. Les entretiens révèlent que le travail en soins palliatifs vise notamment à (re)socialiser la fin de vie. Cette visée entre en contradiction avec la mise en place d’une sédation profonde et continue jusqu’au décès, ce qui amène parfois les équipes à préférer une sédation plus progressiveWhat are the different type of sedation in palliative care units ? How caregivers, patients and relatives negociate any kind of sedation ? What are uses of Midazolam and its negociation saying about the work in palliative care units in France ? This thesis is based on a qualitative survey, conducted among four palliative care structures. The work is based on direct and undirect observations, tracking Midazolam doses progression for 42 patients, and sixty semi-structured interviews. Materials analysis show eight Midazolam uses and among them, five sedations types. Semi-structured interviews show that palliative care work seek notably end of life (re)socialisation. Yet, there is a contradiction between this goal and the implementation of continuous deep sedation until death. Therefore, caregivers sometimes prefer a more progressive form of sedation
2
Bando, Catherine. "Assisted Death: Historical, Moral and Theological Perspectives of End of Life Options." Digital Commons at Loyola Marymount University and Loyola Law School, 2018. https://digitalcommons.lmu.edu/etd/513.
Повний текст джерелаАнотація:
The paper explores historical positions on suicide and philosophical, theological, and moral positions on physician-assisted suicide and euthanasia. In 1900, most people died from infectious diseases, which have relatively short periods of morbid decline. With advances in the biomedical sciences, people are living longer, and most people die from chronic diseases, which are usually accompanied by prolonged periods of morbid decline. In addition to living longer, people today are generally more individualist and seek methods to control many aspects of life. While assisted death is rarely used, it represents a means to control end-of-life suffering. The paper demonstrates that there is substantial opposition to assisted death among philosophers, theologians and bioethicists. The paper also argues that improved education about end-of-life palliative alternatives would alleviate fears about end-of-life suffering. The thesis is that the use of palliative alternatives is morally and ethically superior to physician-assisted suicide or euthanasia.
3
Treggiari, Miriam Monica. "Randomized trial of light versus deep sedation on mental health after critical illness /." Thesis, Connect to this title online; UW restricted, 2007. http://hdl.handle.net/1773/10928.
Повний текст джерела
4
Le, Dorze Matthieu. "Les facultés éthiques des réanimateurs, l'ajustement et l'alignement." Electronic Thesis or Diss., université Paris-Saclay, 2024. http://www.theses.fr/2024UPASR033.
Повний текст джерелаАнотація:
Les réanimatrices et les réanimateurs sont amenés quotidiennement à accompagner la fin de vie. La réalité de leurs décisions et de leurs pratiques de fin de vie y est complexe impliquant de nombreuses personnes (le patient, ses proches, les soignants), de multiples éléments médicaux et non médicaux, et souvent plusieurs inconnues et incertitudes. L'intention de ce travail doctoral est, par une approche descriptive et analytique, d'expliciter cette complexité dans l'objectif de mettre à jour, par une approche normative, des facultés éthiques que les réanimateurs pourraient développer pour bien agir ou du moins pour agir le mieux possible. Ce travail s'appuie sur trois axes méthodologiques : un savoir expérientiel individuel, une réflexion collective et une démarche scientifique pluridisciplinaire associant enquêtes, recherches quantitatives et qualitatives. Il se déploie dans deux axes thématiques en explorant à la fois la qualification de l'obstination déraisonnable, la sédation profonde et continue et la déclaration de la mort dans le contexte ordinaire de la fin de vie en réanimation, et leurs reconfigurations dans le contexte plus spécifique du don d'organes Maastricht III. Cette fabrique de l'éthique structurée par la réalité concrète des situations cliniques conduit à mettre en évidence deux facultés, l'ajustement et l'alignement, construites et enrichies progressivement au cours de la réflexion. Seules des institutions attentives au développement d'un climat éthique apaisé sont à même de permettre aux réanimateurs de mobiliser ces facultés pour investir positivement les tensions liées à l'accompagnement de fin de vie et au don d'organes comme les objets d'une inventivité éthique sans cesse renouveléeIn routine daily practice, intensive care physicians are involved in end-of-life care. Their end-of-life decisions and practices are highly complex, involving many people (patient, relatives, and caregivers), a variety of medical and non-medical factors, and often a number of unknowns and uncertainties.The aim of this work is to describe and analyze this complexity with a view to highlighting, throw a normative approach, the ethical faculties that intensive care physicians could use to act well or at least as well as possible. This work is based on three methodological approaches: individual experience, group discussion, and a multidisciplinary scientific approach that includes surveys as well as quantitative and qualitative research. It is based on two different areas of research: The definition of “unreasonable obstinacy”, continuous deep sedation and the declaration of death in the everyday context of end-of-life in intensive care, and how these are reshaped in relation to the specific issue of controlled donation after circulatory death. This ethical process, based on the practical realities of clinical situations, provides the basis for two skills - fit and line. These skills are developed and improved step by step. It is only through organisations concerned with the development of a peaceful ethical climate that intensive care physicians will be able to use these skills to positively address the tensions associated with end-of-life care and organ donation as a subject of ongoing ethical creativity
5
Conway, Aaron. "Nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: A mixed methods study." Thesis, Australian Catholic University, 2013. https://acuresearchbank.acu.edu.au/download/a71c1257b013741928b98e8cb6c5843c8123a54f7d3ece774609bf0bf0d6c2c2/11420741/64829_downloaded_stream_54.pdf.
