Rate of undesirable events at beginning of academic year: retrospective cohort study.

OBJECTIVE: To determine whether an increase in the rate of undesirable events occurs after care provided by trainees at the beginning of the academic year. DESIGN: Retrospective cohort study using administrative and patient record data. SETTING: University affiliated hospital in Melbourne, Australia. PARTICIPANTS: 19,560 patients having an anaesthetic procedure carried out by first to fifth year trainees starting work for the first time at the hospital over a period of five years (1995-2000). MAIN OUTCOME MEASURES: Absolute event rates, absolute rate reduction, and rate ratios of undesirable events. RESULTS: The rate of undesirable events was higher at the beginning of the academic year compared with the rest of the year (absolute event rate 137 v 107 per 1000 patient hours, relative rate reduction 28%, P<0.001). The overall adjusted rate ratio for undesirable events was 1.40, 95% confidence interval 1.24 to 1.58. This excess risk was seen for all residents, regardless of their level of seniority. The excess risk decreased progressively after the first month, and the trend disappeared fully after the fourth month of the year (rate ratio for fourth month 1.21, 0.93 to 1.57). The most important decreases were for central and peripheral nerve injuries (relative difference 82%), inadequate oxygenation of the patient (66%), vomiting/aspiration in theatre (53%), and technical failures of tracheal tube placement (49%). CONCLUSIONS: The rate of undesirable events was greater among trainees at the beginning of the academic year regardless of their level of clinical experience. This suggests that several additional factors, such as knowledge of the working environment, teamwork, and communication, may contribute to the increase.

The effect of virtual reality on visual vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study.

Individuals with vestibular dysfunction may experience visual vertigo (VV), in which symptoms are provoked or exacerbated by excessive or disorientating visual stimuli (e.g. supermarkets). VV can significantly improve when customized vestibular rehabilitation exercises are combined with exposure to optokinetic stimuli. Virtual reality (VR), which immerses patients in realistic, visually challenging environments, has also been suggested as an adjunct to VR to improve VV symptoms. This pilot study compared the responses of sixteen patients with unilateral peripheral vestibular disorder randomly allocated to a VR regime incorporating exposure to a static (Group S) or dynamic (Group D) VR environment. Participants practiced vestibular exercises, twice weekly for four weeks, inside a static (Group S) or dynamic (Group D) virtual crowded square environment, presented in an immersive projection theatre (IPT), and received a vestibular exercise program to practice on days not attending clinic. A third Group D1 completed both the static and dynamic VR training. Treatment response was assessed with the Dynamic Gait Index and questionnaires concerning symptom triggers and psychological state. At final assessment, significant betweengroup differences were noted between Groups D (p = 0.001) and D1 (p = 0.03) compared to Group S for VV symptoms with the former two showing a significant 59.2% and 25.8% improvement respectively compared to 1.6% for the latter. Depression scores improved only for Group S (p = 0.01) while a trend towards significance was noted for Group D regarding anxiety scores (p = 0.07). Conclusion: Exposure to dynamic VR environments should be considered as a useful adjunct to vestibular rehabilitation programs for patients with peripheral vestibular disorders and VV symptoms.

The effect of virtual reality on visual vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study

Individuals with vestibular dysfunction may experience visual vertigo (VV), in which symptoms are provoked or exacerbated by excessive or disorientating visual stimuli (e.g. supermarkets). VV can significantly improve when customized vestibular rehabilitation exercises are combined with exposure to optokinetic stimuli. Virtual reality (VR), which immerses patients in realistic, visually challenging environments, has also been suggested as an adjunct to VR to improve VV symptoms. This pilot study compared the responses of sixteen patients with unilateral peripheral vestibular disorder randomly allocated to a VR regime incorporating exposure to a static (Group S) or dynamic (Group D) VR environment. Participants practiced vestibular exercises, twice weekly for four weeks, inside a static (Group S) or dynamic (Group D) virtual crowded square environment, presented in an immersive projection theatre (IPT), and received a vestibular exercise program to practice on days not attending clinic. A third Group D1 completed both the static and dynamic VR training. Treatment response was assessed with the Dynamic Gait Index and questionnaires concerning symptom triggers and psychological state. At final assessment, significant betweengroup differences were noted between Groups D (p = 0.001) and D1 (p = 0.03) compared to Group S for VV symptoms with the former two showing a significant 59.2% and 25.8% improvement respectively compared to 1.6% for the latter. Depression scores improved only for Group S (p = 0.01) while a trend towards significance was noted for Group D regarding anxiety scores (p = 0.07). Conclusion: Exposure to dynamic VR environments should be considered as a useful adjunct to vestibular rehabilitation programs for patients with peripheral vestibular disorders and VV symptoms.

