9 resultados para Physicians in literature

em Dalarna University College Electronic Archive


Relevância:

100.00% 100.00%

Publicador:

Resumo:

This essay studies how dialectal speech is reflected in written literature and how this phenomenon functions in translation. With this purpose in mind, Styron's Sophie's Choice and Twain's The Adventures of Huckleberry Finn are analysed using samples of non-standard orthography which have been applied in order to reflect the dialect, or accent, of certain characters. In the same way, Lundgren's Swedish translation of Sophie's Choice and Ferres and Rolfe's Spanish version of The Adventures of Huckleberry Finn are analysed. The method consists of linguistically analysing a few text samples from each novel, establishing how dialect is represented through non-standard orthography, and thereafter, comparing the same samples with their translation into another language in order to establish whether dialectal features are visible also in the translated novels. It is concluded that non-standard orthography is applied in the novels in order to represent each possible linguistic level, including pronunciation, morphosyntax, and vocabulary. Furthermore, it is concluded that while Lundgren's translation intends to orthographically represent dialectal speech on most occasions where the original does so, Ferres and Rolfe's translation pays no attention to dialectology. The discussion following the data analysis establishes some possible reasons for the exclusion of dialectal features in the Spanish translation considered here. Finally, the reason for which this study contributes to the study of dialectology is declared.

Relevância:

100.00% 100.00%

Publicador:

Resumo:

BACKGROUND: Misoprostol is established for the treatment of incomplete abortion but has not been systematically assessed when provided by midwives at district level in a low-resource setting. We investigated the effectiveness and safety of midwives diagnosing and treating incomplete abortion with misoprostol, compared with physicians. METHODS: We did a multicentre randomised controlled equivalence trial at district level at six facilities in Uganda. Eligibility criteria were women with signs of incomplete abortion. We randomly allocated women with first-trimester incomplete abortion to clinical assessment and treatment with misoprostol either by a physician or a midwife. The randomisation (1:1) was done in blocks of 12 and was stratified for study site. Primary outcome was complete abortion not needing surgical intervention within 14-28 days after initial treatment. The study was not masked. Analysis of the primary outcome was done on the per-protocol population with a generalised linear-mixed effects model. The predefined equivalence range was -4% to 4%. The trial was registered at ClinicalTrials.gov, number NCT01844024. FINDINGS: From April 30, 2013, to July 21, 2014, 1108 women were assessed for eligibility. 1010 women were randomly assigned to each group (506 to midwife group and 504 to physician group). 955 women (472 in the midwife group and 483 in the physician group) were included in the per-protocol analysis. 452 (95·8%) of women in the midwife group had complete abortion and 467 (96·7%) in the physician group. The model-based risk difference for midwife versus physician group was -0·8% (95% CI -2·9 to 1·4), falling within the predefined equivalence range (-4% to 4%). The overall proportion of women with incomplete abortion was 3·8% (36/955), similarly distributed between the two groups (4·2% [20/472] in the midwife group, 3·3% [16/483] in the physician group). No serious adverse events were recorded. INTERPRETATION: Diagnosis and treatment of incomplete abortion with misoprostol by midwives is equally safe and effective as when provided by physicians, in a low-resource setting. Scaling up midwives' involvement in treatment of incomplete abortion with misoprostol at district level would increase access to safe post-abortion care. FUNDING: The Swedish Research Council, Karolinska Institutet, and Dalarna University.

Relevância:

90.00% 90.00%

Publicador:

Resumo:

BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. CONCLUSION: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.

Relevância:

90.00% 90.00%

Publicador:

Resumo:

