946 resultados para Operations
Resumo:
Aim of the study was to determine if gynaecological operations have an effect on sexual function using the current medlined literature. We performed a Medline search using the terms "sexual life/function after operative gynaecological treatment", "sexual life/function after operations for gynaecological problems", "sexual life/function after hysterectomy", "sexual life/function, incontinence" and "sexual life/function, pelvic organ prolapse". Reviews were excluded. We divided the operations into four groups of (1) combined prolapse and incontinence operations, (2) prolapse operations only, (3) incontinence operations only and (4) hysterectomy and compared pre-to postoperative sexual outcome. Thirty-six articles including 4534 patients were identified. Only 13 studies used a validated questionnaire. The other authors used self-designed and non-validated questionnaires or orally posed questions by the examiner to determine sexual function. Prolapse operations particularly posterior repair using levator plication seem to deteriorate sexual function, incontinence procedure have some worsening effect on sexual function and hysterectomy seems to improve sexual function with no differences between subtotal or total hysterectomy. Gynaecological operations do influence sexual function. However, little validated data are available to come to this conclusion.
Resumo:
In 1906, two American industrialists, John Munroe Longyear and Frederick Ayer, formed the Arctic Coal Company to make the first large scale attempt at mining in the high-Arctic location of Spitsbergen, north of the Norwegian mainland. In doing so, they encountered numerous obstacles and built an organization that attempted to overcome them. The Americans sold out in 1916 but others followed, eventually culminating in the transformation of a largely underdeveloped landscape into a mining region. This work uses John Law’s network approach of the Actor Network Theory (ANT) framework to explain how the Arctic Coal Company built a mining network in this environmentally difficult region and why they made the choices they did. It does so by identifying and analyzing the problems the company encountered and the strategies they used to overcome them by focusing on three major components of the operations; the company’s four land claims, its technical system and its main settlement, Longyear City. Extensive comparison between aspects of Longyear City and the company’s choices of technology with other American examples place analysis of the company in a wider context and helps isolate unique aspects of mining in the high-Arctic. American examples dominate comparative sections because Americans dominated the ownership and upper management of the company.
Resumo:
In order to determine anticoagulation strategies in OPCAB a questionnaire survey among 750 European cardio-thoracic surgeons was performed. Questions addressed volume of OPCAB procedures performed, intra- and perioperative heparinization and antiplatelet therapy, as well as perioperative management. A total of 325 (43.7%) questionnaires were returned and validated. Perioperative protocols for administration of antiplatelets differed among the respondent surgeons. Perioperative prophylaxis of thrombosis (low or high molecular weight heparin) is performed by 78%. Intraoperative heparin dosage range between 70 U/kg to 500 U/kg, 60% of respondents prefer a low-dose regimen (< or = 150 U/kg). Correspondingly, the lowest activated clotting time (ACT) during surgery is accepted to be 200 s by 24%, 250 s by 18% and 300 s by 26% of surgeons. Protamine is used by 91% of respondents, while 52% perform a 1:1 reversal. A cell-saver and antifibrinolytics are used by 70% and 40%, respectively. Interestingly, 56% of respondents think bleeding in OPCAB patients is not reduced when compared to on-pump CABG. In addition, 34% of respondents believe there is an increased risk of early graft occlusion following OPCAB. This survey demonstrates widely different intra- and perioperative anticoagulation strategies for OPCAB procedures among European surgeons.
Resumo:
The purpose of the internet-based teachware mySCM is that students of economics, informatics and industrial engineering get familiar with quantitative methods for supply chain management. Input-output-relationships of various optimization methods can be detected by sampling input values, parameters, and alternative methods for the same problem. Students can gain extra benefits by passing so-called mini-exams that motivate active learning. mySCM can be used for free, round-the-clock, and any place where access to the Internet is available.
Resumo:
During the last two years of World War I food supply in Switzerland declined and caused shortcomings in consume, leading to social distress and conflict. Mainly two important factors caused these problems: First, Switzerland was highly dependent on food imports and during the war traditional supply lines faded. Second, weather extremes in the years 1916–1917 caused crop failure all over Europe and North America, which intensified the decline of food trade between the nations. In 1918 a conflict between classic urban consumers, such as workers, and famers erupted due to the food shortcomings and led to a lasting discord between urban and agrarian regions in Switzerland. But there was not only disharmony and conflict between the urban and agrarian regions. As a matter of fact several agents (urban and agrarian) interested in presenting adequate coping strategies to overcome the food shortages developed ideas of alternative ways of food production and supply since 1917. The aim of the paper is to outline these strategies that were undertaken to create a new era of food production that was not solely dependent on the agrarian sector or the import-trade. Actual growing of vegetables in estate areas is an important, but just one, factor of establishing a new system of food production, distribution and consume. The market-leading grocery stores in Switzerland nowadays (Coop and Migros) started their business during that time as co-operatives establishing new forms of distribution and food-production. So the interest of the paper is not only in actual «urban farming», but it wants to share some light on how swiss urban and agrarian spheres overlapped their functions in order to create a modern system of agro food-chains at the beginning of the interwar period.