The Application of 3D Reconstruction Techniques in the Analysis of Ancient Tarraco’s Urban Topography

The widespread implementation of GIS-based 3D topographical models has been a great aid in the development and testing of archaeological hypotheses. In this paper, a topographical reconstruction of the ancient city of Tarraco, the Roman capital of the Tarraconensis province, is presented. This model is based on topographical data obtained through archaeological excavations, old photographic documentation, georeferenced archive maps depicting the pre-modern city topography, modern detailed topographical maps and differential GPS measurements. The addition of the Roman urban architectural features to the model offers the possibility to test hypotheses concerning the ideological background manifested in the city shape. This is accomplished mainly through the use of 3D views from the main city accesses. These techniques ultimately demonstrate the ‘theatre-shaped’ layout of the city (to quote Vitrubius) as well as its southwest oriented architecture, whose monumental character was conceived to present a striking aspect to visitors, particularly those arriving from the sea.

Bullet embolism of pulmonary artery: a case report

The authors report the case of a patient victim of gunshots, with a very rare complication: venous bullet embolism from the left external iliac vein to the lingular segment of the left pulmonary artery. Diagnosis is made with whole-body radiography or computed tomography. Digital angiography is reserved for supplementary diagnosis or to be used as a therapeutic procedure.

Thistle Theatre

Located inside Brock's Thistle Complex, the Thistle Theatre, which has since been renamed the Sean O'Sullivan Theatre, features a thrust stage and steep rising tiers of seats in a semi circular 'bowl'. Although often described as a 550 seat theatre, in actuality it originally had exactly 543 seats. It is interesting to note that the official number of seats is now 538. The very first production to be held at the theatre was Lysistrata, the Greek comedy by Aristophanes, on July 29, 1969. Since it's opening in 1969, it has been the centre of a great many cultural events and other performances ranging from concerts and plays to lectures and speeches.

Architectural drawing of Moulton Hall, Chapman College, Orange, California

Architectural drawing of Moulton Hall, Orange, California. Completed in 1975 (2 floors, 44,592 sq.ft.), this building is named in memory of an artist and patroness of the arts, Nellie Gail Moulton. Within this structure are the departments of Art, Communications, and Theatre/Dance as well as the Guggenheim Gallery and Waltmar Theatre.

Architectural drawing of Moulton Hall, Chapman College, Orange, California

Architectural drawing of Moulton Hall, Orange, California. Completed in 1975 (2 floors, 44,592 sq.ft.), this building is named in memory of an artist and patroness of the arts, Nellie Gail Moulton. Within this structure are the departments of Art, Communications, and Theatre/Dance as well as the Guggenheim Gallery and Waltmar Theatre.

Overview drawing of Moulton Hall, Chapman College, Orange, California

Architectural drawing showing Moulton Hall, Orange, California. Completed in 1975 and housing the departments of Art, Communications, and Theatre/Dance as well as the Guggenheim Gallery and Waltmar Theatre.

Architectural model of Moulton Hall Fine Arts Complex, Chapman College, Orange, California

Architectural model of Moulton Hall Fine Arts Complex, Chapman College, Orange, California. Completed in 1975 (2 floors, 44,592 sq.ft.), this building is named in memory of an artist and patroness of the arts, Nellie Gail Moulton. Within this structure are the departments of Art, Communications, and Theatre/Dance as well as the Guggenheim Gallery and Waltmar Theatre. Model photographed by Rene Laursen, Santa Ana, California.

Architectural drawing of Moulton Hall Fine Arts Complex, Chapman College, Orange, California

Architectural drawing of Moulton Hall, showing Waltmar Theatre, Orange, California. Completed in 1975 (2 floors, 44,592 sq.ft.), this building is named in memory of an artist and patroness of the arts, Nellie Gail Moulton. Within this structure are the departments of Art, Communications, and Theatre/Dance as well as the Guggenheim Gallery and Waltmar Theatre. Waltmar Theatre was a gift from the late Walter and Margaret Schmid.

