638 resultados para Accidental drowning
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We developed a method to rapidly and safely live capture wild dugongs based on the “rodeo method” employed to catch marine turtles. This method entails close pursuit of a dugong by boat until it is fatigued. The dugong is then caught around the peduncle region by a catcher leaping off the boat, and the dugong is restrained at the water surface by several people while data are collected. Our sampling protocol involves a short restraint time, typically < 5 min. No ropes or nets were attached to the dugong to avoid the risk of entanglement and subsequent drowning. This method is suitable for shallow, open-water captures when weather and water conditions are fair, and may be adapted for deeper waters.
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In Great Britain and Brazil healthcare is free at the point of delivery and based study only on citizenship. However, the British NHS is fifty-five years old and has undergone extensive reforms. The Brazilian SUS is barely fifteen years old. This research investigated the middle management mediation role within hospitals comparing managerial planning and control using cost information in Great Britain and Brazil. This investigation was conducted in two stages entailing quantitative and qualitative techniques. The first stage was a survey involving managers of 26 NHS Trusts in Great Britain and 22 public hospitals in Brazil. The second stage consisted of interviews, 10 in Great Britain and 22 in Brazil, conducted in four selected hospitals, two in each country. This research builds on the literature by investigating the interaction of contingency theory and modes of governance in a cross-national study in terms of public hospitals. It further builds on the existing literature by measuring managerial dimensions related to cost information usefulness. The project unveils the practice involved in planning and control processes. It highlights important elements such as the use of predictive models and uncertainty reduction when planning. It uncovers the different mechanisms employed on control processes. It also depicts that planning and control within British hospitals are structured procedures and guided by overall goals. In contrast, planning and control processes in Brazilian hospitals are accidental, involving more ad hoc actions and a profusion of goals. The clinicians in British hospitals have been integrated into the management hierarchy. Their use of cost information in planning and control processes reflects this integration. However, in Brazil, clinicians have been shown to operate more independently and make little use of cost information but the potential signalled for cost information use is seen to be even greater than that of their British counterparts.
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FASTtrack: Pharmaceutical Compounding and Dispensing focuses on what you really need to know in order to pass exams. Concise, bulleted information, key points, tips and an all-important self-assessment section which includes MCQs, case studies, sample essay questions and worked examples. Based on the successful textbook, Pharmaceutical Compounding and Dispensing, this FASTtrack book has been designed to assist the student compounder in understanding the key dosage forms encountered within extemporaneous dispensing. For this new second edition all the references to modern texts (for example, the BNF) have been updated, as well as labelling to reflect changes since the publication of the first edition. Some worked examples have been changed owing to the availability of pharmaceutical ingredients. Free access to online videos demonstrating various dispensing procedures is included. Are your exams coming up? Are you drowning in textbooks and lecture notes and wondering where to begin? Take the FASTtrack route to successful study for your examinations. FASTtrack provides the ultimate lecture notes and is a must-have for all pharmacy students wanting to study and test themselves for forthcoming exams.
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Background: Food allergy is often a life-long condition that requires constant vigilance in order to prevent accidental exposure and avoid potentially life-threatening symptoms. Parents’ confidence in managing their child’s food allergy may relate to the poor quality of life anxiety and worry reported by parents of food allergic children. Objective: The aim of the current study was to develop and validate the first scale to measure parental confidence (self-efficacy) in managing food allergy in their child. Methods: The Food Allergy Self-Efficacy Scale for Parents (FASE-P) was developed through interviews with 53 parents, consultation of the literature and experts in the area. The FASE-P was then completed by 434 parents of food allergic children from a general population sample in addition to the General Self-Efficacy Scale (GSES), the Food Allergy Quality of Life Parental Burden Scale (FAQL-PB), the General Health Questionnaire (GHQ12) and the Food Allergy Impact Measure (FAIM). A total of 250 parents completed the re-test of the FASE-P. Results: Factor and reliability analysis resulted in a 21 item scale with 5 sub-scales. The overall scale and sub-scales has good to excellent internal consistency (α’s of 0.63-0.89) and the scale is stable over time. There were low to moderate significant correlations with the GSES, FAIM and GHQ12 and strong correlations with the FAQL-PB, with better parental confidence relating to better general self-efficacy, better quality of life and better mental health in the parent. Poorer self-efficacy was related to egg and milk allergy; self-efficacy was not related to severity of allergy. Conclusions and clinical relevance: The FASE-P is a reliable and valid scale for use with parents from a general population. Its application within clinical settings could aid provision of advice and improve targeted interventions by identifying areas where parents have less confidence in managing their child’s food allergy.