Повний текст джерелаАнотація:
Other information: The cardiac catheterisation laboratory (CCL) is a specialised medical radiology facility where both chronic-stable and life-threatening cardiovascular illness is evaluated and treated. Although there are many potential sources of discomfort and distress associated with procedures performed in the CCL, a general anaesthetic is not usually required. For this reason, an anaesthetist is not routinely assigned to the CCL. Instead, to manage pain, discomfort and anxiety during the procedure, nurses administer a combination of sedative and analgesic medications according to direction from the cardiologist performing the procedure. This practice is referred to as nurse-administered procedural sedation and analgesia (PSA). While anecdotal evidence suggested that nurse-administered PSA was commonly used in the CCL, it was clear from the limited information available that current nurse-led PSA administration and monitoring practices varied and that there was contention around some aspects of practice including the type of medications that were suitable to be used and the depth of sedation that could be safely induced without an anaesthetist present. The overall aim of the program of research presented in this thesis was to establish an evidence base for nurse-led sedation practices in the CCL context. A sequential mixed methods design was used over three phases. The objective of the first phase was to appraise the existing evidence for nurse-administered PSA in the CCL. Two studies were conducted. The first study was an integrative review of empirical research studies and clinical practice guidelines focused on nurse-administered PSA in the CCL as well as in other similar procedural settings. This was the first review to systematically appraise the available evidence supporting the use of nurse-administered PSA in the CCL. A major finding was that, overall, nurse-administered PSA in the CCL was generally deemed to be safe.;However, it was concluded from the analysis of the studies and the guidelines that were included in the review, that the management of sedation in the CCL was impacted by a variety of contextual factors including local hospital policy, workforce constraints and cardiologists' preferences for the type of sedation used. The second study in the first phase was conducted to identify a sedation scale that could be used to monitor level of sedation during nurse-administered PSA in the CCL. It involved a structured literature review and psychometric analysis of scale properties. However, only one scale was found that was developed specifically for the CCL, which had not undergone psychometric testing. Several weaknesses were identified in its item structure. Other sedation scales that were identified were developed for the ICU. Although these scales have demonstrated validity and reliability in the ICU, weaknesses in their item structure precluded their use in the CCL. As findings indicated that no existing sedation scale should be applied to practice in the CCL, recommendations for the development and psychometric testing of a new sedation scale were developed. The objective of the second phase of the program of research was to explore current practice. Three studies were conducted in this phase using both quantitative and qualitative research methods. The first was a qualitative explorative study of nurses' perceptions of the issues and challenges associated with nurse-administered PSA in the CCL. Major themes emerged from analysis of the qualitative data regarding the lack of access to anaesthetists, the limitations of sedative medications, the barriers to effective patient monitoring and the impact that the increasing complexity of procedures has on patients' sedation requirements. The second study in Phase Two was a cross-sectional survey of nurse-administered PSA practice in Australian and New Zealand CCLs.;This was the first study to quantify the frequency that nurse-administered PSA was used in the CCL setting and to characterise associated nursing practices. It was found that nearly all CCLs utilise nurse-administered PSA (94%). Of note, by characterising nurse-administered PSA in Australian and New Zealand CCLs, several strategies to improve practice, such as setting up protocols for patient monitoring and establishing comprehensive PSA education for CCL nurses, were identified. The third study in Phase Two was a matched case-control study of risk factors for impaired respiratory function during nurse-administered PSA in the CCL setting. Patients with acute illness were found to be nearly twice as likely to experience impaired respiratory function during nurse-administered PSA (OR=1.78; 95%CI=1.19-2.67; p=0.005). These significant findings can now be used to inform prospective studies investigating the effectiveness of interventions for impaired respiratory function during nurse-administered PSA in the CCL. The objective of the third and final phase of the program of research was to develop recommendations for practice. To achieve this objective, a synthesis of findings from the previous phases of the program of research informed a modified Delphi study, which was conducted to develop a set of clinical practice guidelines for nurse-administered PSA in the CCL. The clinical practice guidelines that were developed set current best practice standards for pre-procedural patient assessment and risk screening practices as well as the intra and post-procedural patient monitoring practices that nurses who administer PSA in the CCL should undertake in order to deliver safe, evidence based and consistent care to the many patients who undergo procedures in this setting.;In summary, the mixed methods approach that was used clearly enabled the research objectives to be comprehensively addressed in an informed sequential manner, and, as a consequence, this thesis has generated a substantial amount of new knowledge to inform and support nurse-led sedation practice in the CCL context. However, a limitation of the research to note is that the comprehensive appraisal of the evidence conducted, combined with the guideline development process, highlighted that there were numerous deficiencies in the evidence base. As such, rather than being based on high-level evidence, many of the recommendations for practice were produced by consensus. For this reason, further research is required in order to ascertain which specific practices result in the most optimal patient and health service outcomes. Therefore, along with necessary guideline implementation and evaluation projects, post-doctoral research is planned to follow up on the research gaps identified, which are planned to form part of a continuing program of research in this field.
6
Conway, Aaron. "Nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory : a mixed methods study." Thesis, Australian Catholic University, 2013. https://eprints.qut.edu.au/61474/1/Final_version_thesis_AC_all_pages_24_6_13.pdf.
Повний текст джерелаАнотація:
The cardiac catheterisation laboratory (CCL) is a specialised medical radiology facility where both chronic-stable and life-threatening cardiovascular illness is evaluated and treated. Although there are many potential sources of discomfort and distress associated with procedures performed in the CCL, a general anaesthetic is not usually required. For this reason, an anaesthetist is not routinely assigned to the CCL. Instead, to manage pain, discomfort and anxiety during the procedure, nurses administer a combination of sedative and analgesic medications according to direction from the cardiologist performing the procedure. This practice is referred to as nurse-administered procedural sedation and analgesia (PSA). While anecdotal evidence suggested that nurse-administered PSA was commonly used in the CCL, it was clear from the limited information available that current nurse-led PSA administration and monitoring practices varied and that there was contention around some aspects of practice including the type of medications that were suitable to be used and the depth of sedation that could be safely induced without an anaesthetist present.
The overall aim of the program of research presented in this thesis was to establish an evidence base for nurse-led sedation practices in the CCL context. A sequential mixed methods design was used over three phases.
The objective of the first phase was to appraise the existing evidence for nurse-administered PSA in the CCL. Two studies were conducted. The first study was an integrative review of empirical research studies and clinical practice guidelines focused on nurse-administered PSA in the CCL as well as in other similar procedural settings. This was the first review to systematically appraise the available evidence supporting the use of nurse-administered PSA in the CCL. A major finding was that, overall, nurse-administered PSA in the CCL was generally deemed to be safe. However, it was concluded from the analysis of the studies and the guidelines that were included in the review, that the management of sedation in the CCL was impacted by a variety of contextual factors including local hospital policy, workforce constraints and cardiologists’ preferences for the type of sedation used.
The second study in the first phase was conducted to identify a sedation scale that could be used to monitor level of sedation during nurse-administered PSA in the CCL. It involved a structured literature review and psychometric analysis of scale properties. However, only one scale was found that was developed specifically for the CCL, which had not undergone psychometric testing. Several weaknesses were identified in its item structure. Other sedation scales that were identified were developed for the ICU. Although these scales have demonstrated validity and reliability in the ICU, weaknesses in their item structure precluded their use in the CCL. As findings indicated that no existing sedation scale should be applied to practice in the CCL, recommendations for the development and psychometric testing of a new sedation scale were developed.
