Harrisin ja Atranin argumentit

Keskustelua

Trends and characteristics of attendance at the emergency department of a Swiss university hospital: 2002-2012.

BACKGROUND: The numbers of people attending emergency departments (EDs) at hospitals are increasing. We aimed to analyse trends in ED attendance at a Swiss university hospital between 2002 and 2012, focussing on age-related differences and hospital admission criteria. METHODS: We used hospital administrative data for all patients aged ≥16 years who attended the ED (n = 298,306) at this university hospital between 1 January 2002, and 31 December 2012. We descriptively analysed the numbers of ED visits according to the admission year and stratified by age (≥65 vs <65 years). RESULTS: People attending the ED were on average 46.6 years old (standard deviation 20 years, maximum range 16‒99 years). The annual number of ED attendances grew by n = 6,639 (27.6%) from 24,080 in 2002 to 30,719 in 2012. In the subgroup of patients aged ≥65 the relative increase was 42.3%, which is significantly higher (Pearson's χ2 = 350.046, df = 10; p = 0.000) than the relative increase of 23.4% among patients <65 years. The subgroup of patients ≥65 years attended the ED more often because of diseases (n = 56,307; 85%) than accidents (n = 9,844; 14.9%). This subgroup (patients ≥65 years) was also more often admitted to hospital (Pearson's χ2 = 23,377.190; df = 1; p = 0.000) than patients <65 years. CONCLUSIONS: ED attendance of patients ≥65 years increased in absolute and relative terms. The study findings suggest that staff of this ED may want to assess the needs of patients ≥65 years and, if necessary, adjust the services (e.g., adapted triage scales, adapted geriatric screenings, and adapted hospital admission criteria).

Kleine Etyde

Soitinnus: piano.

Le Constitutionnel : journal politique et littéraire

1816/11/02 (Numéro 307-308)-1816/11/03.

De elicienda in foro criminali reorum confessione

Painettu uudelleen: Matthiae Calonii opera omnia II. Holmiae 1830. S. 257-307

Regulae quaedam circa collisionem legum observandae

Invocatio: I.N.J.C.

Mikael Agricolan teosten kielen ala-, ylä-, ja -pää-vartaloiset adpositiot

Adpositions with the stems ala, ylä and pää in the language of Mikael Agricola’s writings The language of Mikael Agricola’s (c 1510–1557) writings represents an interesting phase in the development of the Finnish system for adpositions. In the Finnish language, the older Uralic system of postpositions has undergone expansion and a new system of prepositions has been adopted. On the other hand, the adposition system found in Agricola’s writings has also been strongly affected by foreign models, because Agricola’s texts are mainly translations of religious texts, which by and large use a word-for-word translation strategy. In the thesis, I explore Agricola’s use of adpositions; more specifically, which adpositions carry the meaning of ‘being under’ or ‘being over’ something, and in what other functions these adpositions are used. My main focus is on the semantics of the adpositions. I also study the syntactic features of adpositions and adposition structures; these are intertwined with semantics, since the meaning of adpositions is established in the adposition clause. Finally, I compare Agricola’s use of adpositions to the corresponding adpositions of present-day Finnish. Adpositions with stems ala, ylä and pää form an interesting subject for research. Their frequency in the data, however, is highly uneven. The overwhelming majority of the adpositions studied in the thesis are päälle; there are only two occurrences of adpositions with the stem ylä. Adpositions typically denote a location ‘under’ or ‘above’ something. Almost half of the adpositions, however, can be classified as semantically unmotivated and as representing a foreign model in terms of the Finnish language; they do not occur in present-day Finnish. In Agricola’s texts they act in more grammatical roles than the corresponding adpositions of present-day Finnish. In the thesis, the corresponding adpositions in the source languages are carefully analysed. All other uses of the adpositions are marginal in relation to spatial ones and those based on foreign models. The original meanings of the adpositions have not changed much since Agricola, but adpositions considered to originate from foreign models have been intentionally eliminated in presentday standard Finnish. It is also noteworthy that the system of adpositions with the stems ala, ylä and pää has changed since Agricola. His texts include the adposition ala, which corresponds to the modern adposition alle. Likewise the adposition yllä is absent in Agricola, as are the internal locative cases of the adposition pää.

Fractures in older people - incidence, predictors and consequences

In older populations, fractures are common and the consequences of fractures may be serious both for an individual and for society. However, information is scarce about the incidence, predictors and consequences of fractures in population-based unselected cohorts including both men and women and a long follow-up. The objective of this study was to analyse the incidence and predictors of fractures as well as functional decline and excess mortality due to fractures, among 482 men and 695 women aged 65 or older in the municipality of Lieto, Finland from 1991 until 2002. In analyses, Poisson’s, Cox proportional Hazards and Cumulative Logistic regression models were used for the control of several confounding variables. During the 12-year follow-up with a total of 10 040 person-years (PY), 307 (26%) persons sustained altogether 425 fractures of which 77% were sustained by women. The total incidence of fractures was 53.4 per 1000 PY (95% confidence intervals [95% CI]: 47.9 - 59.5) in women and 24.9 per 1000 PY (95% CI: 20.4 - 30.4) in men. The incidence rates of fractures at any sites and hip fractures were associated with increasing age. No significant changes in the ageadjusted incidence rates of fractures were found in either gender during the 12-year follow-up. The predictors of fractures varied by gender. In multivariate analyses, reduced handgrip strength and body mass index (BMI) lower than 30 in women and a large number of depressive symptoms in men were independent predictors of fractures. A compression fracture in one or more thoracic or upper lumbar vertebras on chest radiography at baseline was associated with subsequent fractures in both genders. Lower body fractures independently predicted both short- (0-2 years) and long-term (up to 8 years) functional decline in mobility and activities of daily living (ADL) performance during the 8-year follow-up. Upper body fractures predicted decline in ADL performance during longterm follow-up. In the 12-year follow-up, hip fractures in men (Hazard Ratio [HR] 8.1, 95% CI: 4.4-14.9) and in women (HR 3.0, 95% CI: 1.9-4.9), and fractures at the proximal humerus in men (HR 5.4, 95% CI: 1.6-17.7) were independently associated with excess mortality. In addition, leisure time inactivity in physical exercise predicted independently both functional decline and excess mortality. Fractures are common among older people posing serious individual consequences. Further studies about the effectiveness of preventing falls and fractures as well as improving care and rehabilitation after fractures are needed.

