The use of recombinant activated factor VII for refractory bleeding post complex cardiothoracic surgery

We reviewed the outcome following use of recombinant activated factor VII (rVIIa) in patients with major bleeding post cardiothoracic surgery in our unit between January 2002 and July 2004. The unit consists of 16 cardiothoracic intensive care beds in a public metropolitan teaching hospital which serves as a referral centre for heart and lung transplant surgery Patients with refactory bleeding following cardiothoracic surgical procedures who were treated with rVIIa were identified. A total of 12 episodes of rVIIa use were recorded in ten patients, including three episodes with ventricular assist devices, and 5 heart and/or lung transplants. The median dose used was 85 mu g/kg. Chest tube drainage decreased in all patients following administration of rVIIa; median chest tube drainage decreased front 445 ml/h to 171 ml/h (P=0.03). Despite cessation of bleeding, mortality was high, when rVIIa was used after more than 24 hours. In six episodes, despite early rVIIa use (within six hours), continued bleeding necessitated return to theatre, where a surgical source of bleeding was found. In this small retrospective study, rVIIa significantly reduced bleeding that was refractory to standard blood product transfusion. In this series of patients., those that did not respond to rVIla early in the postoperative phase were found to have a surgical source of bleeding.

Particle number emissions and source signatures of an industrial facility

The work presented was conducted within the scope of a larger study investigating impacts of the Stuart Oil Shale project, a facility operating to the north of the industrial city of Gladstone, Australia. The aims of the investigations were threefold: (a) the identification of the plant signatures in terms of particle size distributions in the submicrometer range (13-830 nm) through stack measurements, (b) exploring the applicability of these signatures in tracing the source contributions at locations of interest, at a distance from the plant, and (c) assessing the contribution of the plant to the total particle number concentration at locations of interest. The stack measurements conducted for three different conditions of plant operation showed that the particle size distributions were bimodal with average modal count median diameters (CMDs) of 24 (SD 4) and 52 (SD 9) nm. The average of all the particle size distributions recorded within the plant sector at a site located 4.5 km from the plant, over the sampling period when the plant was operating, also showed a bimodal distribution. The modal CMDs in this case were 27 and 50 nm, similar to those at the stack. This bimodal size distribution is distinct from the size distribution of the most common ambient anthropogenic emission source, which is vehicle emissions, and can be considered as a signature of this source. The average contribution of the plant (for plant sector winds) was estimated to be (10.0 +/- 3.8) x 10(2) particles cm(-3) and constituted approximately a 50% increase over the local particle ambient concentration for plant sector winds. This increase in particle number concentration compared to the local background concentration, while high compared to the clean environment concentration, is not significant when compared to concentrations generally encountered in the urban environment of Brisbane.

Post-acute burns education via videoconference for occupational therapists in Queensland

For over five years, post-acute burns care for children in regional areas of Queensland has been provided by videoconference. Some 300 specialist burns consultations are conducted by videoconference annually. To support regional health professionals, particularly occupational therapists who play an integral role in the local management of these children, we have instigated a series of monthly education sessions via videoconference. The sessions have addressed a broad range of topics related to the long-term management of children following a burn injury. During the first six months, up to 22 regional sites participated in multipoint videoconferences. The average number of participants per videoconference was 39 and the average duration of each session was 67 min. Participant satisfaction was measured with a routine survey completed by each site at the conclusion of the videoconference. The survey response rate was 88% (n = 95) and overall feedback was extremely positive. 96% of respondents agreed that the programme provided them with new information and that the content was relevant (95%) and of appropriate depth (84%). The educational programme has provided valuable support to a group of professionals who are taking on greater responsibility for the clinical management of children requiring post-acute burns care.

