Hole in the wall : or a peep at the creed-worshippers. Embellished with cuts by the author.

Mode of access: Internet.

"A peep into the past": Brighton in the olden time, with glances at the present.

Mode of access: Internet.

Colloquial Finnish in Subtitles – a Survey on the British Situation Comedy Peep Show

The use of dialects in audiovisual texts is increasing, but the use of standard language in Finnish subtitles is still the prevalent norm and seldom flouted. This may not be in the best interest of the audience as the way the characters speak – their idiolects – is very important for the atmosphere of the audiovisual text and widely used to give the characters personalities and background. This thesis studies whether the viewing experience could be enhanced by taking the characters’ idiolects into account in subtitling. The study was executed as a survey, and the respondents were recruited from social media and an university of applied sciences. A total of 113 respondents were divided into two groups: the experimental group (n=59) and the control group (n=54). Both groups were shown an excerpt of the British situation comedy Peep Show, but with different subtitles. In the experimental subtitles, three characters were given a written idiolect with a level of colloquial language corresponding to the spoken idiolect of the character, while the control subtitles followed the norm of using standard language. The questionnaire contained background questions, a Likert-scale question and open questions. The quantitative responses were analysed statistically through cross tabulation and Mann–Whitney U test or Kruskal-Wallis test (CI=95%, α=0,05). The results showed a statistically significant difference in keeping track on which of the characters was speaking for the benefit of the experimental subtitles. In the other items no statistically significant difference was found between the groups. In the open questions the use of colloquial language was mostly commented favourably.

The pathophysiology of emphysema : considerations for critical care nursing practice

Emphysema is caused by exposure to cigarette smoking as well as alpha1-antitrypsin deficiency. It has been estimated to cost the National Health Service (NHS) in excess of £800 million per year in related health care costs. The challenges for Critical Care nurses are those associated with dynamic hyperinflation, Auto-PEEP, malnutrition and the weaning from invasive and non-invasive mechanical ventilation. In this paper we consider the impact of the pathophysiology of emphysema, its effects on other body systems as well as the impact acute exacerbations have when patients are admitted to the Intensive Care Unit.

Eyes on their fingertips: some aspects of the arts, science, technology and culture of the fisherfolk of Trivandrum, India

Eyes on Their Finger Tips deals with the traditional marine wisdom of a set of people and the rarest of rare experiences they have had at sea. Through these numerous chapters he takes us into the seas of the fishers. It is a voyage which we cannot make in reality. But through the heroic deeds of his father, the riddles of oldman Sebesti, the shark story of brother Kamalappan, and the rituals of his mother, we get a fascinating peep into the wisdom of the watery world of the small-scale fishers of Trivandrum, Kerala, India.

抚顺市工业废水生物毒性评价

潜在毒性效应指数(PEEP)综合了多种生物测试及生态毒性测试结果,是一种新的评价和比较工业废水潜在毒性的指标,是理化分析评价法的一个重要补充。用蚕豆微核试验、发光细菌急性毒性试验、鱼类急性毒性试验逐一单项分析评价了抚顺市10家典型企业11个排水口废水的生物毒性。结果表明,抚顺工业废水大部分处于中度污染,农药厂、啤酒厂废水的毒性较高,而且这些企业的污水量相对少,迫切需要治理。并采用PEEP综合分析了废水的生物毒性程度,根据控制排放标准规定,PEEP>6时,要对企业排放废水实施控制措施。抚顺市10家典型污染企业废水PEEP均大于6,说明这10家企业都需要进一步控制废水排放及污染问题。

