948 resultados para Embolism, Paradoxical
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The Struggling State explores Eritreans’ disillusion with a government that permanently conscripts the vast majority of its citizens into the military, and examines teachers’ paradoxical roles as educators who are trying to create a bright and peaceful future for the nation while situated to shuttle their students into the military. This title was made Open Access by libraries from around the world through Knowledge Unlatched.
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'The Chatter of the Visible' examines the paradoxical narrative features of the photo montage aesthetics of artists associated with Dada, Constructivism, and the New Objectivity.
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El presente trabajo confronta el abordaje de la cuestión del sujeto en Louis Althusser y Ludwig Wittgenstein. La comparación se produce porque el tratamiento del lenguaje de la filosofía del segundo Wittgenstein es particularmente apropiado para abordar la intervención del discurso en el proceso por el cual la ideología interpela a los individuos como sujetos, según Althusser. El descentramiento del sujeto obliga a repensar la dimensión de la agencia, y con ella, la de la política. Tanto Wittgenstein como Althusser desembocan en una encrucijada: negación teórica de la noción de sujeto y reconocimiento de la existencia paradójica de la misma en la práctica. Ello implica deconstruir el par "determinismo-libertad" sobre el que se asienta la pregunta por la agencia. Sobre el final retomamos el trabajo de Michel Pêcheux sobre los efectos retroactivos del discurso, lo que implica (en concordacia con Wittgenstein) un replanteo del vocabulario de la determinación, prominente en los escritos althusserianos
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Thesis (Master's)--University of Washington, 2016-06
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Despite the expense associated with rehabilitation following stroke, dissatisfaction with psychosocial outcomes is common (Thomas & Parry, 1996). The rehabilitation system has been critiqued as lacking a theoretical base for psychosocial interventions (Goldberg, Segal, Berk, Schall, & Gershkoff, 1997). The current paper examines the possible role of the Chronic Disease Self-Management Program ([CDSMP] Lorig, 1996) in contributing to the psychosocial rehabilitation of people with stroke. This paper focuses on the analysis of incidental comments made by participants about a version of the CDSMP, tailored for people with stroke. These comments, collected over an 18-month follow-up period, provide interesting insights into the key aspects of the program. Six informative themes emerged from the more specific comments, namely (1) the importance of social contact and comparison, (2) increased awareness and knowledge about stroke, (3) motivation to pursue goals and activities, (4) a sense of achievement, (5) maintenance of gains, and (6) the paradoxical nature of social support. According to participants, the program was associated with enhanced self-efficacy. Other reported benefits (such as social support and enhanced knowledge) were indirectly associated with the program and appeared to reflect social aspects of the group and its stroke-specific focus. Maintenance of gains made by participants was seen as a crucial issue.
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The quality of reporting of studies of diagnostic accuracy is less than optimal. Complete and accurate reporting is necessary to enable readers to assess the potential for bias in the study and to evaluate the generalisability of the results. A group of scientists and editors has developed the STARD (Standards for Reporting of Diagnostic Accuracy) statement to improve the reporting the quality of reporting of studies of diagnostic accuracy. The statement consists of a checklist of 25 items and flow diagram that authors can use to ensure that all relevant information is present. This explanatory document aims to facilitate the use, understanding and dissemination of the checklist. The document contains a clarification of the meaning, rationale and optimal use of each item on the checklist, as well as a short summary of the available evidence on bias and applicability. The STARD statement, checklist, flowchart and this explanation and elaboration document should be useful resources to improve reporting of diagnostic accuracy studies. Complete and informative reporting can only lead to better decisions in healthcare.
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Four variations on Two Envelope Paradox are stated and compared. The variations are employed to provide a diagnosis and an explanation of what has gone awry in the paradoxical modeling of the decision problem that the paradox poses. The canonical formulation of the paradox underdescribes the ways in which one envelope can have twice the amount that is in the other. Some ways one envelope can have twice the amount that is in the other make it rational to prefer the envelope that was originally rejected. Some do not, and it is a mistake to treat them alike. The nature of the mistake is diagnosed by the different roles that rigid designators and definite descriptions play in unproblematic and in untoward formulations of decision tables that are employed in setting out the decision problem that gives rise to the paradox. The decision maker’s knowledge or ignorance of how one envelope came to have twice the amount that is in the other determines which of the different ways of modeling his decision problem is correct. Under this diagnosis, the paradoxical modeling of the Two Envelope problem is incoherent.
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This study is an empirical and theoretical contribution to the burgeoning literature on gender and competitive boxing. By using Connell's concepts of labor, power, cathexis, and representation and a combination of content and semiotic analysis, interviews, and observations, we argue that competitive boxing can be studied productively as a paradoxical gender regime that simultaneously enables and constrains how women do gender. On one hand, the sport encourages individual women to display physical aggression when such behavior traditionally has been deemed the antithesis of femininity. Some feminists argue that this form of physical feminism enables women to transcend essentialist discourses that restrict their corporeal power. On the other hand, women boxers in general also encounter resistance to their aspirations. For example, they are still positioned by essentialist discourses about both their bodies and capacity to develop the requisite form of controlled aggression. Strongly gendered links between bodily labor and bodily capital also mean that women have less access to resources than do men and, consequently, fewer opportunities to develop their pugilistic capital. We also maintain that competitive women boxers are implicated in a body project that tends to replicate sporting practices that some feminists and pro-feminists argue are damaging to both men and women.