Ziel dieser Arbeit ist die Untersuchung des Bildzitates und seiner Form. Ausgangspunkt ist ein Kunstwerk, Paul Klees Revolution der Viadukte, und dessen Versprachlichung, dem sognannten Bildzitat, in drei Texten der deutschen Prosa. Als literaturwissenschaftliche Methode wurde ein intermedialer Ansatz nach Rajewsky, sowie von Berndt, Tonger-Erk gewählt. Eine Auswahl des Kunstwerkes und der Texte, die das Kunstwerk zitieren, wurde basierend auf dem Material der Datenbank über literarische Bildzitate in Wien getroffen. Die Analyse der Bildzitate in SAID: Das Rot lächelt, das Blau schweigt. Geschichten über Bilder, Uwe Timm: Der Freund und der Fremde und Gertrud Leutenegger: Vorabend erfolgt nach folgender Fragestellung: 1. Welches sind die grundlegenden Charakteristika des Bildes, die in den literarischen Bildzitaten hervorgehoben werden? 2. Mit welchen sprachlichen Mitteln wird dies hervorgehoben? 3. Welche Rolle spielt der Titel des Gemäldes? Wie der Resultatteil zeigt werden von den Autoren Stilmittel ähnlich die des Gemäldes (Kontrast, Repetition) verwendet. Der Titel des Gemäldes und die Bildzitate werden im Text als verstärkendes Element verwendet. The pictorial quote An analysis of Paul Klees Revolution of the viaduct in three German prose texts. This essay explores the quotation of images in literature. Starting point is Paul Klee's painting The revolution of the viaduct and its verbal expression, which is known as 'image quotation', in three German prose texts. The textual analysis of these works - SAID's Das Rot lächelt,das Blau schweigt. Geschichten über Bilder, Uwe Timm's Der Freund und der Fremde and Gertrud Leutenegger's Vorabend - is based on theories of intermediality. This essay shows that the authors employ stylistic devices similar to those in the painting, such as contrast and repetition, and use them as intermedial references.

Relevância:

80.00% 80.00%

Publicador:

Resumo:

This study contents a research of the Swedish temperance movements IOGT, NTO and TO:s adult education in Dalarna between 1921 and 1939. A theory that is used in this essay is the publicity theory of Jürgen Habermas. A theory in this essay is that the adult educational work of the temperance movements could bee seen as an alternative publicity because the courses that the temperance movement held in general contents a great part of the movements own literature, the participants in the courses held their own lectures to each other and it was mostly only members of the temperance movements who could join the courses. The main subject of the courses was history in literature, English, Esperanto, and knowledge about local democracy. Not many courses content the drinking issue in Sweden at this time, even thought a national referendum was held in the issue during the research period of this essay. The lack of courses in the drinking issue illustrates of the fact that the courses only was held for the members of the temperance movement, and they don’t drink alcohol in any case. It was not a big difference in the contents of the course between the organisation in the temperance movements and between different years in this research.

Relevância:

80.00% 80.00%

Publicador:

Resumo:

Objective Levodopa in presence of decarboxylase inhibitors is following two-compartment kinetics and its effect is typically modelled using sigmoid Emax models. Pharmacokinetic modelling of the absorption phase of oral distributions is problematic because of irregular gastric emptying. The purpose of this work was to identify and estimate a population pharmacokinetic- pharmacodynamic model for duodenal infusion of levodopa/carbidopa (Duodopa®) that can be used for in numero simulation of treatment strategies. Methods The modelling involved pooling data from two studies and fixing some parameters to values found in literature (Chan et al. J Pharmacokinet Pharmacodyn. 2005 Aug;32(3-4):307-31). The first study involved 12 patients on 3 occasions and is described in Nyholm et al. Clinical Neuropharmacology 2003:26:156-63. The second study, PEDAL, involved 3 patients on 2 occasions. A bolus dose (normal morning dose plus 50%) was given after a washout during night. Plasma samples and motor ratings (clinical assessment of motor function from video recordings on a treatment response scale between -3 and 3, where -3 represents severe parkinsonism and 3 represents severe dyskinesia.) were repeatedly collected until the clinical effect was back at baseline. At this point, the usual infusion rate was started and sampling continued for another two hours. Different structural absorption models and effect models were evaluated using the value of the objective function in the NONMEM package. Population mean parameter values, standard error of estimates (SE) and if possible, interindividual/interoccasion variability (IIV/IOV) were estimated. Results Our results indicate that Duodopa absorption can be modelled with an absorption compartment with an added bioavailability fraction and a lag time. The most successful effect model was of sigmoid Emax type with a steep Hill coefficient and an effect compartment delay. Estimated parameter values are presented in the table. Conclusions The absorption and effect models were reasonably successful in fitting observed data and can be used in simulation experiments.