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Background: Electrosurgery units are widely employed in modern surgery. Advances in technology have enhanced the safety of these devices, nevertheless, accidental burns are still regularly reported. This study focuses on possible causes of sacral burns as complication of the use of electrosurgery. Burns are caused by local densifications of the current, but the actual pathway of current within patient's body is unknown. Numerical electromagnetic analysis can help in understanding the issue. Methods: To this aim, an accurate heterogeneous model of human body (including seventy-seven different tissues), electrosurgery electrodes, operating table and mattress was build to resemble a typical surgery condition. The patient lays supine on the mattress with the active electrode placed onto the thorax and the return electrode on his back. Common operating frequencies of electrosurgery units were considered. Finite Difference Time Domain electromagnetic analysis was carried out to compute the spatial distribution of current density within the patient's body. A differential analysis by changing the electrical properties of the operating table from a conductor to an insulator was also performed. Results: Results revealed that distributed capacitive coupling between patient body and the conductive operating table offers an alternative path to the electrosurgery current. The patient's anatomy, the positioning and the different electromagnetic properties of tissues promote a densification of the current at the head and sacral region. In particular, high values of current density were located behind the sacral bone and beneath the skin. This did not occur in the case of non-conductive operating table. Conclusion: Results of the simulation highlight the role played from capacitive couplings between the return electrode and the conductive operating table. The concentration of current density may result in an undesired rise in temperature, originating burns in body region far from the electrodes. This outcome is concordant with the type of surgery-related sacral burns reported in literature. Such burns cannot be immediately detected after surgery, but appear later and can be confused with bedsores. In addition, the dosimetric analysis suggests that reducing the capacity coupling between the return electrode and the operating table can decrease or avoid this problem. © 2013 Bifulco et al.; licensee BioMed Central Ltd.
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The central aim of this interdisciplinary book is to make visible the intentionality behind the 'forgetting' of European women's contributions during the period between the two world wars in the context of politics, culture and society. It also seeks to record and analyse women's agency in the construction and reconstruction of Europe and its nation states after the First World War, and thus to articulate ways in which the writing of women's history necessarily entails the rewriting of everyone's history. By showing that the erasure of women's texts from literary and cultural history was not accidental but was ideologically motivated, the essays explicitly and implicitly contribute to debates surrounding canon formation. Other important topics are women's political activism during the period, antifascism, the contributions made by female journalists, the politics of literary production, genre, women's relationship with and contributions to the avant-garde, women's professional lives, and women's involvement in voluntary associations. In bringing together the work of scholars whose fields of expertise are diverse but whose interests converge on the inter-war period, the volume invites readers to make connections and comparisons across the whole spectrum of women's political, social, and cultural activities throughout Europe.