The objective of the second phase of the program of research was to explore current practice. Three studies were conducted in this phase using both quantitative and qualitative research methods. The first was a qualitative explorative study of nurses’ perceptions of the issues and challenges associated with nurse-administered PSA in the CCL. Major themes emerged from analysis of the qualitative data regarding the lack of access to anaesthetists, the limitations of sedative medications, the barriers to effective patient monitoring and the impact that the increasing complexity of procedures has on patients' sedation requirements.
The second study in Phase Two was a cross-sectional survey of nurse-administered PSA practice in Australian and New Zealand CCLs. This was the first study to quantify the frequency that nurse-administered PSA was used in the CCL setting and to characterise associated nursing practices. It was found that nearly all CCLs utilise nurse-administered PSA (94%). Of note, by characterising nurse-administered PSA in Australian and New Zealand CCLs, several strategies to improve practice, such as setting up protocols for patient monitoring and establishing comprehensive PSA education for CCL nurses, were identified.
The third study in Phase Two was a matched case-control study of risk factors for impaired respiratory function during nurse-administered PSA in the CCL setting. Patients with acute illness were found to be nearly twice as likely to experience impaired respiratory function during nurse-administered PSA (OR=1.78; 95%CI=1.19-2.67; p=0.005). These significant findings can now be used to inform prospective studies investigating the effectiveness of interventions for impaired respiratory function during nurse-administered PSA in the CCL.
The objective of the third and final phase of the program of research was to develop recommendations for practice. To achieve this objective, a synthesis of findings from the previous phases of the program of research informed a modified Delphi study, which was conducted to develop a set of clinical practice guidelines for nurse-administered PSA in the CCL. The clinical practice guidelines that were developed set current best practice standards for pre-procedural patient assessment and risk screening practices as well as the intra and post-procedural patient monitoring practices that nurses who administer PSA in the CCL should undertake in order to deliver safe, evidence-based and consistent care to the many patients who undergo procedures in this setting.
In summary, the mixed methods approach that was used clearly enabled the research objectives to be comprehensively addressed in an informed sequential manner, and, as a consequence, this thesis has generated a substantial amount of new knowledge to inform and support nurse-led sedation practice in the CCL context. However, a limitation of the research to note is that the comprehensive appraisal of the evidence conducted, combined with the guideline development process, highlighted that there were numerous deficiencies in the evidence base. As such, rather than being based on high-level evidence, many of the recommendations for practice were produced by consensus. For this reason, further research is required in order to ascertain which specific practices result in the most optimal patient and health service outcomes. Therefore, along with necessary guideline implementation and evaluation projects, post-doctoral research is planned to follow up on the research gaps identified, which are planned to form part of a continuing program of research in this field.
7
Santos, Marcos Eduardo Lera dos. "Sedação em endoscopia digestiva alta: estudo comparativo com uso combinado de propofol e fentanil versus midazolam e fentanil." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5154/tde-23022012-120930/.
Повний текст джерелаАнотація:
Introdução: o uso da sedação na rotina endoscópica tem sido empregado praticamente de maneira universal. O emprego de propofol parece se relacionar a exame mais confortável, com aumento da satisfação com o exame, pelo médico e pelo paciente. Entretanto, o uso do propofol está associado ao maior risco de sedação profunda e às complicações a ela associadas. Objetivo: comparar dois esquemas de sedação para a realização de endoscopia digestiva alta diagnóstica, grupo midazolam (midazolam e fentanil) com o grupo propofol (propofol e fentanil) quanto ao nível de sedação profunda e, como desfechos secundários, o grau de satisfação, o tempo de recuperação e a frequência de complicações entre os grupos. Método: foi realizado estudo experimental, prospectivo, randômico, cego com 200 pacientes, 100 no grupo midazolam e 100 no grupo propofol. Resultado: utilizando a escala OAA/S e o índice bispectral (BIS), respectivamente 11% e 7% dos pacientes do grupo midazolam e 25% e 19 % do grupo propofol apresentaram níveis de sedação profunda, sendo significativamente mais frequente neste último grupo. Houve boa correlação do nível de sedação da escala clínica OAA/S com o índice bispectral (BIS) para os dois grupos (k=0,63 para o grupo midazolam e k=0,71 para o grupo propofol). Quarenta e dois por cento dos pacientes do grupo propofol e 26% dos pacientes do grupo midazolam precisaram de oferta suplementar de oxigênio (p=0,025). O tempo médio de recuperação dos pacientes do grupo midazolam foi de 44,13 min e do grupo propofol foi de 28,82 min (p<0,001). O grau de satisfação dos pacientes foi semelhante entre os grupos e os médicos deram preferência ao uso da associação propofol/fentanil. Não se observaram complicações graves decorrentes da sedação em ambos os grupos. Conclusão: ambos os esquemas de sedação levam à sedação profunda. O grupo propofol utilizando o propofol e fentanil apresentou eventos de sedação profunda mais frequentemente. Por outro lado, os dois esquemas são seguros. Os pacientes do grupo propofol apresentaram tempo de indução da sedação, de recuperação e de liberação menoresIntroduction: the use of sedation is almost universal for the practice of upper gastrointestinal (GI) endoscopy. The use of propofol seems to be associated with higher physician and patient satisfaction. However there is a higher risk of deep sedation and its related complication when propofol is used. Objective: compare the frequency of deep sedation events with two drug associations for the sedation in upper GI endoscopy. The OAA/S score and the bispectral index monitoring (BIS) were employed for the assessment of consciousness level. Secondarily we compared patient and physician satisfaction, recovery time and the complication rates between the two groups. Methods: two hundred patients sent for upper GI endoscopy were randomized in two groups: midazolam and propofol, each of them with 100 patients. Results: Deep sedation events occurred in 11% (OAA/S score) and 7% (BIS) in group midazolam and significantly more frequent in group propofol (25%- OAA/S score and 19% - BIS). There was a good agreement between the OAA/S score and the bispectral index (BIS) in both groups (k=0.63 and K=0.71 for groups midazolam and propofol, respectively). Forty two per cent of group propofol patients and 26% of group midazolam patients needed oxygen supplementation (p=0.025). The mean recovery time for groups midazolam and propofol patients were 44.13 min and 28.82 min, respectively (p<0.001). While patients were equally satisfied with both drug associations, physicians were more satisfied with the propofol/fentanyl association. We did not record any severe complications related with sedation. Conclusion: both drug associations are associated with deep sedation events. The propofol/fentanyl association causes deep sedation events more frequently when compared with midazolam/fentanyl association. Both associations are safe. The induction sedation, recovery and discharge times were shorter with propofol/fentanyl association
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Ashour, Ashraf Fawzy. "Behaviour and strength of reinforced concrete continuous deep beams." Thesis, University of Cambridge, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.319339.
