499 resultados para Agitation


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This study explores the linkages between culture, emotions and behavioural tendencies in unsuccessful intercultural business negotiations. A set of novel research hypotheses are developed. They are tested using a negotiation scenario analysis involving 106 Finnish and 114 Indian study participants. Three key findings emerge from the statistical tests conducted. First, new empirical evidence suggesting that qualitatively different emotions (dejection vs. agitation) are experienced after a failed intercultural business negotiation by individualists and collectivists is provided. Second, the existence of the relationship between perspective-taking ability and emotional volatility in the context of failed intercultural business negotiation involving individualists and collectivists is revealed. Third, partial support is found for the idea that different types of negative emotions can lead to the same behavioural tendency (approach) among individualists and collectivists when intercultural business negotiation fails. The paper concludes by outlining a set of theoretical and managerial implications and suggestions for further research.

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This study identifies and investigates the potential use of in-eye trigger mechanisms to supplement the widely available information on release of ophthalmic drugs from contact lenses under passive release conditions. Ophthalmic dyes and surrogates have been successfully employed to investigate how these factors can be drawn together to make a successful system. The storage of a drug-containing lens in a pH lower than that of the ocular environment can be used to establish an equilibrium that favours retention of the drug in the lens prior to ocular insertion. Although release under passive conditions does not result in complete dye elution, the use of mechanical agitation techniques which mimic the eyelid blink action in conjunction with ocular tear chemistry promotes further release. In this way differentiation between passive and triggered in vitro release characteristics can be established. Investigation of the role of individual tear proteins revealed significant differences in their ability to alter the equilibrium between matrix-held and eluate-held dye or drug. These individual experiments were then investigated in vivo using ophthalmic dyes. Complete elution was found to be achievable in-eye; this demonstrated the importance of that fraction of the drug retained under passive conditions and the triggering effect of in-eye conditions on the release process. Understanding both the structure-property relationship between drug and material and in-eye trigger mechanisms, using ophthalmic dyes as a surrogate, provides the basis of knowledge necessary to design ocular drug delivery vehicles for in-eye release in a controllable manner.

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The era between the close of the nineteenth century and the onset of the First World War witnessed a marked increase in radical agitation among Indian and Irish nationalists. The most outspoken political leaders of the day founded a series of widely circulated newspapers in India and Ireland, placing these editors in the enviable position of both reporting and creating the news. Nationalist journalists were in the vanguard of those pressing vocally for an independent India and Ireland, and together constituted an increasingly problematic contingent for the British Empire. The advanced-nationalist press in Ireland and the nationalist press in India took the lead in facilitating the exchange of provocative ideas--raising awareness of perceived imperial injustices, offering strategic advice, and cementing international solidarity. Irish and Indian press coverage of Britain's imperial wars constituted one of the premier weapons in the nationalists' arsenal, permitting them to build support for their ideology and forward their agenda in a manner both rapid and definitive. Directing their readers' attention to conflicts overseas proved instructive in how the Empire dealt with those who resisted its policies, and also showcased how it conducted its affairs with its allies. As such, critical press coverage of the Boxer Rebellion, Boer War, Russo-Japanese War, and World War I bred disaffection for the Empire, while attempts by the Empire to suppress the critiques further alienated the public. This dissertation offers the first comparative analysis of the major nationalist press organs in India and Ireland, using the prism of war to illustrate the increasingly persuasive role of the press in promoting resistance to the Empire. It focuses on how the leading Indian and Irish editors not only fostered a nationalist agenda within their own countries, but also worked in concert to construct a global anti-imperialist platform. By highlighting the anti-imperial rhetoric of the nationalist press in India and Ireland and illuminating their strategies for attaining self-government, this study deepens understanding of the seeds of nationalism, making a contribution to comparative imperial scholarship, and demonstrating the power of the media to alter imperial dynamics and effect political change.