Waltmar Theatre, Chapman College, Orange, California

Waltmar Theatre, Chapman College, Orange, California. Part of the Moulton Fine Arts Complex which houses the departments of Art, Communications, and Theatre/Dance as well as the Guggenheim Gallery and Waltmar Theatre. Waltmar Theatre was a gift from the late Walter and Margaret Schmid.

Waltmar Theatre, Moulton Hall, Chapman College, Orange, California

Waltmar Theatre steps, Moulton Hall, Chapman College, Orange, California, ca. 1975. Designed by Leason Pomeroy III & Associates of Orange, using a tilt-up concrete construction method. Completed in 1975, this 44,592 sq.ft. building is named in memory of an artist and patroness of the arts, Nellie Gail Moulton. Within this structure are the departments of Art, Communications, and Theatre/Dance as well as the Guggenheim Gallery and Waltmar Theatre. Waltmar Theatre was a gift from the late Walter and Margaret Schmid. The Guggenheim Gallery is used for the art exhibits presented by the art department and other departments on campus.

Waltmar Theatre, Moulton Hall, Chapman College, Orange, California

Waltmar Theatre entrance steps, Moulton Hall, Chapman College, Orange, California, ca. 1975. Designed by Leason Pomeroy III & Associates of Orange, using a tilt-up concrete construction method. Completed in 1975, this 44,592 sq.ft. building is named in memory of an artist and patroness of the arts, Nellie Gail Moulton. Within this structure are the departments of Art, Communications, and Theatre/Dance as well as the Guggenheim Gallery and Waltmar Theatre. Waltmar Theatre was a gift from the late Walter and Margaret Schmid. The Guggenheim Gallery is used for the art exhibits presented by the art department and other departments on campus.

Dramatizing whoredom : prostitution in the work of Tennessee Williams

Cette thèse explore le leitmotiv de la prostitution dans l’oeuvre de Tennessee Williams et soutient que la plupart des personnages de Williams sont engagés dans une forme de prostitution ou une autre. En effectuant une analyse formaliste des textes de Williams qui illustrent toute forme de prostitution, avec une attention particulière à quatre grandes pièces, A Streetcar Named Desire (1947), Cat on a Hot Tin Roof (1955), Suddenly Last Summer (1958) et Sweet Bird of Youth (1959), cette présente étude fait valoir que le dramaturge utilise un mode de fiction—le gothique—en lien avec une pratique transgressive—la prostitution—pour relier les classes sociales et troubler les catégories de prostitution. Ce faisant, Williams offre une vision plus représentative et nuancée de la prostitution. Théoriquement, cette thèse repose sur des oeuvres critiques portant sur le genre, la sexualité et l'histoire de Michel Foucault, David Savran, et Michael Paller afin de situer la dramaturgie de Williams dans le contexte historique et culturel des années 1940 et 1950. La première partie de cette thèse (chapitres un et deux) fournit de nombreuses informations autobiographiques et biographiques qui expliquent pourquoi la prostitution est devenue le thème de prédilection pour Williams. Cette section met l’accent sur sa préoccupation constante à l’égard de sa prostitution artistique (en prostituant son art pour le succès commercial) et sexuelle (en payant pour des prostitués). Cette partie présente également un inventaire détaillé des prostituté(e)s, que je divise en trois catégories: 1) la prostitution des enfants, 2) la prostitution masculine et 3) la prostitution féminine. La deuxième partie de cette étude, composée des chapitres trois et quatre, identifie les personnages de Williams qui s’engagent dans une forme de prostitution morale. Ce groupe comprend ceux qui tirent directement profit de la prostitution des autres ainsi que ceux qui se marient uniquement pour un gain financier ou une promotion sociale ou les deux. L’oeuvre de Williams résiste la représentation stéréotypée de la prostituée en littérature comme étant uniquement de sexe féminin ou provenant des classes sociales défavorisées ou les deux. La prostituée de Williams n’est ni une figure romantique ni une rebelle menaçant la société. Cette thèse conclut qu’en représentant des enfants prostitués, des femmes de rue, des prostitués de sexe masculin, des souteneurs, des proxénètes, des propriétaires de bordels, des leaders corrompus et des personnes qui se prostituent en concluant des mariages de convenance, Williams a effectivement et incontestablement dramatisé la prostitution sous toutes ses formes.