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Mickos, Johan. "Design of a Network Library for Continuous Deep Analytics." Thesis, KTH, Skolan för elektroteknik och datavetenskap (EECS), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-232129.
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Data-intensive stream processing applications have escalated in popularity in recent years, producing numerous designs and implementations for handling unbounded streams of high-volume data. The sheer size and dimensionality of these types of data requires multiple machines to push processing throughput of hundreds of millions events per second at low latencies. Advances in the fields of distributed deep learning and stream processing have highlighted networking-specific challenges and requirements such as flow control and scalable communication abstractions. Existing stream processing frameworks, however, only address subsets of these requirements. This thesis proposes a design and implementation in the Rust programming language for a modular networking library able to address these requirements together. The design entails protocol framing, buffer management, stream multiplexing, flow control, and stream prioritization. The implemented prototype handles multiplexing of logical streams and credit-based flow control through a flexible application programming interface. The prototype is tested for overall throughput and round-trip latency in a distributed environment, displaying promising results in both categories.Under de senaste åren har applikationer för dataintensiv ström bearbetning blivit avsevärt mer vanliga. Detta har lett till en uppsjö av modeller och implementationer för hantering av dataströmmar av gränslös volym. Blotta datamängden och dess dimensionalitet kräver otaliga maskiner för att med låg latens hantera hundratals miljoner händelser per sekund. Framsteg inom området för distribuerad djupinlärning och ström bearbetning har blottlagt nätverksspecifika utmaningar och krav såsom flödeskontroll och skalbara kommunikationsabstraktioner. Nuvarande beräkningssystem för ström bearbetning uppfyller dessvärre bara en del av dessa villkor. Detta examensarbete presenterar en modell och implementation i programmeringsspråket Rust för ett modulärt nätverksbibliotek som kan hantera alla dessa krav på en gång. Modellen inbegriper datainramning, bufferhantering, ström multiplexing, flödeskontroll och ström prioritering. Prototypen som här implementerats hanterar multiplexing av logiska dataströmmar och kreditbaserad flödeskontroll genom ett flexibelt applikationsgränssnitt. Prototypen har testats i avseende å nätverk genomströmning och tur-och-returtid i ett distribuerat upplägg, med lovande resultat i bägge kategorier.
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Otero, Maria Jose. "Teaching Children How to Stay Still Using Movies to Provide Continuous Feedback." Thesis, University of North Texas, 2019. https://digital.library.unt.edu/ark:/67531/metadc1609110/.
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External beam radiation therapy is often used as a form of treatment for individuals diagnosed with cancer. However, because staying completely still can often be difficult for children, sedation is often used daily to remedy the need for stillness. In this document, we introduce the development, implementation, and testing of a technology designed to teach healthy children to self-monitor and control their movements. This technology monitored a child's body movement and created a continuous feedback loop, playing a preferred movie based on the amount of body movement observed. Study 1 compares the amount of body movement observed when children were instructed to remain still (instructions alone) to access to a movie contingent on maintained low rates of movement (contingent movie). Study 2 compares the amount of body movement observed in the instructions alone condition with two other conditions: non-contingent access to a movie (non-contingent movie) and contingent movie. Study 3 compares the amount of body movement observed in the instructions alone condition to the contingent movie condition over an extended period of time. Lastly, Study 4 compares the amount of body movement observed when children have previously been taught to stay still using the technology described above across various days throughout various conditions. Generally, we found three things: a) instructions alone were insufficient to produce the level of control over motion required; b) some control over motion was established in the non-contingent movie condition relative to the instructions alone condition; and c) the combination of movies and feedback contingent on movement was necessary to gain the level of control over body motion necessary to adhere to the medical protocol.
Книги з теми "Continuous and deep sedation"
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Sterckx, Sigrid, Kasper Raus, and Freddy Mortier, eds. Continuous Sedation at the End of Life. Cambridge: Cambridge University Press, 2013. http://dx.doi.org/10.1017/cbo9781139856652.
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Urman, Richard D., and Alan D. Kaye, eds. Moderate and Deep Sedation in Clinical Practice. Cambridge: Cambridge University Press, 2012. http://dx.doi.org/10.1017/cbo9781139084000.
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Malamed, Stanley F. Sedation: A guide to patient management. 3rd ed. St. Louis: Mosby, 1995.
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G, Reves J., and Sladen Robert N, eds. Anesthesia and sedation by continuous infusion: Proceedings of a symposium, May 31-June 1, 1991. Princeton, N.J: Excerpta Medica, 1992.
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L, Quinn Christine, ed. Sedation: A guide to patient management. 2nd ed. St. Louis: Mosby, 1989.
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Favaro, Alice. Después de la caída del ‘ángel’. Venice: Edizioni Ca' Foscari, 2020. http://dx.doi.org/10.30687/978-88-6969-416-5.
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Ángel Bonomini was born in Buenos Aires in 1929 where he lived until his death at the age of sixty-four in 1994. He worked for various newspapers and magazines as an art critic and translator, but always maintaining his literary activity. He inherited the tradition of the Argentine fantastic and was a prolific writer: his production includes essays, poems and fantastic tales.Although he lived in a period of great cultural splendor and his literary talent was recognised by authors such as Borges and Bioy Casares, he fell into an unexplained oblivion, disappearing quite early from the contemporary intellectual environment. His first poems, which date back to the 1950s, were published in Sur magazine and some of his tales were included in well-known anthologies of fantastic literature.Among his collections of poems there are: Primera enunciación (1947), Argumento del enamorado. Baladas con Ángel (1952) written with María Elena Walsh, Torres para el silencio (1982) and Poética (1994). In 1972 he achieved great success with the publication of his first collection of fantastic tales, Los novicios de Lerna, followed by the publication of other books: Libro de los casos (1975), Los lentos elefantes de Milán (1978), Cuentos de amor (1982), Historias secretas (1985) and Más allá del puente (1996), posthumously published.A particular use of the fantastic characterises his work and distinguishes him from his contemporary authors. In his tales there is a continuous contrast between metaphysics and existentialism; in this way, he makes a deep investigation of the reality and, at the same time, he tries to go beyond it.This volume aims to analyse some emblematic tales by Bonomini in which it is possible to find the main topoi of Argentine fantastic and to understand why the author’s literary work is worth studying.