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One of the paradoxical effects of the 7 July bombings in London was to expose the ambivalence in the British government's attempt to wage war on terror by forcefully prosecuting war against those who resort to jihad abroad, actively participating in coalitions of the wining whether in Afghanistan or Iraq, while affording some of Islamism's key ideologists and strategists a high degree of latitude in the United Kingdom itself. This indicates a number of contradictions in official policy that simultaneously recognizes the globalized threat from violent Islamic militancy while, under the rubric of multiculturalism, tolerating those very strains of Islamist radicalism, some of which draw upon the interdependent and transnational character of conflict, to render the UK vulnerable to those very same violent forces. Consequently, the British authorities displayed a studied indifference towards this developing transnational phenomenon both during the 1990s and in some respects even after the London bombings. To explore the curious character of the government's response to the Islamist threat requires the examination of the emergence of this radical ideological understanding and what it entails as a reaction to modernization and secularism in both thought and practice. The analysis explores how government policies often facilitated the non-negotiable identity politics of those promoting a pure, authentic and regenerated Islamic order both in the UK and abroad. This reflected a profound misunderstanding of the growing source and appeal of radical Islam that can be interpreted as a consequence of the slow-motion collision between modernity in its recent globalized form and an Islamic social character, which renders standard western modernization theory, and indeed, the notion of a 'social science' itself, deeply questionable.
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Background: evaluation of the 'Keep Well At Home' (KWAH) Project in West London indicated that a programme of screening persons aged 75 and over had not reduced rates of emergency attendances and admissions to hospital. However, coverage of the target population was incomplete. The present analysis addresses 'efficacy'-whether individuals who completed the screening protocol as intended did subsequently use Accident & Emergency (A&E) services less often. Methods: the target population was divided into five groups, depending on whether an individual had completed none, one or both phases of screening, and whether deviations from the protocol related to incomplete coverage or refusal to participate further. We ascertained use of emergency services before screening and for up to 3 years afterwards by linkage of records from KWAH to those of local A&E Departments. Patterns of emergency care were examined as crude races and, via proportional hazards models, after adjustment for available confounders. Results: there was an increase of 51% (95% CI 22-86%) in the crude rate of emergency admissions in the year after first-phase screening compared with the 12 months before assessment. This was most obvious in individuals deemed at high risk who also underwent the second-phase assessment (adjusted hazard ratio relative to individuals not 'at risk'= 2.33; 95% CI 1.59-3.42). Conclusions: the available data do not allow us to distinguish between several possible explanations for the paradoxical increase in use of emergency services. However, what seem to be sensible policies do not necessarily have their intended effects when implemented in practice.
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beta-Adrenoceptor antagonists have revolutionized the management of heart failure in humans. However, fundamental questions remain concerning their use. Currently, there is considerable debate about the role of beta(2)-adrenoceptors in heart failure and whether incremental clinical benefit can be obtained by blockade of beta(2)-adrenoceptors in addition to beta(1)-adrenoceptors. Polymorphic forms of beta(1)- and beta(2)-adrenoceptors exist, which might contribute to the variable clinical outcomes that are observed with P-adrenoceptor antagonists. There is evidence for a low-affinity state of beta(1)-adrenoceptors and ventricular beta(3)-adrenoceptors, and these are discussed in the context of heart failure. Finally, there is seemingly paradoxical evidence that restoration and normalization of the beta-adrenoceptor system is beneficial in animal models of heart failure. We reconcile this view with the current clinical use and proven benefit of beta-adrenoceptor antagonists.
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Purpose: PI-88 is a mixture of highly sulfated oligosaccharides that inhibits heparanase, an extracellular matrix endoglycosidase, and the binding of angiogenic growth factors to heparan sulfate. This agent showed potent inhibition of placental blood vessel angiogenesis as well as growth inhibition in multiple xenograft models, thus forming the basis for this study. Experimental Design: This study evaluated the toxicity and pharmacokinetics of PI-88 (80-315 mg) when administered s.c. daily for 4 consecutive days bimonthly (part 1) or weekly (part 2). Results: Forty-two patients [median age, 53 years (range, 19-78 years); median performance status, 1] with a range of advanced solid tumors received a total of 232 courses. The maximum tolerated dose was 250 mg/d. Dose-limiting toxicity consisted of thrombocytopenia and pulmonary embolism. Other toxicity was generally mild and included prolongation of the activated partial thromboplastin time and injection site echymosis. The pharmacokinetics were linear with dose. Intrapatient variability was low and interpatient variability was moderate. Both AUC and C-max correlated with the percent increase in activated partial thromboplastin time, showing that this pharmacodynamic end point can be used as a surrogate for drug exposure, No association between PI-88 administration and vascular endothelial growth factor or basic fibroblast growth factor levels was observed. One patient with melanoma had a partial response, which was maintained for >50 months, and 9 patients had stable disease for >= 6 months. Conclusion: The recommended dose of PI-88 administered for 4 consecutive days bimonthly or weekly is 250 mg/d. PI-88 was generally well tolerated. Evidence of efficacy in melanoma supports further evaluation of PI-88 in phase II trials.
