978 resultados para Sepsis - Theses
Resumo:
The central goal of food safety policy in the European Union (EU) is to protect consumer health by guaranteeing a high level of food safety throughout the food chain. This goal can in part be achieved by testing foodstuffs for the presence of various chemical and biological hazards. The aim of this study was to facilitate food safety testing by providing rapid and user-friendly methods for the detection of particular food-related hazards. Heterogeneous competitive time-resolved fluoroimmunoassays were developed for the detection of selected veterinary residues, that is coccidiostat residues, in eggs and chicken liver. After a simplified sample preparation procedure, the immunoassays were performed either in manual format with dissociation-enhanced measurement or in automated format with pre-dried assay reagents and surface measurement. Although the assays were primarily designed for screening purposes providing only qualitative results, they could also be used in a quantitative mode. All the developed assays had good performance characteristics enabling reliable screening of samples at concentration levels required by the authorities. A novel polymerase chain reaction (PCR)-based assay system was developed for the detection of Salmonella spp. in food. The sample preparation included a short non-selective pre-enrichment step, after which the target cells were collected with immunomagnetic beads and applied to PCR reaction vessels containing all the reagents required for the assay in dry form. The homogeneous PCR assay was performed with a novel instrument platform, GenomEra™, and the qualitative assay results were automatically interpreted based on end-point time-resolved fluorescence measurements and cut-off values. The assay was validated using various food matrices spiked with sub-lethally injured Salmonella cells at levels of 1-10 colony forming units (CFU)/25 g of food. The main advantage of the system was the exceptionally short time to result; the entire process starting from the pre-enrichment and ending with the PCR result could be completed in eight hours. In conclusion, molecular methods using state-of-the-art assay techniques were developed for food safety testing. The combination of time-resolved fluorescence detection and ready-to-use reagents enabled sensitive assays easily amenable to automation. Consequently, together with the simplified sample preparation, these methods could prove to be applicable in routine testing.
Resumo:
This paper is the result of the archaeo-morphological analysis of an area located to the north of the city of Valencia (Spain). This research has been developed in the context of one of the author’s PhD, which aims to analyse the whole of the city’s historical territory. The morphology of Valencia’s historical landscape and its different features have been analysed with a diachronic and multidisciplinary approach, combining data obtained from different types of analysis and through methodological procedures based on archaeo-morphology, traditional archaeology and landscape archaeology. For the first time, this methodology has been used in this territory. The results obtained represent a challenge regarding traditionally defended theses.
Resumo:
Peat is an organic substance with the maintenance of a mineral part, what shows it as interesting object for studying. Both organic and mineral parts of peat find application in various fields of activity of the people. Antibacterial properties of peat are known since an antiquity. Today people have expanded a spectrum of application of peat to use of by-products of its processing for reception of rather ecologically harmless fuel. The master theses are focused on peat, as on ambiguous raw materials for processing and fuel manufacture. The purpose of theses to show how much widely applied peat, technologies on its processing and its influence on environment at all stages of its working out.