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Sterckx, Sigrid, and Kasper Raus. Continuous Sedation at the End of Life. Edited by Stuart J. Youngner and Robert M. Arnold. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199974412.013.7.
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This chapter examines continuous sedation as a way to relieve unbearable suffering in patients at the end of life. After considering consensus and guidelines on continuous sedation, it looks at the debate over terminology and definition. It then discusses the practice of continuous sedation in various countries and how it is performed, along with the importance of patient consent and autonomy in all sedation guidelines. The chapter goes on to analyze some of the commonly invoked justifications for continuous sedation, including the doctrine of double effect, last resort and refractory suffering, autonomy and patient consent, and proportionality. It also reviews contentious issues raised by continuous sedation, such as whether it should be restricted to patients with a very short life expectancy, artificial nutrition and hydration, and existential or psychological suffering.
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Urman, Richard D., and Alan D. Kaye. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2012.
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Kaye, Alan David, and Richard D. Urman. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2017.
Знайти повний текст джерелаЧастини книг з теми "Continuous and deep sedation"
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Hartogh, Govert den. "Continuous deep sedation and homicide." In What Kind of Death, 119–30. New York: Routledge, 2022. http://dx.doi.org/10.4324/9781003281115-9.
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Cristalli, Aldo, and Andrea De Gasperi. "Deep Sedation and Anesthesia for Advanced Gastrointestinal Endoscopy: Challenging a Continuum." In Endotherapy in Biliopancreatic Diseases: ERCP Meets EUS, 65–80. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-42569-2_7.
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Kuhn, Eva, Elodie Camier-Lemoine, Bradley Lonergan, and Christine Dunger. "An Ethical Discussion of (Un-)Certainty at the End of Life: Exemplification by Means of Continuous Deep Sedation and Advance Directives." In Ethical Challenges for Healthcare Practices at the End of Life: Interdisciplinary Perspectives, 23–54. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-83186-8_3.
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Ahmed, Hesham M., Christopher T. Aquina, Vicente H. Gracias, J. Javier Provencio, Mariano Alberto Pennisi, Giuseppe Bello, Massimo Antonelli, et al. "Deep Sedation." In Encyclopedia of Intensive Care Medicine, 683. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-00418-6_1455.
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Burtea, Daniela, and Anca Dimitriu. "Deep Sedation." In Pocket Guide to Advanced Endoscopy in Gastroenterology, 115–20. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-42076-4_14.
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Ganzberg, Steven I. "Deep Sedation and GA." In Oral Sedation for Dental Procedures in Children, 157–71. Berlin, Heidelberg: Springer Berlin Heidelberg, 2015. http://dx.doi.org/10.1007/978-3-662-46626-1_10.
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Nardelli, Pasquale, Stefano Fresilli, and Marta Mucchetti. "Avoidance of Deep Sedation." In Reducing Mortality in Critically Ill Patients, 81–92. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-71917-3_9.
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Miller, Russell R. "Conscious Sedation and Deep Sedation, Including Neuromuscular Blockade." In Bedside Procedures for the Intensivist, 19–36. New York, NY: Springer New York, 2010. http://dx.doi.org/10.1007/978-0-387-79830-1_2.
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Pawlowski, John. "Moderate and Deep Sedation Techniques." In Principles and Practice of Interventional Pulmonology, 63–72. New York, NY: Springer New York, 2012. http://dx.doi.org/10.1007/978-1-4614-4292-9_6.
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Bishop, Christopher M., and Hugh Bishop. "Continuous Latent Variables." In Deep Learning, 495–531. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-45468-4_16.
Повний текст джерелаТези доповідей конференцій з теми "Continuous and deep sedation"
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Gallagher, John C., and Eric T. Matson. "Analog Dopplegangers: Twinning with Deep Continuous-Time Recurrent Neural Networks." In 2024 International Joint Conference on Neural Networks (IJCNN), 1–7. IEEE, 2024. http://dx.doi.org/10.1109/ijcnn60899.2024.10651456.
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Ruiz-Vitte, Ainhoa, Alberto Comesaña, Blanca Larraga-García, Eduardo Rocón, and Álvaro Gutiérrez. "Deep Learning for Continuous Recognition of Activities of Daily Living." In 2024 E-Health and Bioengineering Conference (EHB), 1–4. IEEE, 2024. https://doi.org/10.1109/ehb64556.2024.10805639.
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De Vega Sanchez, Blanca, Ignacio Lobato Astiárraga, Carlos Disdier Vicente, Ana Maria Andrés Porras, Stefania Soldarini, Claudia Iglesias Perez, Sofia Jaurrieta Largo, et al. "DEEP SEDATION: USE OF TARJET CONTROL INFUSION VERSUS ADMINISTRATION OF PROPOFOL IN CONTINUOUS PERFUSION DURING THE PERFORMANCE OF BRONCOSCOPIES." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.pa4183.
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Cerullo, A., and C. Stuart. "021 The effectiveness of dexmedetomidine for paediatric sedation in a radiology setting." In Great Ormond Street Hospital Conference 2018: Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.21.
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Morrison, C., L. Hepburn, and G. Stuart. "076 Dexmedetomidine sedation to facilitate CT coronary angiography in children: a novel approach." In Great Ormond Street Hospital Conference 2018: Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.76.
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Medina-Prado, L., JM Sempere, S. Baile-Maxía, M. Bozhychko, C. Mangas-Sanjuán, L. Compañy, Francisco Ruiz, JR Aparicio, and JA Casellas. "SAFETY OF DEEP SEDATION WITH PROPOFOL IN PATIENTS ASA III." In ESGE Days. © Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1704780.