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Bipolar disorder is a chronic psychopathology that reaches from 1 to 4% of the world population. This mood disorder is characterized by cyclical mood changes, in which an individual alternates between states of depression and mania. Mania is described in the literature as an abnormal state of exacerbation of humor, in which the subject presents an expansive, euphoric behavior, but with increased irritability, psychomotor agitation and a feeling of invincibility, which will contribute to risks exposure. The treatment of this psychopathology is complex and it is not effective in all cases, and it evokes many side effects. In this respect, the system of Nociceptin/Orphanin FQ (N/OFQ) can be studied as a possible therapeutic target for the treatment of bipolar disorder, due to its modulatory role on monoaminergic systems and on mood. This study aims to investigate the effect of NOP receptor ligands in an animal model of mania induced by methylphenidate. To this aim, locomotor activity was assessed in an open field, in mice treated with methylphenidate (10 mg/kg, sc, 15 min). Valproate (300 mg / kg, ip, 30 min), standard treatment of mania, prevented methylphenidate-induced hyperlocomotion. The acute treatment with the antagonist of NOP receptor UFP-101 (1-10 nmol, icv, 5 min) per se did not affect the spontaneous locomotion of mice, but it was able of attenuating hyperlocomotion induced by methylphenidate. The acute treatment with N/OFQ (1 and 0.1 nmol, icv, 5 min) did not alter the distance moved, but when tested at a dose of 1 ηmol, N/OFQ slightly reduced methylphenidate-induced hiperlocomotion. In conclusion, the administration of UFP-101 and N/OFQ produced antimanic-like actions. Furthermore, these data suggest that the system of N/OFQ performs a complex modulation of voluntary movement, and consequently on dopaminergic neurotransmission.

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Hexavalent chromium is a heavy metal present in various industrial effluents, and depending on its concentration may cause irreparable damage to the environment and to humans. Facing this surrounding context, this study aimed on the application of electrochemical methods to determine and remove the hexavalent chromium (Cr6+) in simulated wastewater. To determine was applied to cathodic stripping voltammetry (CSV) using ultra trace graphite electrodes ultra trace (work), Ag/AgCl (reference) and platinum (counter electrode), the samples were complexed with 1,5- diphenylcarbazide and then subjected to analysis. The removal of Cr6+ was applied electrocoagulation process (EC) using Fe and Al electrodes. The variables that constituted the factorial design 24, applied to optimizing the EC process, were: current density (5 and 10 mA.cm-2), temperature (25 and 60 ºC), concentration (50 and 100 ppm) and agitation rate (400 and 600 RPM). Through the preliminary test it was possible the adequacy of applying the CSV for determining of Cr6+, removed during the EC process. The Fe and Al electrodes as anodes sacrifice showed satisfactory results in the EC process, however Fe favored complete removal in 30 min, whereas with Al occurred at 240 min. In the application of factorial design 24 and analysis of Response Surface Methodology was possible to optimize the EC process for removal of Cr6+ in H2SO4 solution (0.5 mol.L-1), in which the temperature, with positive effect, was the variable that presented higher statistical significance compared with other variables and interactions, while in optimizing the EC process for removal of Cr6+ in NaCl solution (0.1 mol.L-1) the current density, with positive effect, and concentration, with a negative effect were the variables that had greater statistical significance with greater statistical significance compared with other variables and interactions. The utilization of electrolytes supports NaCl and Na2SO4 showed no significant differences, however NaCl resulted in rapid improvement in Cr6+ removal kinetics and increasing the NaCl concentration provided an increase in conductivity of the solution, resulting in lower energy consumption. The wear of the electrodes evaluated in all the process of EC showed that the Al in H2SO4 solution (0.5 mol.L-1), undergoes during the process of anodization CE, then the experimental mass loss is less than the theoretical mass loss, however, the Fe in the same medium showed a loss of mass greater experimental estimated theoretically. This fact is due to a spontaneous reaction of Fe with H2SO4, and when the reaction medium was the NaCl and Na2SO4 loss experimental mass approached the theoretical mass loss. Furthermore, it was observed the energy consumption of all processes involved in this study had a low operating cost, thus enabling the application of the EC process for treating industrial effluents. The results were satisfactory, it was achieved complete removal of Cr6+ in all processes used in this study.

