Pain relief for the removal of femoral sheath in interventional cardiology adult patients (Review)

Pain relief for removal of femoral sheath after cardiac procedures
Procedures for the non-surgical management of coronary heart disease include balloon angioplasty and intracoronary stenting. At the start of each procedure an introducer sheath is inserted through the skin (percutaneously) into an artery, frequently a femoral artery in the groin. This allows the different catheters used for the procedure to be exchanged easily without causing trauma to the skin. At the end of the procedure the sheath is removed and, if the puncture site isn't "sealed" using a device closure, firm pressure is required over the site for 30 minutes or more to control any bleeding and reduce vascular complications. Removing the sheath and the firm pressure required to control bleeding can cause pain, although this is generally mild. Some centres routinely give pain relief before removal such as intravenous morphine, or an injection of a local anaesthetic in the soft tissue around the sheath (called a subcutaneous injection). Adequate pain control during sheath removal is also associated with a reduced incidence of a vasovagal reaction, a potentially serious complication involving a sudden drop of blood pressure and a slowed heart rate. Four studies were reviewed in total. Three trials involving 498 participants compared subcutaneous lignocaine, a short acting local anaesthetic, with a control group (participants received either no pain relief or an inactive substance known as a placebo). Two trials involving 399 people compared intravenous opioids (fentanyl or morphine) and an anxiolytic (midazolam) with a control group. One trial involving 60 people compared subcutaneous levobupivacaine, a long acting local anaesthetic, with a control group. Intravenous pain regimens and subcutaneous levobupivacaine appear to reduce the pain experienced during femoral sheath removal. However, the size of the reduction was small. A significant reduction in pain was not experienced by participants who received subcutaneous lignocaine or who were in the control group. There was insufficient data to determine a correlation between pain relief administration and either adverse events or complications. Some patients may benefit from routine pain relief using levobupivacaine or intravenous pain regimens. Identifying who may potentially benefit from pain relief requires clinical judgement and consideration of patient preference. The mild level of pain generally experienced during this procedure should not influence the decision as some people can experience moderate levels of pain.

Aid, debt relief and new sources of finance for meeting the millennium development goals

This article focuses on aid, debt relief and new sources of finance for meeting the Millennium Development Goals (MDGs). It was said that MDGs provide a clear set of objectives for mobilizing the international development community, especially in the area of development finance. The call for increased aid as well as for more debt relief in the creation of new sources of development finance has increased since the United Nations Financing for Development Summit and the subsequent report of the panel chaired by then President Ernesto Zedillo of Mexico on development finance. The goal of reducing the proportion of people living in extreme poverty by 2015 cannot be achieved in Sub-Saharan Africa (SSA). Such optimistic forecast suggests that MDG income poverty target will not be achieved in SSA until 2147.

A heuristic approach to Asian hedge fund allocation

The article offers information about hedge funds, which refers to pooled investments that are privately organized and professionally managed by investment managers. It examines the statistical properties of the 70 Asian hedge funds and shows the inappropriateness of the traditional mean-variance optimizer to form optimal hedge fund portfolios. The article also introduces a practical heuristic approach using the senti-variance as a measure for downside risk, and describes the risk measures and the methodology to generate optimal hedge fund portfolio.

Law, Theology, and Morality: Conceptions of the Rights to Relief of the Poor in the Twelfth and Thirteenth Centuries

This article presents an analysis of certain ways of thinking about law and its relationship to the poor, in particular the rights and entitlements of the poor to the basic necessities of life and the obligations of society to provide those necessities. It focuses on the works of Peter the Chanter and his “circle” at Paris in the late twelfth and early thirteenth centuries. Significant in their writings on the quandary between respect for private property and the need to allow those in need to take a share of this private property in order to survive is their negotiation of the intellectual boundaries and understandings between law, theology, and morality. In addition, an understanding of their discussions in light of canonistic and theological works of the time reveal a hitherto under-appreciated contribution to the “subjective rights” language in Peter the Chanter.