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Correia, C., N. Almeida, M. Sant’Anna, C. Macedo, C. Gregório, and P. Figueiredo. "Quality Criteria In Upper Gastrointestinal Endoscopy - Can Deep Sedation Influence It?" In ESGE Days 2021. Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1724617.
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Wijayaratne, T., Z. Aung, P. Thiagarajan, R. Annamaneni, R. Sudhir, and R. Panchal. "P193 Day-case deep sedation bronchoscopy with target-controlled sedation (TCS) and high-flow nasal oxygen (HFNO) in the bronchoscopy suite." In British Thoracic Society Winter Meeting 2024, QEII Centre, Broad Sanctuary, Westminster, London SW1P 3EE, 27 to 29 November 2024, Programme and Abstracts, A223.2—A224. BMJ Publishing Group Ltd and British Thoracic Society, 2024. http://dx.doi.org/10.1136/thorax-2024-btsabstracts.354.
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Bakhtiar, H., R. Scatena, and A. M. Ahasic. "Evaluation of Continuous Sedation Usage in the ICU of a Community-Based Teaching Hospital." In American Thoracic Society 2019 International Conference, May 17-22, 2019 - Dallas, TX. American Thoracic Society, 2019. http://dx.doi.org/10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a6674.
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Tnase, D., S. Georgiev, A. Eicken, and P. Ewert. "Creation of Bidirectional Cavopulmonary Connections under Deep Conscious Sedation: A Modified Approach." In 52nd Annual Meeting of the German Society for Pediatric Cardiology. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1705549.
Повний текст джерелаЗвіти організацій з теми "Continuous and deep sedation"
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Meadors, Grant, Shira Goldhaber-Gordon, and Lexington Smith. Deep learning to help find continuous gravitational waves. Office of Scientific and Technical Information (OSTI), November 2021. http://dx.doi.org/10.2172/1830555.
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EFFC/DFI Concrete Task Group. Guide to Tremie Concrete for Deep Foundations, 3rd Edition. European Federation of Foundation Contractors and Deep Foundations Institute, December 2024. https://doi.org/10.37308/effc-dfi-ctg-trem-e3-2024.
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The primary purpose of this Guide is to give guidance on fresh concrete characterisation with respect to its performance, the concrete mix design process, and the methods used to test the fresh concrete. The principles of this Guide apply to tremie concrete for deep foundations but may also be applied for other forms of deep foundations (e.g. continuous flight auger piling). This Third Edition of the Tremie Guide includes a general review of the Second Edition, comprises more specific advice on testing fresh concrete (in a completely revised Section 5.3), emphasises the Task Group’s understanding of designing sustainable concrete (in a new Section 5.6), and gives an update on interpretation of concrete flow mechanisms made on the basis of numerical modelling (in a revised Section 9, now supplemented by a new Appendix G). This Third Edition replaces the Second Edition.
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EFFC/DFI Concrete Task Group. German Guide to Tremie Concrete for Deep Foundations, 2nd Edition - Leitfaden Kontraktorbetonfür Tiefgründungen, Zweite Fassung. European Federation of Foundation Contractors and Deep Foundations Institute, June 2018. https://doi.org/10.37308/effc-dfi-ctg-trem-germe2-2018.
Повний текст джерелаАнотація:
The primary purpose of this report is to provide guidance for characterization related to performance, mix design process, and methods used to test fresh concrete. The principles of this guide apply to tremie concrete for deep foundations but may also be applied for other forms of deep foundations (e.g., continuous flight auger piling). The guide addresses design considerations including concrete rheology, mix design, reinforcement detailing, concrete cover, and good practice rules for placement. A review of methods to test the as-built elements is presented together with advice on the identification and interpretation of the results.
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Cerulli, Giovanni. Estimating Dose-Response Functions in Stata. Instats Inc., 2023. http://dx.doi.org/10.61700/iiawi76rkf2fr469.
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This seminar equips researchers with the knowledge and skills to identify and estimate dose-response functions using Stata, offering an in-depth exploration of two prominent approaches for estimating dose-response functions: the Generalized Propensity Score (GPS) method and the Regression-adjustment-based Dose-Response Models (CTREAT). These methods are widely used in the field of causal inference with continuous treatment (or exposure) and have applications in various domains such as medicine, social sciences, and economics. The seminar includes practical exercises, a Q&A session, and post-seminar support, offering participants a deep understanding of dose-response functions and their application in various research fields. An official Instats certificate of completion is provided along with 1 ECTS equivalent points.
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Schmid, Juan Pedro. Fiscal Unruliness: Checking the Usual Suspects for Jamaica's Debt Buildup. Inter-American Development Bank, February 2014. http://dx.doi.org/10.18235/0008438.
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Jamaica's fiscal and debt position has long been recognized as a major issue for the country, and the country has made several attempts to resolve this challenge by increasing revenue or reducing expenditures. Despite these adjustments, Jamaica has systematically failed to achieve its budget targets. This analysis shows that the major weakness in the budget planning execution is revenue projection, which influences planned expenditures. In contrast, the limitation in reducing rigid recurrent expenditures -mostly interest and wage salary payments- has led to the introduction of measures aimed at meeting appropriate revenue targets. In addition, capital expenditure has systematically underperformed relative to the budget, possibly to compensate for these weaknesses. However, fiscal targets have still underperformed relative to budget projections. These repeated, lower-than-expected revenues combined with rigid expenditures led to continuous debt buildup, reaching a level that needs deep institutional reforms.
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Chejanovsky, Nor, Diana Cox-Foster, Victoria Soroker, and Ron Ophir. Honeybee modulation of infection with the Israeli acute paralysis virus, in asymptomatic, acutely infected and CCD colonies. United States Department of Agriculture, December 2013. http://dx.doi.org/10.32747/2013.7594392.bard.