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An amperometric FIA method for nitrite quantification based on nitrite electroreduction and employing a carbon paste electrode (CPE) chemically modified with iron hexacyanoferrate (HCF) as an amperometric detector was developed. The influence of experimental conditions on the preparation of the electrode materials was evaluated and the materials obtained in each study were used for the development of modified electrodes. The electrochemical sensors were prepared by a fast, simple, and inexpensive procedure, and the long-term performance of the electrodes were quite satisfactory as the stability was maintained over one year. HCF was an effective redox mediator for nitrite electroreduction in acidic media, allowing nitrite detection at +0.2 V vs. Ag/AgClsat, which is a potential free of possible interfering species that are normally present in food and water samples. The electrochemical cell used in the FIA system was similar to a batch injection analysis cell, enabling recirculation of the carrier solution. This is an attractive feature because it allows the use of a high flow rate (6 mL min-1) leading to high sensitivity and analysis speed, while keeping reagent consumption low. The proposed method had a detection limit of 9 μmol L-1 and was successfully employed for nitrite quantification in spiked water and sausage samples. The obtained results were in good agreement with those provided by the spectrophotometric official method. At a 95 % confidence level it was not observed statistical differences neither in nitrite content nor in the precision provided by both methods. The experimental conditions for the synthesis of HCF were optimized and the best electrode material was prepared by mixing FeCl3, K4[Fe(CN)6] and carbon powder subjected to an acid and thermal treatment (400 ºC), followed by ultrasonic agitation at 4 °C. This material was used to construct an electrode with improved analytical performance to reduce nitrite, which presented greater stability compared to HCF film electrodeposited on the EPC, showing that the preparation procedure of the electrode material is an effective strategy for the development of HCF modified electrodes.

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Assessing the soil nutrient availability to plants under lab conditions is one of the main challenges to Soil Fertility and Chemistry, due to the complex behavior and the interaction of the soil properties. Many extractant solutions associated with mechanical forms of agitation have been proposed, showing different correlations with plant growth and nutrients absorption. Using ultrasonic energy is a agitation procedure of the soil:extractant solution suspension (based on the cavitation phenomenon). It allows the establishment of relations between the amount of extracted nutrient and the ultrasonic energy level. Thus, this work aims: to evaluate the effect of cavitation intensity on the extraction of P, Zn, Cu, Mn and Fe in soil samples from five Latosols under different uses around Uberlândia and Uberaba, Minas Gerais State; to obtain extracting curves as function of ultrasonic energy levels; and to obtain an index from extracting curves to expresses the nutrient retention by the soil solid phase. A soil-solution suspension (ratio 1:10) was sonicated using a probe ultrasound equipment under different combinations of power and time: i) 30 W for 35, 70, 140 and 280 s; ii) 50 W for 21, 42, 84 and 168 s; and iii) 70 W for 15, 30, 60 and 120 s. The extractant solutions used were Mehlich-1 (for all elements), Olsen and distilled water for P. After each sonication, P concentration was quantified by molybdenum blue colorimetric method and Zn, Cu, Mn and Fe by flame atomic absorption spectrophotometry. The cavitation intensity did not affect the P extraction, only the total energy applied. The P extraction was influenced by extractant solution, decreasing as follows: Mehlich-1>Olsen>water. In cultivated Latosols, the P extraction increased linearly with ultrasonic energy, and the slope of the 1:1 linear regression reflects the P retention in the soil. The Zn and Fe extractions were influenced only by total energy applied. Mn and Cu extractions were influenced by both cavitation intensity and total ultrasonic energy. Soils containing similar amounts of P, Cu, Zn, Mn, and Fe may have a different extraction rate. Likewise, soils containing different amounts of those elements may have the same extraction rate.

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Deeply conflicting views on the political situation of Judaea under the Roman prefects (6-41 c.e.) have been offered. According to some scholars, this was a period of persistent political unrest and agitation, whilst according to a widespread view it was a quiescent period of political calm (reflected in Tacitus’ phrase sub Tiberio quies). The present article critically examines again the main available sources –particularly Josephus, the canonical Gospels and Tacitus– in order to offer a more reliable historical reconstruction. The conclusions drawn by this survey calls into question some widespread and insufficiently nuanced views on the period. This, in turn, allows a reflection on the non-epistemic factors which might contribute to explain the origin of such views.