Rent: apartment blocks and their uses

In 1974, pursuing his interest in the infra-ordinary – ‘the banal, the quotidian, the obvious, the common, the ordinary, the back-ground noise, the habitual’ – Georges Perec wrote about an idea for a novel:
‘I imagine a Parisian apartment building whose façade has been removed … so that all the rooms in the front, from the ground floor up to the attics, are instantly and simultaneously visible’.
In Life A User’s Manual (1978) the consummation of this precis, patterns of existence are measured within architectural space with an archaeological sensibility that sifts through narrative and décor, structure and history, services and emotion, the personal and the system, ascribing commensurate value to each.
Apartment comes from the Italian appartare meaning ‘to separate’. The space of the boundary between activities is reduced to a series of intimately thin lines: the depth of a floor, a party wall, a window, the convex peep-hole in a door, or the façade that Perec seeks to render invisible. The apartness of the apartment is accelerated when aligned with short-term tenancies. Here Perec’s interweaving of personal histories over time using the structure of the block, gives way to convivialities of detachment: inhabitants are temporary, their personalities anonymous, their activities unknown or overlooked.
Borrowing methods from Perec, to move somewhere between conjecture, analysis and other documentation and tracing relationships between form, structure, materiality, technology, organisation, tenure and narrative use, this paper interrogates the late twentieth-century speculative apartment block in Britain and Ireland arguing that its speculative and commodified purpose allows a series of lives that are often less than ordinary to inhabit its spaces.
Henri Lefebvre described the emergence of an ‘abstract space’ under capitalism in terms which can be applied to the apartment building: the division of space into freely alienable privatised parcels which can be exchanged. Vertical distributions of class and other new, contiguous social and spatial relationships are couched within a paradox: the building which allows such proximities is also a conductor of division. Apartment comes from the Italian appartare meaning ‘to separate’. The space of the boundary between activities is reduced to a series of intimately thin lines: the depth of a floor, a party wall, a window, the convex peep-hole in a door, or the façade that Perec seeks to render invisible. The apartness of the apartment is accelerated when aligned with short-term tenancies. Here Perec’s interweaving of personal histories over time using the structure of the block, gives way to convivialities of detachment: inhabitants are temporary, their personalities anonymous, their activities unknown or overlooked.

Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries

Importance Limited information exists about the epidemiology, recognition, management, and outcomes of patients with the acute respiratory distress syndrome (ARDS).

Objectives To evaluate intensive care unit (ICU) incidence and outcome of ARDS and to assess clinician recognition, ventilation management, and use of adjuncts—for example prone positioning—in routine clinical practice for patients fulfilling the ARDS Berlin Definition.

Design, Setting, and Participants The Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients undergoing invasive or noninvasive ventilation, conducted during 4 consecutive weeks in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across 5 continents.

Exposures Acute respiratory distress syndrome.

Main Outcomes and Measures The primary outcome was ICU incidence of ARDS. Secondary outcomes included assessment of clinician recognition of ARDS, the application of ventilatory management, the use of adjunctive interventions in routine clinical practice, and clinical outcomes from ARDS.

Results Of 29 144 patients admitted to participating ICUs, 3022 (10.4%) fulfilled ARDS criteria. Of these, 2377 patients developed ARDS in the first 48 hours and whose respiratory failure was managed with invasive mechanical ventilation. The period prevalence of mild ARDS was 30.0% (95% CI, 28.2%-31.9%); of moderate ARDS, 46.6% (95% CI, 44.5%-48.6%); and of severe ARDS, 23.4% (95% CI, 21.7%-25.2%). ARDS represented 0.42 cases per ICU bed over 4 weeks and represented 10.4% (95% CI, 10.0%-10.7%) of ICU admissions and 23.4% of patients requiring mechanical ventilation. Clinical recognition of ARDS ranged from 51.3% (95% CI, 47.5%-55.0%) in mild to 78.5% (95% CI, 74.8%-81.8%) in severe ARDS. Less than two-thirds of patients with ARDS received a tidal volume 8 of mL/kg or less of predicted body weight. Plateau pressure was measured in 40.1% (95% CI, 38.2-42.1), whereas 82.6% (95% CI, 81.0%-84.1%) received a positive end-expository pressure (PEEP) of less than 12 cm H2O. Prone positioning was used in 16.3% (95% CI, 13.7%-19.2%) of patients with severe ARDS. Clinician recognition of ARDS was associated with higher PEEP, greater use of neuromuscular blockade, and prone positioning. Hospital mortality was 34.9% (95% CI, 31.4%-38.5%) for those with mild, 40.3% (95% CI, 37.4%-43.3%) for those with moderate, and 46.1% (95% CI, 41.9%-50.4%) for those with severe ARDS.