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Honey bee (Apis mellifera) colony losses pose a severe risk to the food chain. The IAPV (Israeli acute paralysis virus) was correlated with CCD, a particular case of colony collapse. Honey bees severely infected with IAPV show shivering wings that progress to paralysis and subsequent death. Bee viruses, including IAPV, are widely present in honey bee colonies but often there are no pathological symptoms. Infestation of the beehive with Varroa mites or exposure to stress factors leads to significant increase in viral titers and fatal infections. We hypothesized that the honey bee is regulating/controlling IAPV and viral infections in asymptomatic infections and this control is broken through "stress" leading to acute infections and/or CCD. Our aims were: 1. To discover genetic changes in IAPV that may affect tissue tropism in the host, and/or virus infectivity and pathogenicity. 2. To elucidate mechanisms used by the host to regulate/ manage the IAPV-infection in vivo and in vitro. To achieve the above objectives we first studied stress-induced virus activation. Our data indicated that some pesticides, including myclobutanil, chlorothalonil and fluvalinate, result in amplified viral titers when bees are exposed at sub lethal levels by a single feeding. Analysis of the level of immune-related bee genes indicated that CCD-colonies exhibit altered and weaker immune responses than healthy colonies. Given the important role of viral RNA interference (RNAi) in combating viral infections we investigated if CCD-colonies were able to elicit this particular antiviral response. Deep-sequencing analysis of samples from CCD-colonies from US and Israel revealed high frequency of small interfering RNAs (siRNA) perfectly matching IAPV, Kashmir bee virus and Deformed wing virus genomes. Israeli colonies showed high titers of IAPV and a conserved RNAi pattern of targeting the viral genome .Our findings were further supported by analysis of samples from colonies experimentally infected with IAPV. Following for the first time the dynamics of IAPV infection in a group of CCD colonies that we rescued from collapse, we found that IAPV conserves its potential to act as one lethal, infectious factor and that its continuous replication in CCD colonies deeply affects their health and survival. Ours is the first report on the dominant role of IAPV in CCD-colonies outside from the US under natural conditions. We concluded that CCD-colonies do exhibit a regular siRNA response that is specific against predominant viruses associated with colony losses and other immune pathways may account for their weak immune response towards virus infection. Our findings: 1. Reveal that preventive measures should be taken by the beekeepers to avoid insecticide-based stress induction of viral infections as well as to manage CCD colonies as a source of highly infectious viruses such as IAPV. 2. Contribute to identify honey bee mechanisms involved in managing viral infections.
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Yatsymirska, Mariya. SOCIAL EXPRESSION IN MULTIMEDIA TEXTS. Ivan Franko National University of Lviv, February 2021. http://dx.doi.org/10.30970/vjo.2021.49.11072.
Повний текст джерелаАнотація:
The article investigates functional techniques of extralinguistic expression in multimedia texts; the effectiveness of figurative expressions as a reaction to modern events in Ukraine and their influence on the formation of public opinion is shown. Publications of journalists, broadcasts of media resonators, experts, public figures, politicians, readers are analyzed. The language of the media plays a key role in shaping the worldview of the young political elite in the first place. The essence of each statement is a focused thought that reacts to events in the world or in one’s own country. The most popular platform for mass information and social interaction is, first of all, network journalism, which is characterized by mobility and unlimited time and space. Authors have complete freedom to express their views in direct language, including their own word formation. Phonetic, lexical, phraseological and stylistic means of speech create expression of the text. A figurative word, a good aphorism or proverb, a paraphrased expression, etc. enhance the effectiveness of a multimedia text. This is especially important for headlines that simultaneously inform and influence the views of millions of readers. Given the wide range of issues raised by the Internet as a medium, research in this area is interdisciplinary. The science of information, combining language and social communication, is at the forefront of global interactions. The Internet is an effective source of knowledge and a forum for free thought. Nonlinear texts (hypertexts) – «branching texts or texts that perform actions on request», multimedia texts change the principles of information collection, storage and dissemination, involving billions of readers in the discussion of global issues. Mastering the word is not an easy task if the author of the publication is not well-read, is not deep in the topic, does not know the psychology of the audience for which he writes. Therefore, the study of media broadcasting is an important component of the professional training of future journalists. The functions of the language of the media require the authors to make the right statements and convincing arguments in the text. Journalism education is not only knowledge of imperative and dispositive norms, but also apodictic ones. In practice, this means that there are rules in media creativity that are based on logical necessity. Apodicticity is the first sign of impressive language on the platform of print or electronic media. Social expression is a combination of creative abilities and linguistic competencies that a journalist realizes in his activity. Creative self-expression is realized in a set of many important factors in the media: the choice of topic, convincing arguments, logical presentation of ideas and deep philological education. Linguistic art, in contrast to painting, music, sculpture, accumulates all visual, auditory, tactile and empathic sensations in a universal sign – the word. The choice of the word for the reproduction of sensory and semantic meanings, its competent use in the appropriate context distinguishes the journalist-intellectual from other participants in forums, round tables, analytical or entertainment programs. Expressive speech in the media is a product of the intellect (ability to think) of all those who write on socio-political or economic topics. In the same plane with him – intelligence (awareness, prudence), the first sign of which (according to Ivan Ogienko) is a good knowledge of the language. Intellectual language is an important means of organizing a journalistic text. It, on the one hand, logically conveys the author’s thoughts, and on the other – encourages the reader to reflect and comprehend what is read. The richness of language is accumulated through continuous self-education and interesting communication. Studies of social expression as an important factor influencing the formation of public consciousness should open up new facets of rational and emotional media broadcasting; to trace physical and psychological reactions to communicative mimicry in the media. Speech mimicry as one of the methods of disguise is increasingly becoming a dangerous factor in manipulating the media. Mimicry is an unprincipled adaptation to the surrounding social conditions; one of the most famous examples of an animal characterized by mimicry (change of protective color and shape) is a chameleon. In a figurative sense, chameleons are called adaptive journalists. Observations show that mimicry in politics is to some extent a kind of game that, like every game, is always conditional and artificial.
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Banin, Amos, Joseph Stucki, and Joel Kostka. Redox Processes in Soils Irrigated with Reclaimed Sewage Effluents: Field Cycles and Basic Mechanism. United States Department of Agriculture, July 2004. http://dx.doi.org/10.32747/2004.7695870.bard.