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The focus of this paper is brand destruction, however in a slightly different sense than the traditional marketing literature depicts it. The concept of brand destruction basically tends to be discussed either (1) as an accidental, counter-productive event in a campaign which leads to the ruining of the brand, or (2) an intentional act by competitors in the market, which results the same breakdown mentioned above. As this paper shows, there are other ways to consider as well, when speaking about brand destruction. An often overlooked type of brand destruction is a rather new phenomenon: destroying the brand by customers or business partners. The adequate scene for this case is the internet itself, especially different social media platforms, e. g. Facebook, Twitter, Tumblr, Instagram, etc. Also popular weblogs can play an important role in brand destruction made by customers or business partners (general cases related to social media are depicted in Lipsman – Mud – Rich – Bruich, 2012). This paper presents a couple of cases in the online field and focuses basically on online communicative activities, in which a brand’s negative properties come to discussion. Both Hungarian and foreign examples are easy to find and they all demonstrate the growing power of consumers. This observation led marketing experts to start talking about the ‘smooth seizure of power by consumers’. Whilst the critic of this concept is considered to be relevant, this paper describes the elements and methods of the ‘seizure’ – from an online social point of view. The key of handling brand destruction cases efficiently lies in the role of social media users. They are not only consumers, but the opportunity for producing online contents is in their hands as well – this fact results in the idea of ‘prosumers’. Thus customers on social media platforms must be handled as a ‘critical mass’: as civic warriors with strong weapons in their armoury. No companies are allowed to feel safe, as the slightest error may well be punished by the crowd.
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Exposure to certain bloodborne pathogens can prematurely end a person’s life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail to consistently use PPE as required by federal regulation, accrediting agencies, hospital policy, and professional association standards. The purpose of this mixed methods survey study was to (a) examine factors surgical team members perceive influence choices of wearing or not wearing PPE during operative/invasive procedures and (b) determine what would influence consistent use of PPE by surgical team members. Using an ex post facto, non-experimental design, the memberships of five professional associations whose members comprise surgical teams were invited to complete a mixed methods survey study. The primary research question for the study was: What differences (perceptual and demographic) exist between surgical team members that influence their choices of wearing or not wearing PPE during operative/invasive procedures? Four principal differences were found between surgical team members. Functional (i.e., profession or role based) differences exist between the groups. Age and experience (i.e., time in profession) differences exist among members of the groups. Finally, being a nurse anesthetist influences the use of risk assessment to determine the level of PPE to use. Four common themes emerged across all groups informing the two study purposes. Those themes were: availability, education, leadership, and performance. Subsidiary research questions examined the influence of previous accidental exposure to blood or body fluids, federal regulations, hospital policy and procedure, leaders’ attitudes, and patients’ needs on the use of PPE. Each of these was found to strongly influence surgical team members and their use of PPE during operative/invasive procedures. Implications based on the findings affect organizational policy, purchasing and distribution decisions, curriculum design and instruction, leader behavior, and finally partnership with PPE manufacturers. Surgical team members must balance their innate need to care for patients with their need to protect themselves. Results of this study will help team members, leaders, and educators achieve this balance.
Resumo:
Exposure to certain bloodborne pathogens can prematurely end a person’s life. Healthcare workers (HCWs), especially those who are members of surgical teams, are at increased risk of exposure to these pathogens. The proper use of personal protective equipment (PPE) during operative/invasive procedures reduces that risk. Despite this, some HCWs fail to consistently use PPE as required by federal regulation, accrediting agencies, hospital policy, and professional association standards. The purpose of this mixed methods survey study was to (a) examine factors surgical team members perceive influence choices of wearing or not wearing PPE during operative/invasive procedures and (b) determine what would influence consistent use of PPE by surgical team members. Using an ex post facto, non-experimental design, the memberships of five professional associations whose members comprise surgical teams were invited to complete a mixed methods survey study. The primary research question for the study was: What differences (perceptual and demographic) exist between surgical team members that influence their choices of wearing or not wearing PPE during operative/invasive procedures? Four principal differences were found between surgical team members. Functional (i.e., profession or role based) differences exist between the groups. Age and experience (i.e., time in profession) differences exist among members of the groups. Finally, being a nurse anesthetist influences the use of risk assessment to determine the level of PPE to use. Four common themes emerged across all groups informing the two study purposes. Those themes were: availability, education, leadership, and performance. Subsidiary research questions examined the influence of previous accidental exposure to blood or body fluids, federal regulations, hospital policy and procedure, leaders’ attitudes, and patients’ needs on the use of PPE. Each of these was found to strongly influence surgical team members and their use of PPE during operative/invasive procedures. Implications based on the findings affect organizational policy, purchasing and distribution decisions, curriculum design and instruction, leader behavior, and finally partnership with PPE manufacturers. Surgical team members must balance their innate need to care for patients with their need to protect themselves. Results of this study will help team members, leaders, and educators achieve this balance.