Desempenho operacional de um protótipo "aerossolo"

O desempenho operacional de máquinas e equipamentos agrícolas é de fundamental importância para o conhecimento do comportamento desses em condições de trabalho. O presente estudo teve por objetivo avaliar o desempenho operacional de um protótipo "Aerossolo", tracionado por um trator Valtra BM100 4x2 TDA, com potência no motor de 73,6 kW (100 cv). O equipamento é de arrasto, constituído por comando hidráulico, cabeçalho com luva telescópica para regulagem longitudinal, duas seções dispostas lateralmente, contando com 28 lâminas em cada uma delas, lastros de concreto, rodas de transporte e rolo destorroador. O trabalho foi conduzido no Departamento de Engenharia Rural da UNESP -Jaboticabal, em delineamento em blocos casualizados, no esquema fatorial 3 x 3, com quatro repetições. A combinação dos nove tratamentos deu-se por três condições de lastragens (0; 960 e 1.307 kg) e três ângulos das seções (0º; 7º e 14º). Os resultados evidenciaram aumento de 32,4% no consumo operacional (L há-1) relacionado à maior lastragem, bem como em 26,8% com o maior ângulo das seções, ambos comparados à condição sem lastro e com menor ângulo, respectivamente. A profundidade de trabalho, a força de tração e a potência na barra aumentaram com o aumento do ângulo das seções e com a adição de lastros.

Effect of the application of different water depths and nitrogen and potassium doses on quality of Tanzania grass

The objective of this study was to evaluate the effects of the application of different water depths and nitrogen and potassium doses in the quality of Tanzania grass, in the southern of the state of Tocantins. The experiment was conducted on strips of traditional sprinklers, and used, as treatments, a mixture of fertilizer combinations of N and K2O always in the ratio of 1 N:0.8 K2O. This study determined throughout the experiment: plant height (PH), the crude protein (CP) and neutral detergent fiber (NDF). The highest plant height obtained was 132.4 cm, with a fertilizer dose of 691.71 kg ha-1 in the proportion of N:0.8 K2O, in other words, 384.28 kg ha-1 of N and 307.43 kg ha-1 of K2O, and water depth of 80% of the ETc. The highest crude protein content was 12.2%, with the fertilizer dose application of 700 kg ha-1 yr-1 in the proportion of 1 N to 0.8 of K2O, in other words, 388.89 kg ha-1 of N and 311.11 kg ha-1 of K2O and absence of irrigation. The lowest level of neutral detergent fiber was 60.7% with the application of the smallest dose of fertilizer and highest water depth. It was concluded in this study that there was an increase in plant height by increasing the fertilizer dose and water depth. The crude protein content increased 5.4% in the dry season, by increasing the fertilizer dose and water depth. In the dry season, there was an increase of NDF content by 4.5% by increasing the application of fertilizer and water depth.

L'Univers

1868/02/22 (Numéro 307).

Impacto do ecocardiograma transesofágico intraoperatório na mortalidade em cirurgia de revascularização do miocárdio com circulação extracorpórea

OBJETIVO: avaliar as taxas de mortalidade e morbidade de doentes submetidos à revascularização do miocárdio (RVM) com circulação extracorpórea (CEC) que utilizaram rotineiramente o ecocardiograma transesofágico intraoperatório (ETEio). MÉTODOS: estudo retrospectivo, observacional com avaliação de prontuários de 360 doentes no período entre abril de 2010 a abril de 2012. Foram analisados: idade, peso, altura sexo, EUROscore, diabete melito, fração de ejeção e artérias acometidas. Os desfechos foram compilados no intra e no pós-operatório (infarto do miocárdio, acidente vascular cerebral, disfunção renal, hemodiálise, fibrilação atrial, tempo de internação no centro de tratamento intensivo). RESULTADOS: foram incluídos 53 doentes, com 27 recebendo a monitoração. Foram excluídos 307 porque não foram operados pela mesma equipe cirúrgica. Os dois grupos foram homogêneos quanto a idade, peso e sexo, porém, a fração ejeção foi menor no grupo que recebeu o ecotransesofágico (G ETEio: 56,3%; G Não ETEio: 65,9% ± 11; p=0,01). Nos doentes em que não foi utilizado o ETEio, a mortalidade foi maior (G ETEio: 0% e G Não ETEio: 7,6%; p=0,01). Não houve diferença significativa entre os grupos quanto à incidência de acidente vascular encefálico, infarto agudo do miocárdio, fibrilação atrial aguda e lesão renal. CONCLUSÃO: a utilização do ecocardiograma transesofágico intraoperatório em pacientes submetidos à revascularização do miocárdio, com circulação extracorpórea, diminuiu a mortalidade perioperatória; orientou quanto a utilização dos fármacos inotrópicos e vasodilatadores e contribuiu para uma melhor evolução dos doentes.