Повний текст джерелаАнотація:
The overall objectives of the project were: (a) To measure and study in situ the effect of irrigation with reclaimed sewage effluents on redox processes and related chemical dynamics in soil profiles of agricultural fields. (b) To study under controlled conditions the kinetics and equilibrium states of selected processes that affect redox conditions in field soils or that are effected by them. Specifically, these include the effects on heavy metals sorption and desorption, and the effect on pesticide degradation. On the basis of the initial results from the field study, increased effort was devoted to clarifying and quantifying the effects of plants and water regime on the soil's redox potential while the study of heavy metals sorption was limited. The use of reclaimed sewage effluents as agricultural irrigation water is increasing at a significant rate. The relatively high levels of suspended and, especially, dissolved organic matter and nitrogen in effluents may affect the redox regime in field soils irrigated with them. In turn, the changes in redox regime may affect, among other parameters, the organic matter and nitrogen dynamics of the root zone and trace organic decomposition processes. Detailed data of the redox potential regime in field plots is lacking, and the detailed mechanisms of its control are obscure and not quantified. The study established the feasibility of long-term, non-disturbing monitoring of redox potential regime in field soils. This may enable to manage soil redox under conditions of continued inputs of wastewater. The importance of controlling the degree of wastewater treatment, particularly of adding ultrafiltration steps and/or tertiary treatment, may be assessed based on these and similar results. Low redox potential was measured in a field site (Site A, KibutzGivat Brenner), that has been irrigated with effluents for 30 years and was used for 15 years for continuous commercial sod production. A permanently reduced horizon (Time weighted averaged pe= 0.33±3.0) was found in this site at the 15 cm depth throughout the measurement period of 10 months. A drastic cultivation intervention, involving prolonged drying and deep plowing operations may be required to reclaim such soils. Site B, characterized by a loamy texture, irrigated with tap water for about 20 years was oxidized (Time weighted average pe=8.1±1.0) throughout the measurement period. Iron in the solid phases of the Givat Brenner soils is chemically-reduced by irrigation. Reduced Fe in these soils causes a change in reactivity toward the pesticide oxamyl, which has been determined to be both cytotoxic and genotoxic to mammalian cells. Reaction of oxamyl with reduced-Fe clay minerals dramatically decreases its cytotoxicity and genotoxicity to mammalian cells. Some other pesticides are affected in the same manner, whereas others are affected in the opposite direction (become more cyto- and genotoxic). Iron-reducing bacteria (FeRB) are abundant in the Givat Brenner soils. FeRB are capable of coupling the oxidation of small molecular weight carbon compounds (fermentation products) to the respiration of iron under anoxic conditions, such as those that occur under flooded soil conditions. FeRB from these soils utilize a variety of Fe forms, including Fe-containing clay minerals, as the sole electron acceptor. Daily cycles of the soil redox potential were discovered and documented in controlled-conditions lysimeter experiments. In the oxic range (pe=12-8) soil redox potential cycling is attributed to the effect of the daily temperature cycle on the equilibrium constant of the oxygenation reaction of H⁺ to form H₂O, and is observed under both effluent and freshwater irrigation. The presence of plants affects considerably the redox potential regime of soils. Redox potential cycling coupled to the irrigation cycles is observed when the soil becomes anoxic and the redox potential is controlled by the Fe(III)/Fe(II) redox couple. This is particularly seen when plants are grown. Re-oxidation of the soil after soil drying at the end of an irrigation cycle is affected to some degree by the water quality. Surprisingly, the results suggest that under certain conditions recovery is less pronounced in the freshwater irrigated soils.
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Hillestad, Torgeir Martin. The Metapsychology of Evil: Main Theoretical Perspectives Causes, Consequences and Critique. University of Stavanger, 2014. http://dx.doi.org/10.31265/usps.224.
Повний текст джерелаАнотація:
The purpose of this text or dissertation is to throw some basic light on a fundamental problem concerning manhood, namely the question of evil, its main sources, dynamics and importance for human attitudes and behaviour. The perspective behind the analysis itself is that of psychology. Somebody, or many, may feel at bit nervous by the word “evil” itself. It may very well be seen as too connected to religion, myth and even superstition. Yet those who are motivated to lose oneself in the subject retain a deep interest in human destructiveness, malevolence and hate, significant themes pointing at threatening prospects for mankind. The text is organized or divided into four main ordinary chapters, the three first of them organized or divided into continuous and numbered sections. A crucial point or question is of cause how to define evil itself. It can of cause be done both intentional, instrumental and by consequence. Other theorists however have stated that the concept of evil exclusively rests on a myth originated in the Judean-Christian conception of Satan and ultimate evil. This last argument presupposes evil itself as non-existent in the real rational world. It seems however a fact that most people attach certain basic meaning to the concept, mainly that it represents ultimately bad and terrible actions and behaviour directed toward common people for the purpose of bringing upon them ultimate pain and suffer. However, there is no room for essentialism here, meaning that we simply can look “inside” some original matter to get to know what it “really” is. Rather, a phenomenon gets its identity from the constituted meaning operating within a certain human communities and contexts loaded with intentionality and inter-subjective meaning. As mentioned above, the concept of evil can be interpreted both instrumental and intentional, the first being the broadest of them. Here evil stands for behaviour and human deeds having terrifying or fatal consequences for subjects and people or in general, regardless of the intentions behind. The intentional interpretation however, links the concept to certain predispositions, characteristics and even strong motives in subjects, groups and sometimes political systems and nations. I will keep in mind and clear the way for both these perspectives for the discussion in prospect. This essay represents a psychological perspective on evil, but makes it clear that a more or less complete account of such a psychological view also should include a thorough understanding or integration of some basic social and even biological assumptions. However, I consider a social psychological position of significant importance, especially because in my opinion it represents some sort of coordination of knowledge and theoretical perspectives inherent in the subject or problem itself, the main task here being to integrate perspectives of a psychological as well as social and biological kind. Since humans are essential social creatures, the way itself to present knowledge concerning the human condition, must be social of some sort and kind, however not referring to some kind of reductionism where social models of explanation possess or holds monopoly. Social and social psychological perspectives itself represents parts of the whole matter regarding understanding and explanation of human evil. The fact that humans present, or has to represent themselves as humans among other humans, means that basically a social language is required both to explain and describe human manners and ways of being. This then truly represents its own way or, more correctly, level or standard of explanation, which makes social psychology some sort of significant, though not sufficient. More substantial, the vision itself of integrating different ontological and theoretical levels and objects of science for the purpose of manifesting or make real a full-fledged psychological perspective on evil, should be considered or characterized a meta-psychological perspective. The text is partially constructed as a review of existing theories and theorists concerning the matter of evil and logically associated themes such as violence, mass murder, genocide, antisocial behaviour in general, aggression, hate and cruelty. However, the demands of making a theoretical distinction between these themes, although connected, is stressed. Above all, an integral perspective combining different scientific disciplines is aimed at.