Relevância:

80.00% 80.00%

Publicador:

Resumo:

With the rapid advancement of the webtechnology, more and more educationalresources, including software applications forteaching/learning methods, are available acrossthe web, which enables learners to access thelearning materials and use various ways oflearning at any time and any place. Moreover,various web-based teaching/learning approacheshave been developed during the last decade toenhance the capability of both educators andlearners. Particularly, researchers from bothcomputer science and education are workingtogether, collaboratively focusing ondevelopment of pedagogically enablingtechnologies which are believed to improve theinfrastructure of education systems andprocesses, including curriculum developmentmodels, teaching/learning methods, managementof educational resources, systematic organizationof communication and dissemination ofknowledge and skills required by and adapted tousers. Despite of its fast development, however,there are still great gaps between learningintentions, organization of supporting resources,management of educational structures,knowledge points to be learned and interknowledgepoint relationships such as prerequisites,assessment of learning outcomes, andtechnical and pedagogic approaches. Moreconcretely, the issues have been widelyaddressed in literature include a) availability andusefulness of resources, b) smooth integration ofvarious resources and their presentation, c)learners’ requirements and supposed learningoutcomes, d) automation of learning process interms of its schedule and interaction, and e)customization of the resources and agilemanagement of the learning services for deliveryas well as necessary human interferences.Considering these problems and bearing in mindthe advanced web technology of which weshould make full use, in this report we willaddress the following two aspects of systematicarchitecture of learning/teaching systems: 1)learning objects – a semantic description andorganization of learning resources using the webservice models and methods, and 2) learningservices discovery and learning goals match foreducational coordination and learning serviceplanning.

Relevância:

80.00% 80.00%

Publicador:

Resumo:

Hybrid Photovoltaic Thermal (PVT) collectors are an emerging technology that combines PV and solar thermal systems in a single solar collector producing heat and electricity simultaneously. The focus of this thesis work is to evaluate the performance of unglazed open loop PVT air system integrated on a garage roof in Borlänge. As it is thought to have a significant potential for preheating ventilation of the building and improving the PV modules electrical efficiency. The performance evaluation is important to optimize the cooling strategy of the collector in order to enhance its electrical efficiency and maximize the production of thermal energy. The evaluation process involves monitoring the electrical and thermal energies for a certain period of time and investigating the cooling effect on the performance through controlling the air mass flow provided by a variable speed fan connected to the collector by an air distribution duct. The distribution duct transfers the heated outlet air from the collector to inside the building. The PVT air collector consists of 34 Solibro CIGS type PV modules (115 Wp for each module) which are roof integrated and have replaced the traditional roof material. The collector is oriented toward the south-west with a tilt of 29 ᵒ. The collector consists of 17 parallel air ducts formed between the PV modules and the insulated roof surface. Each air duct has a depth of 0.05 m, length of 2.38 m and width of 2.38 m. The air ducts are connected to each other through holes. The monitoring system is based on using T-type thermocouples to measure the relevant temperatures, air sensor to measure the air mass flow. These parameters are needed to calculate the thermal energy. The monitoring system contains also voltage dividers to measure the PV modules voltage and shunt resistance to measure the PV current, and AC energy meters which are needed to calculate the produced electrical energy. All signals recorded from the thermocouples, voltage dividers and shunt resistances are connected to data loggers. The strategy of cooling in this work was based on switching the fan on, only when the difference between the air duct temperature (under the middle of top of PV column) and the room temperature becomes higher than 5 °C. This strategy was effective in term of avoiding high electrical consumption by the fan, and it is recommended for further development. The temperature difference of 5 °C is the minimum value to compensate the heat losses in the collecting duct and distribution duct. The PVT air collector has an area of (Ac=32 m2), and air mass flow of 0.002 kg/s m2. The nominal output power of the collector is 4 kWppv (34 CIGS modules with 115 Wppvfor each module). The collector produces thermal output energy of 6.88 kWth/day (0.21 kWth/m2 day) and an electrical output energy of 13.46 kWhel/day (0.42 kWhel/m2 day) with cooling case. The PVT air collector has a daily thermal energy yield of 1.72 kWhth/kWppv, and a daily PV electrical energy yield of 3.36 kWhel /kWppv. The fan energy requirement in this case was 0.18 kWh/day which is very small compared to the electrical energy generated by the PV collector. The obtained thermal efficiency was 8 % which is small compared to the results reported in literature for PVT air collectors. The small thermal efficiency was due to small operating air mass flow. Therefore, the study suggests increasing the air mass flow by a factor of 25. The electrical efficiency was fluctuating around 14 %, which is higher than the theoretical efficiency of the PV modules, and this discrepancy was due to the poor method of recording the solar irradiance in the location. Due to shading effect, it was better to use more than one pyranometer.