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Aim To develop an appropriate dosing strategy for continuous intravenous infusions (CII) of enoxaparin by minimizing the percentage of steady-state anti-Xa concentration (C-ss) outside the therapeutic range of 0.5-1.2 IU ml(-1). Methods A nonlinear mixed effects model was developed with NONMEM (R) for 48 adult patients who received CII of enoxaparin with infusion durations that ranged from 8 to 894 h at rates between 100 and 1600 IU h(-1). Three hundred and sixty-three anti-Xa concentration measurements were available from patients who received CII. These were combined with 309 anti-Xa concentrations from 35 patients who received subcutaneous enoxaparin. The effects of age, body size, height, sex, creatinine clearance (CrCL) and patient location [intensive care unit (ICU) or general medical unit] on pharmacokinetic (PK) parameters were evaluated. Monte Carlo simulations were used to (i) evaluate covariate effects on C-ss and (ii) compare the impact of different infusion rates on predicted C-ss. The best dose was selected based on the highest probability that the C-ss achieved would lie within the therapeutic range. Results A two-compartment linear model with additive and proportional residual error for general medical unit patients and only a proportional error for patients in ICU provided the best description of the data. Both CrCL and weight were found to affect significantly clearance and volume of distribution of the central compartment, respectively. Simulations suggested that the best doses for patients in the ICU setting were 50 IU kg(-1) per 12 h (4.2 IU kg(-1) h(-1)) if CrCL < 30 ml min(-1); 60 IU kg(-1) per 12 h (5.0 IU kg(-1) h(-1)) if CrCL was 30-50 ml min(-1); and 70 IU kg(-1) per 12 h (5.8 IU kg(-1) h(-1)) if CrCL > 50 ml min(-1). The best doses for patients in the general medical unit were 60 IU kg(-1) per 12 h (5.0 IU kg(-1) h(-1)) if CrCL < 30 ml min(-1); 70 IU kg(-1) per 12 h (5.8 IU kg(-1) h(-1)) if CrCL was 30-50 ml min(-1); and 100 IU kg(-1) per 12 h (8.3 IU kg(-1) h(-1)) if CrCL > 50 ml min(-1). These best doses were selected based on providing the lowest equal probability of either being above or below the therapeutic range and the highest probability that the C-ss achieved would lie within the therapeutic range. Conclusion The dose of enoxaparin should be individualized to the patients' renal function and weight. There is some evidence to support slightly lower doses of CII enoxaparin in patients in the ICU setting.
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Objective/Hypothesis: The purpose of this study was to examine respiratory function in a group of patients with muscle tension dysphonia (MTD) Design: Cross-sectional analytical study. Methods: Participants included 15 people with a diagnosis of MTD referred to speech pathology for management of their voice disorder, fiberoptic evidence of glottal or supraglottic constriction during phonation with or without posterior chink, or bowing combined and deviation in perceptual voice quality. A second group of 15 participants with no history of voice disorder served as healthy controls,. Baseline pulmonary function test measures included forced expiratory volume in the first second (FEV1), FVC, FEF25 to 75, FIF50, FEV1/FVC, ratio and FEF50/FIF50 ratio. Hypertonic saline challenge test measures included FEV1 and FIF50 after provocation, close response slope, and provocation dose. Results: Compared with healthy controls, participants with MTD demonstrated a higher prevalence of glottal constriction during inspiration after provocation with nebulized hypertonic saline as demonstrated by a reduction in FIF50 after the hypertonic saline challenge. There was no significant difference between the MTD and healthy control groups in baseline pulmonary function testing. Participants with MTD demonstrated a higher prevalence than healthy controls of abnormal glottic closure during inspiration similar to paradoxical vocal fold movement (PVFM). This suggests that they either had previously undiagnosed coexisting PVFM or that the condition of MTD could be expanded to include descriptions of aberrant glottic function during respiration. This study enhances the understanding of PVFM and MTD by combining research advances made in the fields of otolaryngology and respiratory medicine.
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This paper examines the paradox of revisability. This paradox was proposed by Jerrold Katz as a problem for Quinean naturalised epistemology Katz employs diagonalisation to demonstrate what he takes to be an inconsistency in the constitutive principles of Quine's epistemology. Specifically, the problem seems to rest with the principle of universal revisability which states that no statement is immune to revision. In this paper it is argued that although there is something odd about employing universal revisability to revise itself, there is nothing paradoxical about this. At least, there is no paradox along the lines suggested by Katz.