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Introduction Sleep disturbances are common in critically ill patients treated in the intensive care unit (ICU) with the potential for serious consequences and long-term effects on health outcomes and patient morbidity.
Objectives Our aim was to describe sleep management and sedation practices of adult ICUs in ten countries and to evaluate roles and responsibilities of the ICU staff in relation to key sleep and sedation decisions.
Methods A multicenter, self-administered survey sent to nurse managers of adult ICUs across 10 countries. The questionnaire comprised four domains: sleep characteristics of the critically ill; sleep and sedation practices; non-pharmacological and pharmacological interventions used to improve sleep; and the autonomy and influence of nurses on sleeping practices in the ICU.
Results Overall response rate was 66% (range 32% UK to 100% Cyprus), providing data from 522 ICUs. In all countries, the most frequent patient characteristic perceived to identify sleep was lying quietly with closed eyes (N=409, 78%) (range 92% Denmark to 36% Italy). The most commonly used sedation scale was the Richmond Agitation-Sedation Score (RASS) (N=220, 42%) (range 81% UK to 0% Denmark, Cyprus where most ICUs used the Ramsay score). In most ICUs, selection of sleep medication (N=265, 51%) and assessment of effect (N=309, 59%) was performed by physicians and nurses based on collaborative discussion. In a minority of ICUs (N=161, 31%), decisions and assessments were made by physicians alone. The most commonly used (in all countries) non-pharmacological intervention to promote sleep was reducing ICU staff noise (N=473, 91%) (range 100% Denmark, Norway to 78% Canada). Only 95 ICUs (18%) used earplugs on a frequent basis (range 0% Greece, Cyprus, Denmark to 57% Sweden). Propofol was the drug used most commonly for sedation (N=359, 69%) (range 96% Sweden to 29% Canada). Chloral hydrate was used by only 63 (12%) ICUs (range 0% Greece, Cyprus, Denmark, Italy to 56% Germany). Sedation scales were used on a routine basis by 77% of the 522 ICUs. Participants scored nursing autonomy for sleep and sedation management as moderate; median score of 5 (scale of 0 to 10), range 7 (Canada, Greece, Sweden) to 4 (Norway, Poland). Nursing influence on sleep and sedation decisions was perceived considerable; median score 8, range 9 (Denmark) to 5 (Poland).
Conclusions We found considerable across country variation in sleep promotion and sedation management practices though most have adopted a sedation scale as recommended in professional society guidelines. Most ICUs in all countries used a range of pharmacological and non-pharmacological interventions to promote sleep. Most units reported inter-professional decision-making with nurses perceived to have substantial influence on sleep/sedation decisions.


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Background: Delirium is frequently diagnosed in critically ill patients and is associated with poor clinical outcomes. Haloperidol is the most commonly used drug for delirium despite little evidence of its effectiveness. The aim of this study was to establish whether early treatment with haloperidol would decrease the time that survivors of critical illness spent in delirium or coma. Methods: We did this double-blind, placebo-controlled randomised trial in a general adult intensive care unit (ICU). Critically ill patients (≥18 years) needing mechanical ventilation within 72 h of admission were enrolled. Patients were randomised (by an independent nurse, in 1:1 ratio, with permuted block size of four and six, using a centralised, secure web-based randomisation service) to receive haloperidol 2·5 mg or 0·9% saline placebo intravenously every 8 h, irrespective of coma or delirium status. Study drug was discontinued on ICU discharge, once delirium-free and coma-free for 2 consecutive days, or after a maximum of 14 days of treatment, whichever came first. Delirium was assessed using the confusion assessment method for the ICU (CAM-ICU). The primary outcome was delirium-free and coma-free days, defined as the number of days in the first 14 days after randomisation during which the patient was alive without delirium and not in coma from any cause. Patients who died within the 14 day study period were recorded as having 0 days free of delirium and coma. ICU clinical and research staff and patients were masked to treatment throughout the study. Analyses were by intention to treat. This trial is registered with the International Standard Randomised Controlled Trial Registry, number ISRCTN83567338. Findings: 142 patients were randomised, 141 were included in the final analysis (71 haloperidol, 70 placebo). Patients in the haloperidol group spent about the same number of days alive, without delirium, and without coma as did patients in the placebo group (median 5 days [IQR 0-10] vs 6 days [0-11] days; p=0·53). The most common adverse events were oversedation (11 patients in the haloperidol group vs six in the placebo group) and QTc prolongation (seven patients in the haloperidol group vs six in the placebo group). No patient had a serious adverse event related to the study drug. Interpretation: These results do not support the hypothesis that haloperidol modifies duration of delirium in critically ill patients. Although haloperidol can be used safely in this population of patients, pending the results of trials in progress, the use of intravenous haloperidol should be reserved for short-term management of acute agitation. Funding: National Institute for Health Research. © 2013 Elsevier Ltd.