Conclusions and Relevance Among ICUs in 50 countries, the period prevalence of ARDS was 10.4% of ICU admissions. This syndrome appeared to be underrecognized and undertreated and associated with a high mortality rate. These findings indicate the potential for improvement in the management of patients with ARDS.

Étude multicentrique sur les stratégies de ventilation mécanique employées chez les enfants avec un œdème pulmonaire lésionnel

Des études adultes sur l’œdème pulmonaire lésionnel et le Syndrome de Détresse Respiratoire Aiguë ont mené à l’établissement de recommandations sur les stratégies de ventilation mécanique à employer chez ces patients. Cependant, il n’est pas clair si les recommandations adultes sont également bénéfiques pour l’enfant. Objectif Décrire les stratégies de ventilation mécanique employées chez les enfants atteints d’un œdème pulmonaire lésionnel. Méthodes Étude épidémiologique transversale tenue dans 59 unités de Soins Intensifs Pédiatriques de 12 pays en Amérique du Nord et en Europe. Six jours d’étude ont eu lieu entre juin et novembre 2007. Les enfants atteints d’un œdème pulmonaire lésionnel étaient inclus et des données sur la sévérité de leur maladie, les paramètres de ventilation mécanique et les thérapies adjuvantes employées ont été recueillies. Résultats Des 3823 enfants dépistés, 414 (10.8%) avaient un œdème pulmonaire lésionnel et 165 (40%) ont été inclus dans l’étude (124 étaient sous ventilation mécanique conventionnelle, 27 sous ventilation à haute fréquence par oscillation et 14 sous ventilation non invasive). Dans le groupe sous ventilation conventionnelle, 43.5% étaient ventilés avec un mode contrôlé à pression, le volume courant moyen était de 8.3±3.3 ml/kg et l’utilisation de la PEP et FiO2 était hétérogène. Conclusions Cette étude démontre une hétérogénéité dans les stratégies de ventilation mécanique employées chez les enfants souffrant d’un œdème pulmonaire lésionnel. Celle-ci pourrait être en partie reliée à la robustesse des critères diagnostiques actuellement utilisés pour définir l’ALI/SDRA. Une évaluation rigoureuse de ces stratégies est nécessaire pour guider la standardisation des soins et optimiser l’issue de ces patients.

La Presión Intra-abdominal Influye Sobre los Limites de la Presión de la Vía Aérea Durante la Ventilación Protectora Pulmonar

Background: The Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have a impact on the respiratory system and the recommendations for mechanical ventilation of patients with IAH/ACS remain unclear. Our study characterize the influence of elevated intra-abdominal pressure (IAP) and positive end-expiratory pressure (PEEP) on airway plateau pressure (PPLAT) and bladder pressure (PBLAD). Methods: Nine (n=9) deeply anesthetized swine were mechanically ventilated via tracheostomy: volume-controlled mode at tidal volume = 10 ml/kg, frequency=15, Inspiratory:Expiratory ratio=1:2 and PEEP of 1 and 10 cmH2O (PEEP1 and PEEP10, respectively). A tracheostomy tube was place in the peritoneal cavity and different levels of IAP were applied utilizing a CPAP system. Measurements were performed during both PEEP1 and PEEP10. Results: PBLAD increased as experimental IAP rose. Minimal underestimation of IAP by PBLAD was observed. Applying PEEP10 did not significantly affect the correlation between experimental IAP and PBLAD. PBLAD (in cmH2O) was reflected by changes in PPLAT regardless of the PEEP.