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Based on a well-established stratigraphic framework and 47 AMS-14C dated sediment cores, the distribution of facies types on the NW Iberian margin is analysed in response to the last deglacial sea-level rise, thus providing a case study on the sedimentary evolution of a high-energy, low-accumulation shelf system. Altogether, four main types of sedimentary facies are defined. (1) A gravel-dominated facies occurs mostly as time-transgressive ravinement beds, which initially developed as shoreface and storm deposits in shallow waters on the outer shelf during the last sea-level lowstand; (2) A widespread, time-transgressive mixed siliceous/biogenic-carbonaceous sand facies indicates areas of moderate hydrodynamic regimes, high contribution of reworked shelf material, and fluvial supply to the shelf; (3) A glaucony-containing sand facies in a stationary position on the outer shelf formed mostly during the last-glacial sea-level rise by reworking of older deposits as well as authigenic mineral formation; and (4) A mud facies is mostly restricted to confined Holocene fine-grained depocentres, which are located in mid-shelf position. The observed spatial and temporal distribution of these facies types on the high-energy, low-accumulation NW Iberian shelf was essentially controlled by the local interplay of sediment supply, shelf morphology, and strength of the hydrodynamic system. These patterns are in contrast to high-accumulation systems where extensive sediment supply is the dominant factor on the facies distribution. This study emphasises the importance of large-scale erosion and material recycling on the sedimentary buildup during the deglacial drowning of the shelf. The presence of a homogenous and up to 15-m thick transgressive cover above a lag horizon contradicts the common assumption of sparse and laterally confined sediment accumulation on high-energy shelf systems during deglacial sea-level rise. In contrast to this extensive sand cover, laterally very confined and maximal 4-m thin mud depocentres developed during the Holocene sea-level highstand. This restricted formation of fine-grained depocentres was related to the combination of: (1) frequently occurring high-energy hydrodynamic conditions; (2) low overall terrigenous input by the adjacent rivers; and (3) the large distance of the Galicia Mud Belt to its main sediment supplier.
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This synthesis dataset contains records of freshwater peat and lake sediments from continental shelves and coastal areas. Information included is site location (when available), thickness and description of terrestrial sediments as well as underlying and overlying sediments, dates (when available), and references.
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Background: Hospital-treated deliberate self harm and suicide among older adults have rarely been examined at a national level. Methods: The Irish Central Statistics Office provided suicide and undetermined death data for 1980-2006. The National Registry of Deliberate Self Harm collected data relating to deliberate self harm presentations made in 2006-2008 to all 40 Irish hospital emergency departments. Results: Rates of female suicide among older adults (over 55 years) were relatively stable in Ireland during 1980-2006 whereas male rates increased in the 1980s and decreased in more recent decades. Respectively, the annual male and female suicide and undetermined death rate was 22.1 and 7.6 per 100,000 in 1997-2006. Male and female deliberate self harm was 3.0 and 11.0 times higher at 67.4 and 83.4 per 100,000, respectively. Deliberate self harm and suicide decreased in incidence with increasing age. Deliberate self harm generally involved drug overdose (male: 72%; female 85%) or self-cutting (male: 15%; female 9%). The most common methods of suicide were hanging (41%) and drowning (29%) for men and drowning (39%) and drug overdose (24%) for women. City and urban district populations had the highest rates of hospital-treated self harm. The highest suicide rates were in urban districts. Conclusions: Older Irish adults have high rates of hospital-treated deliberate self harm but below average rates of suicide. Drowning was relatively common as a method of suicide. Restricting availability of specific medications may reduce both forms of suicidal behavior.