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Bakgrund: Alzheimers sjukdom (AD) är den vanligaste formen av demenssjukdomar och antalet människor som insjuknar i AD förväntas öka kraftigt med tiden. Dessutom kännetecknas personer med AD ofta av beteendemässiga och psykiska symtom (BPSD) som kan innefatta agitation, depression, vanföreställningar, oro, ångest, hallucinationer, sömnrubbningar, rastlöshet och apati. Dessa symtom kan orsaka lidande hos patienten och är svåra att hantera för både vårdgivaren och anhöriga, samt försvårar omvårdnadsarbetet. Syftet var att beskriva icke-farmakologiska metoder och effekter av dessa metoder vid omvårdnad av personer med Alzheimers sjukdom som har beteendemässiga och psykiska symtom. Metod: En litteraturöversikt bestående av 16 utvalda kvantitativa forskningsartiklar har genomförts. Artiklarna publicerades mellan år 2006-2016. Resultat. De studerade icke-farmakologiska metoderna var musikterapi, vissa typer av massage, reminiscence-terapi, vårdhundterapi och ljusterapi. Resultaten visade att icke-farmakologiska metoder kan ha en varierande effekt på BPSD. Litteraturöversikten visade att musikintervention var mest effektiv för att minska agitationsbeteende. Individualiserad musik i samband med speciella minnen minskade stress, fobier hos personer med svår demens. Intervention av handmassage, aromaterapi, taktil massage och terapeutisk beröring minskade aggression och agitationsbeteende. Vissa studier visade dock att fotmassageintervention och vårdhundterapi kunde öka verbal aggressivitet hos personer med demens, medan en annan studie visade att djurassisterade aktiviteter kunde minska nedstämdhet medan glädje och generell uppmärksamhet ökade. Effekten av ljusbehandling var förbättrad sömn, minskad depression, agitation och ätstörningar. Slutsats. Icke-farmakologiska metoder kan minska beteendemässiga och psykiska symtom hos personer med Alzheimers sjukdom, dock med varierande effekt. De varierande resultaten kan tolkas som att icke-farmakologiska metoder bör individanpassas och att det behövs vidare forskning inom området.

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Musik som verktyg för att lindra oro och stress är en tilltalande omvårdnadsåtgärd då den kan anpassas direkt till individen. Den är utan biverkningar samt kostnadseffektiv. Syfte: Att undersöka effekten av musikåtgärder i omvårdnad av personer med demenssjukdom. Metod: Föreliggande studie är en litteraturstudie omfattande båda kvantitativa och kvalitativa studier från databaserna Web of Science, PubMed och CINAHL. 13 artiklar skrivna på engelska utgjorde resultatunderlaget. Resultat: Resultatet är baserat på empiriska studier varav tio stycken var kvantativa studier och två stycken var kvalitativa studier. Resultatet redovisas under sammanlagt fyra teman: Musik och minskning av agitation, Musik och förbättring av kognition, Musik och ökning av välbefinnande samt Musik och höjning av socialt engagemang. Slutsats: Musik som en omvårdnadsåtgärd av personer med demenssjukdom kan med fördel användas av sjuksköterskor som ett moment i den personcentrerade omvårdnaden, som underhållning samt som ett medel att knyta samman människor.