Caracterización de los pacientes críticos ventilados en la Fundación Santa Fe de Bogotá 2009 a 2013

Objetivo: Caracterizar a los pacientes que recibieron ventilación mecánica en las unidades de cuidado intensivo (UCI) de la Fundación Santa Fe de Bogotá entre los años 2009 y 2013. Metodología: Se analizó una cohorte retrospectiva de los pacientes en UCI que requirieron soporte ventilatorio mecánico al ingreso a la unidad independientemente de la causa. Resultados: La media de edad de los pacientes fue 63,83 años; el diagnóstico más frecuente de ingreso fue revascularización miocárdica, seguido por neumonía y recambio valvular aórtico; en el 43% de los casos la causa de la falla fue el estado postoperatorio. Los modos ventilatorios más frecuentemente utilizados fueron SIMV (27,5%) y ventilación asistida controlada (26,12%). El 50% de los pacientes fueron ventilados con PEEP < 6 cmH2O. La mortalidad bruta fue del 15%. 22% de los pacientes tuvieron estancia prolongada en UCI. Se aplicó protocolo de retiro de ventilación mecánica en el 77% de los pacientes. La duración de la ventilación mecánica es mayor a medida que aumenta la edad del paciente entre los 60 y los 80 años. La mortalidad es cercana al 50% alrededor de los 50 años y mayor a 80% después de los 80 años. El soporte ventilatorio por cinco o más días aumentó la mortalidad a 80% o más. Discusión y Conclusiones: Estos resultados son comparables a los encontrados en estudios previos. Este estudio puede ser considerado como el primer paso para generar un registro adecuado de la ventilación de la mecánica de las unidades de cuidado intensivo del país.

Analysis of the alveolar recruitment maneuvers applied at seven intensive care units

Introduction: During the past years, alveolar recruitment maneuvers (RM) have produced growing interest due to their beneficial potential in pulmonary protection, and have been introduced in clinical practice. Objective: To describe and analyze the knowledge of MR and its application at seven intensive care units in the city of Cali, Colombia. Methods and materials: Descriptive Cross-Sectional Study with an intentional sample of 64 professionals working in seven intensive care units and who apply MR. The self-completed survey was made up of thirteen questions, and the application period was two months. Results: Out of 64 professionals surveyed, 77.8% of them follow a protocol guide; 54.7% employes during RM the ideal Positive end-expiratory pressure (PEEP), which maintains a saturation > 90% and a PaO2 > 60 mmHg; 42.1% tolerates airway pressures between 35 and 50 cmH2O; 48.4% perform RM with a progressive increase of the PEEP and a low tidal volume. Conclusions: Regarding the knowledge related to RM, heterogeneity was found in the answers. There is currently no consensus about which is the most effective and secure way to implement an MR. This study can be the starting point to create awareness towards the revision of knowledge, capacities and abilities that are required to perform RM.

Evaluación de la educación emocional en el ciclo medio de Educación Primaria.

Monográfico con el título: 'La formación práctica de estudiantes universitarios : repensando el Practicum'. Resumen basado en el de la publicación

Sobre cinemas e vídeo-locadoras pornôs, províncias de outros corpos e outros significados

Esta pesquisa aborda os cenários sexuais e algumas dinâmicas associadas a três cinemas e duas vídeo-locadoras pornôs localizadas no centro de Porto Alegre, Rio Grande do Sul, Brasil. A etnografia destes espaços serve de pano de fundo para abordar uma dimensão pouco referida nos estudos sobre a sexualidade humana, as práticas sexuais de homens mais velhos que buscam satisfazer desejos em relações homossexuais. O envelhecimento, fenômeno amplamente estudado por disciplinas como a gerontologia – e também um tema antigo nos quadros da Antropologia Social, disciplina na qual inserem-se os esforços deste trabalho –, normalmente é analisado a partir de sexualidades heterocêntricas. Chama a atenção a invisibilidade da orientação sexual nos estudos sobre envelhecimento, assim como a paralela marginalidade das questões do envelhecimento nos estudos sobre homossexualidades. Assim, entre salas e corredores, cabines coletivas e peep shows individuais, dinâmicas associadas à satisfação de desejos homoeróticos de homens mais velhos foram observadas e etnografadas nos anos de 2002 e, principalmente, 2003. É respaldado neste esforço etnográfico que se torna patente referir nestes espaços uma valorização de outros corpos que não apenas os atléticos, e fases da vida que não apenas a juventude. Este resultado sugere que corpos envelhecidos e proporções não apolíneas também configuram objetos de desejos, o que remete a províncias de significados configuradas de formas distintas daquelas que valorizam o jovem e as proporções hercúleas como as únicas formas e caminhos dos desejos. Outro resultado remete à possível influência da história destes espaços na própria forma como se organizam as dinâmicas e as valorizações dos corpos.