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The impact of widowhood on suicide and accident mortality in Ireland was investigated using Poisson regression analysis applied to routine data relating to all 10 561 suicidal and accidental deaths of married or widowed persons aged at least 35 years in Ireland during 1986–2005. Mortality rates were almost always higher among the widowed and often by a 2-fold, statistically significant difference. The excess mortality was equivalent to 2083 or 57.6% of all suicidal or accidental deaths of widowed persons in 1986–2005. Routine contact with recently widowed persons by public health professionals may be warranted with a view to reducing their excess mortality.
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In this thesis we study aspects of (0,2) superconformal field theories (SCFTs), which are suitable for compactification of the heterotic string. In the first part, we study a class of (2,2) SCFTs obtained by fibering a Landau-Ginzburg (LG) orbifold CFT over a compact K\"ahler base manifold. While such models are naturally obtained as phases in a gauged linear sigma model (GLSM), our construction is independent of such an embedding. We discuss the general properties of such theories and present a technique to study the massless spectrum of the associated heterotic compactification. We test the validity of our method by applying it to hybrid phases of GLSMs and comparing spectra among the phases. In the second part, we turn to the study of the role of accidental symmetries in two-dimensional (0,2) SCFTs obtained by RG flow from (0,2) LG theories. These accidental symmetries are ubiquitous, and, unlike in the case of (2,2) theories, their identification is key to correctly identifying the IR fixed point and its properties. We develop a number of tools that help to identify such accidental symmetries in the context of (0,2) LG models and provide a conjecture for a toric structure of the SCFT moduli space in a large class of models. In the final part, we study the stability of heterotic compactifications described by (0,2) GLSMs with respect to worldsheet instanton corrections to the space-time superpotential following the work of Beasley and Witten. We show that generic models elude the vanishing theorem proved there, and may not determine supersymmetric heterotic vacua. We then construct a subclass of GLSMs for which a vanishing theorem holds.
Characterization of the defined MDC types and compilation of MDC initiation times (excel-file 19 kB)
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Mud accumulates on continental shelves under a variety of environmental conditions and results in a diverse formation of mud depocenters (MDCs). Their three-dimensional architectures have been in the focus of several recent studies. Due to some terminological confusion concerning MDCs, the present study sets out to define eight individual MDC types in terms of surface sediment distribution and internal geometry. Under conditions of substantial sediment supply, prodeltas (distal zones off river deltas; triangular sheets), subaqueous deltas (disconnected from deltas by strong normal-to-shore currents; wedge-like clinoforms), and mud patches (scattered distribution) and mud blankets (widespread covers) are formed. Forced by hydrodynamic conditions, mud belts in the strict sense (detached from source; elongated bodies), and shallow-water contourite drifts (detached from source; growing normal to prevailing current direction; triangular clinoforms) develop. Controlled by local morphology, mud entrapments (in depressions, behind morphological steps) and mud wedges (triangular clinoforms growing in flow direction) are deposited. Shelf mud deposition took place (1) during early outer-shelf drowning (~14 ka), (2) after inner-shelf inundation to maximum flooding (9.5-6.5 ka), and (3) in sub-recent times (<2 ka). Subsequent expansion may be (1) concentric, in cases where the depocenter formed near the fluvial source, (2) uni-directional, extending along advective current transport paths, and (3) progradational, forming clinoforms that grow either parallel or normal to the bottom current direction. Classical mud belts may be initiated around defined nuclei, the remote sites of which are determined by seafloor morphology rather than the location of the source. From a stratigraphic perspective, mud depocenters coincide with sea-level highstand-related, shelf-wide condensed sections. They often show a conformable succession from transgressive to highstand systems tract stages.