"I’ll call you when we are ready" (One family’s experience of critical care and end of life decision making)

The purpose of this paper is to explore through narrative accounts one family's expérience of critical care, after the admission of a family member to an Intensive Care Unit (ICU) and their subséquent death five weeks later. Numerous studies support the need for effective communication and clear information to be given to the family. In this instance it was évident from their stories that there were numerous barriers to communication, including language and a lack of insight into the needs of the family. Many families do not understand the complexities of nursing care in an ICU so lack of communication by nursing staff was identified as uncaring behavior and encounters. Facilitating a family's proximity to a dying patient and encouraging them to participate in care helps to maintain some sensé of personal control. Despite a commitment to involving family members in care, which was enshrined in the Unit Philosophy, relatives were banished to the waiting room for hours. They experienced feelings of powerlessness and helplessness as they waited with other relatives for news following investigations or until 'the doctor had completed his rounds'. Explanations of "we must make 'the patient' comfortable" was no consolation for those who wished to be involved in care. The words "I'il call you when we are ready" became a mantra to the forgotten families who waited patiently for those with power to admit them to the ICU. Implications are this family felt they were left alone to cope with the traumatic expériences leading up to and surrounding the death. They felt mainly supported by the priest, who not only administered the last rites but provided spiritual support to the family and dealt sensitively with many issues. Paternalism in décision making when there is a moral obligation to ensure that discussions on end of life dilemmas are an inclusive process with families, doctors, nurses was not understood, therefore it caused conflict within the family over EOL décision making. The family felt that the opportunity to share expériences through telling and retelling their stories would enable them to reconfigure the past and create purpose in the future.

Determinação da toxicidade aguda e caracterização de risco ambiental do herbicida Roundup (glifosato) sobre três espécies de peixes

Considering their commercial importance, as these are the species of freshwater fish more commercialized in Brazil, their occurence in different kinds of aquatic environments (lakes, rivers and dams) and for being tolerant to a wide range of variation of various physical parameters and chemical water, the fish species Oreochromis niloticus, Cyprinus carpio and Colossoma macropomum were chosen for this study, furthermore, to test the toxicity we used the herbicide Roundup. The fingerlings of tilapia (Oreochromis niloticus), commun carp (Cyprinus carpio) and tambaqui (Colossoma macropomum) were submitted to the herbicide roundup in the following concentrations: 0.0 (control); 18,06; 19,10; 20,14; 21,18 and 22,22 mg.L-1, 0.0 (control); 13,89; 14,86; 15,83; 16,81 and 17,78 mg.L-1, and 0.0 (control); 18,06; 19,10; 20,14; 21,18 and 22,22 mg.L-1, respectively, three for 96 hours. The LC50 - 96h for O. niloticus, C. carpio and C. macropomum was 21,63, 15,33 and 20,06 mg.L-1 of the herbicide roundup, respectively. The results show that this herbicide is classified as slightly toxic to the three species. The values of dissolved oxygen, pH and temperature recorded in the aquarium control and aquarium experimental of the three fish species have remained without significant variations during the tests, which reduces the possibility of death caused by sudden variations of these parameters during the 96 hours the experiment. The values of LC50 between different species of fish were observed, noting that the species O.niloticus, C. carpio and C. macropomum showed no expressive differences. The values of environmental risk of Roundup were calculated to obtain more stringent parameters in assessing the dangerousness of those on nontargets. The risk of environmental contamination by Roundup for the Nile tilapia, common carp, and tambaqui are low for the lowest application rate (1 L.ha-1) and depths (1.5 and 2.0 m). The dilution of 100%, the highest recommended dose (5 L.ha-1) and depths (1.5 and 2.0 m) the risk is moderate for the three species. The values of the Risk Ratio (QR) were greater than 0,1, indicating that the values of the CAE and LC50 are above acceptable levels and there is a need, this study, a refinement in ecotoxicological tests

Pyrolysis of rice husk and corn stalk in auger reactor:Part 1. Characterization of char and gas at various temperatures

In this study, rice husk and corn stalk have been pyrolyzed in an auger pyrolysis reactor at pyrolysis temperatures of 350, 400, 450, 500, 550, and 600 °C in order to investigate the effect of the pyrolysis temperature on the pyrolysis performance of the reactor and physicochemical properties of pyrolysis products (this paper focuses on char and gas). The results have shown that the pyrolysis temperature significantly affects the mass yields and properties of the pyrolysis products. The mass yields of pyrolysis liquid and char are comparable to those reported for the same feedstocks processed in fluidized bed reactors. With the increase of the pyrolysis temperature, the pyrolysis liquid yield shows a peak at 500 °C, the char yield decreases, and the gas yield increases for both feedstocks. The higher heating value (HHV) and volatile matter content of char increase as the pyrolysis temperature increases from 350 to 600 °C. The gases obtained from the pyrolysis of rice husk and corn stalk mainly contain CO2, CO, CH4, H2, and other light hydrocarbons; the molar fractions of combustible gases increase and therefore their HHVs subsequently increase with the increase of the pyrolysis temperature.