O uso da pressão expiratória positiva durante o desmame da ventilação mecânica : uma comparação com os métodos de pressão suporte e tubo T.

Introdução: O uso da pressão expiratória positiva na via aérea (EPAP) não é sugerido como técnica de desmame. O EPAP pode previnir o colapso das vias aéreas durante a expiração. Objetivo: O objetivo deste trabalho é verificar se a utilização da pressão expiratória positiva na via aérea (EPAP) apresenta benefícios na redução da hiperinsuflação dinâmica com redução do trabalho respiratório e melhora da oxigenação em pacientes submetidos ao processo de desmame da ventilação mecânica. Material e Métodos: Quarenta pacientes submetidos à ventilação mecânica por um período maior que 48 horas em 2 unidades de terapia intensiva foram avaliados prospectivamente em um estudo randomizado controlado cruzado. Todos os pacientes foram submetidos métodos de ventilação de pressão de suporte (PSV), tubo-t e EPAP, durante 30 minutos, com um período de descanso de 30 minutos entre cada método. Os pacientes foram monitorizados pelo VenTrack (Novametrix, EUA). As variáveis estudadas, mensuradas no minuto 1, 15 e 30, foram: PEEP intínseca (PEEPi), trabalho respiratório (WOBtotal), frequência respiratória (f), volume de ar corrente (Vt) e saturação periférica de oxigênio (SaO2). A amostra geral foi analisada e dividida em subgrupos DPOC (n= 14) e não-DPOC (n=26), traqueostomizados (n=15) e não-traqueostomizados (n=25). As comparações foram feitas pela Análise de Variância (ANOVA) e teste-t. O nível de significância foi de 95%. Resultados: PEEPi DPOC e não-DPOC minuto 1 (0,014 + 0,03 versus 0,17 + 0,38 cmH2O) e minuto 15 (0,042 + 0,13 versus 0,41 + 0,78 cmH2O) (p<0,05). No subgrupo não-traqueo, nos métodos de PSV15 (0,26 + 0,5 cm H2O) e EPAP15 (0,02 + 0,07 cm H2O), assim como PSV 30 (0,21 + 0,4 cm H2O) e EPAP 30 (0,02 + 0,1 cm H2O) (p<0,05). Para traqueo vs não-traqueo, no método EPAP minuto 1 (PEEPi traqueo 0,58 + 0,94 cm H2O; PEEPi não-traqueo 0,08 + 0,28 cmH2O) e minuto 15 (PEEPi traqueo 0,91 + 2,06 cm H2O; PEEPi não-traqueo 0,02 + 0,07 cmH2O) (p<0,05). Em relação ao WOBtotal houve um aumento significativo no método EPAP em relação ao tubo-t na análise geral da amostra (p<0,05). A f mostrou-se maior no método EPAP para o subgrupo não-DPOC e não-traqueo (minutos 1, 15 e 30). A SaO2 foi maior no subgrupo PSV quando comparada com tubo-t na análise geral da amostra, (p<0,05) Conclusões: A EPAP não demonstrou redução na PEEPi na análise geral da amostra, subgrupo DPOC, não-DPOC e traqueostomizados. Houve redução na PEEPi no grupo não-traqueostomizados. Houve aumento do WOBtotal com o uso da EPAP. Neste estudo a EPAP não demonstrou vantagens em relação aos outros métodos.