Dietary ALA, But not LNA, Increase Growth, Reduce Inflammatory Processes, and Increase Anti‑Oxidant Capacity in the Marine Finfish Larimichthys crocea

 Waiting for HERDC - Lisa B.

Using fund transfer pricing for comparing financial performance among business units

This study aims to demonstrate by a simplified analysis how fund transfer pricing can be used to measure financial performance taking into account the flow of resources in a bank with only two branches. The present study was developed in three sections. The first section provides information regarding fund transfer pricing and its characteristics. This is followed by a section with an analysis demonstrating how fund transfer pricing can assist top management to evaluate financial performance in a financial institutions with only two business units. Finally, the third section has the concluding remarks about the benefits and limitations of the use of fund transfer pricing. This study uses a simple version of fund transfer pricing system to address a further complex problem which is the exchange of services among business units in a decentralized organization. The analysis has shown how fund transfer pricing can be used to manage a bank, directing the efforts of branch managers.

Because it takes a village to fund the answers: Crowdfunding University Research

Whichever way you look at it, online crowdfunding is ramifying. From its foundations supporting creative industry initiatives, crowdfunding has branched into almost every aspect of public and private enterprise. Niche crowdfunding platforms and models are burgeoning across the globe faster than you can trill “kerching”. Early adopters have been quick to discover that in addition to money, they also get free market information and an opportunity to develop a relationship with their market base. Despite these evident benefits, universities have been cautious entrants in the crowdfunding space and more generally in the emerging ‘collaborative economy’ (Owyang, 2013). There are many cultural and institutional legacies that might explain this reluctance. For example, to date universities have achieved social (and economic) distinction through refining a set of exclusionary practices including, but not limited to, versions of gatekeeping, ranking and credentialing. These practices are reproduced in the expected behaviors of individual academics who garner social currency and status as experts, legislators and interpreters (Osborne, 20014: 435). Digitalization and the emergent knowledge and collaboration economies, have the potential to disrupt the academy’s traditional appeals to distinction and to re-engage universities and academics with their public stakeholders. This chapter will examine some of the challenges and benefits arising from public micro-funding of university-based research initiatives during a period of industrial transition in the university sector.Broadly then this chapter asks; what does scholarship mean in a digital ecosystem where sociality (rather than traditional systems for assessing academic merit) affords research opportunity and success? How might university research be rethought in a networked world where personal and professional identities are blurred? What happens when scholars adopt the same pathways as non-scholars for knowledge discovery, development and dissemination through use of emerging practices such as crowdfunding. These issues will be discussed through detailed exploration of a successful pilot project to crowdfund university research; Research My World. This project, a collaboration between Deakin University and the crowdfunding platform pozible.com, set out to secure new sources of funding for the ‘long-tail’ of academic research. More generally, it aimed to improve the digital capacity of the participating researchers and create new opportunities for public engagement for the researchers themselves as well as the university. We will examine how crowdfunding and social media platforms alter academic effort (the dis-intermediation or re-intermediation of research funding, reduction of the compliance burden, opportunities for market validation and so on), as well as the particular workflows of scholarly researchers themselves (improvements in “digital presence-building”, provision of cheap alternative funding, opportunities to crowdsource non-academic knowledge). In addressing these questions, this chapter will explore the influence that crowdfunding campaigns have for transforming contemporary academic practices across a range of disciplinary instances, providing the basis for a new form of engagement-led research. To support our analysis we will provide an overview of the initiative through quantitative analysis of a dataset generated by the first iteration of Research My World projects.

Another explanation of the mutual fund fee puzzle

This paper demonstrates that investor sentiment explains the recent puzzle of the negative relation between fees and before-fee performance of equity mutual funds. Using a composite proxy for investor sentiment, the puzzle can be explained stronger by investor sentiment, compared to the strategic fee-setting explanation discussed in the literature. More-sentiment driven investors would like to select more skilled fund managers, leading to a better future performance in short run. Additionally, when sentiment is high (low), it results in lower (higher) fees. Our results highlight the use of investor sentiment approach in determining mutual fund fees and performance.