Melatonin for cardioprotection in ST elevation myocardial infarction: Are we ready for the challenge?

Melatonin, an endocrine product of the pineal gland, is formed predominantly during the nighttime. Light has an inhibitory effect on pineal melatonin secretion. Pineal melatonin release is synchronised by this daily light-dark cycle via a multisynaptic pathway between the eyes and the pineal gland. Light stimulates the retina to modulate the activity of the suprachiasmatic nucleus, the master biological clock.1 The suprachiasmatic nucleus controls pineal melatonin synthesis and the concentrations of melatonin in the sera of healthy subjects, which reach values of 10−10 to 10−9 mol/L during the night, with much lower concentrations being present during the day. Many publications have shown that melatonin has an important role in a variety of cardiovascular pathophysiologic processes: the indoleamine has anti-inflammatory, antioxidant, antihypertensive, antithrombotic and antilipaemic properties.

Audit report on the Iowa Corn Promotion Board for the years ended August 31, 2016 and 2015

Audit report on the Iowa Corn Promotion Board for the years ended August 31, 2016 and 2015

9 months to get ready

This document explains what to expect during each month of pregnancy. It also discusses exercise during pregnancy, prenatal care, sex during pregnancy, normal complaints and problems of pregnancy and other issues.

Fresh Techniques: Getting ready to use hip hop in the classroom

A workbook-style reflection exercise prompts readers to consider potential uses of hip-hop in their own library instruction in a culturally responsive manner.

Evaluation of endophytic actinobacteria as antagonists of Pythium aphanidermatum in corn.

2007

Cover Crops and Nitrogen Fertilization Effects on Nitrogen Soil Fractions under Corn Cultivation in a No-Tillage System.

ABSTRACT: The use of cover crops has recently increased and represents an essential practice for the sustainability of no-tillage systems in the Cerrado region. However, there is little information on the effects of nitrogen fertilization and cover crop use on nitrogen soil fractions. This study assessed changes in the N forms in soil cropped to cover crops prior to corn growing. The experiment consisted of a randomized complete block design arranged in split-plots with three replications. Cover crops were tested in the plots, and the N topdressing fertilization was assessed in the subplots. The following cover species were planted in succession to corn for eight years: Urochloa ruziziensis, Canavalia brasiliensis M. ex Benth, Cajanus cajan (L.) Millsp, and Sorghum bicolor (L.) Moench. After corn harvesting, the soil was sampled at depths of 0.00-0.10 and 0.10-0.20 m. The cover crops showed different effects at different soil depths. The soil cultivated with U. ruziziensis showed higher contents of total-N and particulate-N than the soil cultivated with C. cajan. Particulate-N was the most sensitive to changes in the soil management among the fractions of N assessed. The soil under N topdressing showed a lower content of available-N in the 0.10-0.20 m layer, which may be caused by the season in which the sampling was conducted or the greater uptake of the available-N by corn.

Biological characteristics of black armyworm Spodoptera cosmioides on genetically modified soybean and corn crops that express insecticide Cry proteins.

This study aimed to evaluate the development and reproduction of the black armyworm, Spodoptera cosmioides when larvae fed on leaves of Bt-corn hybrids, expressing a single Cry1F and also Cry1F, Cry1A.105 and Cry2Ab2 in pyramided corn and their non-Bt-isoline (hybrid 2B688), as well as on leaves of two soybean isolines expressing the Cry1Ac protein and its non-Bt isoline (A5547-227). We also assessed the effect of these Bt and non-Bt plants on the leaf consumption rate of S. cosmioides larvae. This pest was unable to develop when fed on any of the corn isolines (Bt and non-Bt). When both 1st and 3rd instar larvae were fed on corn leaf, mortality was 100% in both Bt and non-Bt corn. In contrast, when corn leaves were offered to 5th instar larvae, there were survivors. Defoliation and leaf consumption was higher with non-Bt corn than with both of the Bt corn isolines. There was no negative effect of Bt soybean leaves on the development and reproduction of S. cosmioides with respect to all evaluated parameters. Our study indicates that both Bt and non-Bt corn adversely affect the development of S. cosmioides while Bt soybean did not affect its biology, suggesting that this lepidopteran has major potential to become an important pest in Bt soybean crops.