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Bakgrund: I Sverige insjuknar varje år ungefär 25 000 människor i någon form av demenssjukdom, en sjukdom som ökar världen över och troligtvis kommer att fördubblas inom de närmsta 20 åren. Demenssjukdom drabbar hjärnan vilket påverkar minnet och den kognitiva förmågan och kan ge beteendemässiga och psykiska symtom (BPSD). Studier visar att nio av tio personer någon gång kommer att visa symtom som ångest, oro, vandrande och aggressiva beteenden. Läkemedelsadministrering för att behandla symtom som oro, ångest och agiterande beteenden är inte ovanligt. Dock kan läkemedel ofta orsaka biverkningar hos äldre människor. Att istället använda djurterapi för att behandla symtom som kan uppstå vid demenssjukdomar kan ses som ett positivt alternativ då studier visat att djurterapi har en positiv inverkan på människan med demenssjukdom och andra kognitiva sjukdomar. Syfte: Syftet med denna studie var att beskriva vilken inverkan djurterapi har på människor med demenssjukdom och andra kognitiva sjukdomar. Metod: Studien är en litteraturöversikt baserad på artiklar med kvantitativ och kvalitativ ansats (n=15). Resultat: Resultatet av denna litteraturstudie visar att djurterapi ger minskad stressnivå, minskat uppvisande av aggressiva beteenden, färre vanföreställningar, minskad ångest, nedstämdhet, sorgsenhet, depressiva symtom och apatiska beteenden samt ökning av glädje, lycka, engagemang, vakenhet, medvetenhet, verbala uttryck samt ökat minne. Konklusion: Resultatet tyder på att djurterapi med fördel kan användas som alternativ eller kompletterande behandling för människor med demenssjukdom. Dock ser författarna att utökad forskning behövs för att se långvarig inverkan av djurterapins effekter.

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The research presented in this dissertation is aimed to the automation of the Fenton process. The Fenton reaction is finalized to the waste water pre-treatment in order to promote the abatement of the organic contaminants and make it more degradable. Reagents adopted are constituted by a mixture of iron ions and hydrogen peroxide and their effect is strictly influenced by several variables, such as: the reagents molar ratio and their quantities counterpoised to the substrate, temperature, pH, agitation, etc. Therefore, the optimization is far from being considered an easy procedure. The research was carried out using a batch configuration, through which the optimal [Fe2+]/[H2O2] and [substrate]/[H2O2] ratios were identified. Then, in order to improve the process, a semibatch configuration was performed. The preliminary results show that is possible to obtain a greater abatement efficiency for high organic burden using the semibatch configuration here proposed.

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Demens är en neurodegenerativ sjukdom där kognitiv och funktionell nedsättning uppstår. Det finns inget botemedel för demenssjukdom utan målet är att förbättra och stödja livet för individerna som drabbats, vilket kan tillämpas genom anpassning av den fysiska miljön. Syftet med litteraturstudien var att belysa den fysiska miljöns påverkan på individer med demenssjukdom utifrån vårdpersonal och forskares uppfattningar. Metoden som tillämpades var en litteraturstudie enligt Polit och Becks (2012) nio-stegsmodell med datainsamling genom databaserna Cinahl och PubMed. Artiklarna genomgick Polit och Becks (2012) granskningsmallar för kvalitativa respektive kvantitativa studier. Detta resulterade i 12 vetenskapliga artiklar som bearbetades till olika teman. Resultatet redovisades med fem olika teman: minskad agitation, ökad orienteringsförmåga, ökat engagemang och uppmärksamhet, ökad social interaktion och ökat välbefinnande. Slutsatsen var att individerna med demenssjukdom påverkades av den fysiska miljön genom att den utbringade lugn, autonomi, trygghet, självständighet, frihet, värdighet och en känsla av att ha kontroll och att känna sig hemma. Detta samtidigt som personalen kunde få mer tid till att umgås och/eller utföra aktiviteter med individerna.