FATORES DETERMINANTES DA SOBREVIVÊNCIA DAS MICRO E PEQUENAS EMPRESAS DO SETOR INDUSTRIAL NA CIDADE DE SANTOS

A importância das micro e pequenas empresas na economia brasileira já é sentida desde há muito tempo, pois esse segmento é fundamental na geração de riqueza para a sociedade. Apesar da importância econômica, ainda persiste um elevado grau de descontinuidade nas mesmas, o que lhes outorga dificuldades de transporem os dois primeiros e mais críticos anos de existência. Esta pesquisa visa identificar os fatores determinantes da sobrevivência das micro e pequenas empresas do setor industrial na cidade de Santos. A relevância do estudo se intensifica em decorrência da cidade de Santos estar vivenciando um momento de desenvolvimento econômico impulsionado pelas descobertas de petróleo na camada do pré-sal. Isso poderá aumentar ainda mais o número de criação de MPEs, principalmente no setor industrial, e que provavelmente necessitarão de informações nas quais possam se espelhar. O estudo é de caráter exploratório e descritivo. Os dados foram colhidos por meio de uma pesquisa de campo com aplicação de um questionário baseado em quatro dimensões: empreendedorismo, ambiental, recursos financeiros e organização interna. A pesquisa apresentou como principais fatores de sobrevivência o tempo dedicado à empresa; a adequação dos produtos a demanda; a capacidade de assumir riscos e a liderança do gestor. A amostra de estudo foi definida por conveniência, constituída de MPEs pertencentes ao setor econômico industrial, pois é o mais aderente à cadeia de exploração de petróleo. Foram consideradas as empresas que ultrapassaram os dois primeiros anos de existência, de acordo com os critérios de avaliação de sobrevivência adotado pelo SEBRAE (2011).

Corruption in the post-Soviet workplace: the experiences of recent graduates in contemporary Ukraine

While Ukraine was bestowed market economy status by the European Union in 2005 its labour market still endures many structural problems. By exploring the experiences of young graduate employees this article highlights the difficultly in obtaining work within Ukraine's labour market and the problems they face once they have secured employment. Rather than seeing the development of a transparent labour market the collapse of the command economy has seen a relatively closed system develop. The article demonstrates how many jobs are secured through the use of connections or the demanding, and payment, of bribes.The situation does not improve once graduates obtain long-term employment. Interviewees discuss the lack of job security, the informal payment of wages and the lack of legal protection from corrupt employer practices. The article has broader resonance outside of the Ukrainian case study as the discussion of workplace corruption highlights how the issue is concerned with much more than simply cash based transactions and how those that endure it are likely to turn to the informal economy for employment.

Nation, region and history in post-communist transitions:identity politics in Ukraine, 1991-2006

Since independence in 1991, issues of nation and identity have become highly debated topics in Ukraine. This monograph explores not only how national identity is being (re)constructed by the Ukrainian state, but also the processes by which it is negotiated through society. The central argument of this work is that too much attention, concerning identity in Ukraine, has focused on markers of ethnicity and language. Instead, the author advocates a regional approach, engaging with the issue of how Ukraine's regional differences affect nation-building processes. Following the tumultuous events of the 'Orange Revolution', the view of Ukraine as a country inherently 'divided' between 'East' and 'West' has (re)emerged to become a popular explanation for political events. The study outlines the necessity for academics, policymakers and indeed politicians to veer away from this simplistic 'West versus East' divide. The book advocates an analysis of Ukraine's unique brand of regionalism not in terms of divisions, but in terms of regional differences and diversity. The author deconstructs the concept of 'Eastern Ukraine' by focusing on three Ukrainian localities, all adjacent to the Ukrainian-Russian border. The study examines how individuals provide 'their' own understanding of the place of their region within the wider processes of nation building across Ukraine. In doing so, the book develops a 'regional' approach to the study of identity politics in Ukraine.

The problems of corruption in Post-Soviet Ukraine's Higher Education sector

This article provide an in-depth examination into how the existence of "informal" work practices, in a particular location, namely, the higher education system in Ukraine impacts the everyday lives of a specific population group, namely, students. The article provides a comprehensive overview of corruption in post-Soviet education systems, suggesting some historical and contemporary reasons for its current scale. In particular, the article focuses on students' experiences of corruption, first, exploring the difficulties that many individuals face when trying to gain access to the higher education system, and second, outlining students' experiences while progressing through the course. The article's concluding section examines the wider outcome of these processes on Ukrainian society as a whole as well as the impacts on individual students.