Effect of post-emergent herbicides application on carotenoid concentration in green corn.

Considering the influence of herbicides in the metabolism of the carotenoids in corn, the objective of the present study was to evaluate the effect of herbicides and genotype on carotenoids concentration. The green corn hybrids BRS 1030 and P30F53 were subjected to a post-emergent herbicides application at 20 and 30 days after emergence. Carotenoids were extracted from corn grains and analyzed to quantify ?- and ?-carotene, lutein, zeaxanthin, ?-cryptoxanthin, total carotenoids (TC), and total of vitamin A carotenoids precursors (proVA). The application of foramsulfuron + iodosulfuron-methyl-sodium (40 + 2.6 g ha-1), nicosulfuron (20 g ha-1), mesotrione (120 g ha-1) and tembotrione (80 g ha-1 and 100 g ha-1) promoted higher concentration of carotenoids in fresh green corn. Lutein, zeaxanthin, ?-cryptoxanthin, ?-carotene, ?-carotene, proVA carotenoids, and TC concentration increased after foramsulfuron + iodosulfuron-methyl-sodium in late application (V5 to V6), nicosulfuron in both applications, mesotrione applied post-initial (V3 to V4), tembotrione (100 g ha-1) in both applications and tembotrione (80 g ha-1) in late post-application, at least for one hybrid. The content of carotenoids in the green corn kernels differed between ?BRS 1030? and ?P30F53?. Our results suggest a possibility of significant increase of carotenoids in green corn kernels through the handling of corn production with post-emergent herbicides.

Use of organic compost containing waste from small ruminants in corn production.

Composting is a useful way of transforming livestock waste into organic fertilizer, which is proven to increase soil nutrient levels, and thus crop yield. Remains from production and slaughter of small ruminants can become a source of important elements for plant growth, such as N, after microorganism-driven decomposition.The aim of this investigation was to evaluate the effects of this compost on soil fertility and on the nutritional status and yield of the corn crop. The experiment was conducted in a Haplic Luvisol in a randomized block design with six treatments and five application rates of the organic compound in Mg ha-1: 3 (half the standard rate), 6 (standard rate), 9 (one and a half times the standard rate), 12 (twice the standard rate), and 24 (four times the standard rate) and an additional treatment with mineral fertilizers (110, 50 e 30 kg ha-1 of N, P2O5 and K2O, respectively), with four blocks. Evaluations were performed for two harvests of rainfed crops, measuring soil fertility, nutritional status, and grain yield. The compost increased P, K, Na and Zn values in the 0.00-0.20 m layer in relation of mineral fertilization in 616, 21, 114 and 90 % with rate 24 Mg ha-1 in second crop. Leaf N, Mg, and S contents, relative chlorophyll content, and the productivity of corn kernels increased in 27, 32, 36, 20 e 85 %, respectively, of low rate (3 Mg ha-1) to high rate (24 Mg ha-1) with of application of the compost. Corn yield was higher with application of organic compost in rate of 24 Mg ha-1 than mineral fertilizer combination in second crop.

Nitrogen oxides and CO2 from an Oxisol cultivated with corn in succession to cover crops.

2016

Soil microbilogica properties and available nitrogen for corn in monoculture and intercropped with forage.

2016

Combined effects of soil biotic and abiotic factors, influenced by sewage sludge incorporation, on the incidence of corn stalk rot.

Abstract: The objectives of this study were to evaluate the combined effects of soil bioticand abiotic factors on the incidence of Fusarium corn stalk rot, during four annual incorporations of two typesofsewagesludge intosoil ina 5-years field assay under tropical conditions and topredict the effectsof these variables on the disease. For each type of sewage sludge, the following treatments were included: control with mineral fertilization recommended for corn; control without fertilization; sewage sludge based on the nitrogen concentration that provided the same amount of nitrogen as in the mineral fertilizer treatment; and sewage sludge that provided two, four and eight times the nitrogen concentration recommended for corn. Increasing dosages of both types of sewage sludge incorporated into soil resulted in increased corn stalk rot incidence, being negatively correlated with corn yield. A global analysis highlighted the effect of the year of the experiment, followed by the sewage sludge dosages. The type of sewage sludge did not affect the disease incidence. Amultiple logistic model using a stepwise procedure was fitted based on the selection of a model that included the three explanatory parameters for disease incidence: electrical conductivity, magnesium and Fusarium population. In the selected model, the probability of higher disease incidence increased with an increase of these three explanatory parameters. When the explanatory parameters were compared, electrical conductivity presented a dominant effect and was the main variable to predict the probability distribution curves of Fusarium corn stalk rot, after sewage sludge application into the soil.