Resumo:
Tämän tutkimuksen tavoitteena oli määritellä strategiaprosessiin liittyvät kriittiset alueet, konsernijohdon tehtävät strategiaprosessissa sekä edellisten pohjalta kehittää konsernityyppiselle yritykselle normatiivinen strategiaprosessin malli kriittisten alueiden hallitsemiseksi. Tavoitteena oli myös lisätä strategisen ajattelun ja strategiaprosessien ymmärtämistä selittämällä niiden historiallista kehittymistä sekä niiden käsitteistöä ja käsitteiden sisältöä. Probleemaa lähestyttiin sekä doktriinin kautta että tulkitsemalla strategiaprosessissa ilmeneviä ongelmia ja analysoimalla niiden syy ja seuraussuhteita. Käsillä oleva teoreettis praktinen tutkimus toteutettiin osittain toiminta-analyyttisella tutkimusotteella, osittain toiminta analyyttisella tutkimusotteella case tutkimuksen ja komparatiivisen analyysin tukemana sekä osittain päätöksentekometodologisella tutkimusotteella. Työn teoreettinen osa tehtiin kirjallisuustutkimuksena. Siinä luotiin strategiaprosessin ja konsernijohtamisen käsitteellinen perusta ja tutkimuksen viitekehys. Konsernijohtaminen laajennettiin tutkimuksessa tulosten osalta yleistäen koskemaan muitakin hajautettuja yritysorganisaatioita kuin pelkän juridiikan pohjalta muodostuneita konserneja. Tutkimuksen aluksi tarkasteltiin strategisen ajattelun koulukuntia eri näkemyksineen sekä toisaalta strategia-ajattelun kehittymistrendeja 1950 luvulta nykyhetkeen. Samoin tarkasteltiin sitä, kuinka strategiaprosessit oval kehittyneet samara ajanjaksona. Huomion painopisteen todettiin siirtyneen strategisen johtamisen inhimilliseen puoleen strategisem johtajuuden samalla korostuessa ja strategisen ajattelun laajentuessa Empiirinen osuus toteutettiin case tutkimuksena. Sen kuluessa kartoitettiin strategiaprosessin keskeiset ongelma alueet ja analysoitiin niiden takana olevat syyt, jotta voidin määritellä strategiapmsessin kehittämisen suunnat ja painopisteaiueet. Teoreettisen ja empiirisen osan penisteella määriteltiin strategiaprosessin kriittiset alueet yleisellä tasolla. Kriittisellä alueella tarkoitetaan asiakokonaisuutta tai asiaa, jonka on oltava kunaossa, jotta strategiaprosessit toimisivat. Nämä alueet liittyvat itse strategiaprosessiin suoraan tai välillisesti muun johtamistyön kautta. Strategiaprosessin kriittisten alueiden määrittelyn yhteydessä asetettiin doktriiniin tukeutuen strategiaprosessin kehittämissuunnat konsernijohdon nakäkökulmasta tarkasteltuna. Näihin kehittämissuuntiin ja edelleen doktriiniin tukeutuen määriteltiin konsernijohdon strategiaprosessin substanssitehtävät, prosessia tukevat tehtävät sekä prosessin toteuttamis- ja kehittämistehtävtä. Konsernijohdon strategiaprosessin tehtävät eivät muodosta sekventiaalista ja hierarkista järjestelmää vaan ovat joukko aktiviteetteja, joita toteutetaan tarpeen mukaan. Konsernijohdon strategiaprosessi määriteltiin ja kuvattiin tutkimuksessa johdon työskentelyprosessiksi sellaisten toimeenpanokelpoisten strategioiden tuottamiseksi ja toimeenpanemiseksi, jotka lisäävät yrityksen (konsernin) arvoa omistajan näkökulmasta mutta huomioivat myös muiden keskeisten sidosryhmien vaatimukset, tavoitteet ja rajoitteet. Konsernijohdon strategiaprosessi nähdään tässä jatkuvana konsernitasoisena päämäärä- ja keinopuolen tarkasteluna. Siinä konsernijohto tiedostaa konsernin ulkoisesta ja sisäisestä ymparistostä tulevat signaalit sekä pitää yllä näkemystä konsernin strategisesta asemasta. Tiedon massan näkemyksen saavutettua kriittisen rajansa se pakottaa konsernijohdon aivioimaan aiempia ratkaisuja uudessa valossa. Tämä validointi perustuu jatkuvasti esitettyihin neljään kysymykseen: onko ympäristö , premissi ja toimeenpanoseurannasta kertyneen tietämyksen perusteella nähtävissä vaikutuksia välittömiin toimenpiteisiin, vaikutuksia toimintasuunnitelmiin tai kriittisiin seurannan kohteisiin, vaikutuksia suunnanvalintoihin tai vaikutuksia perususkomuksiin? Konsernijohdon strategiaprosessi etenee jatkuvana prosessina päätösten ja ajan virrassa.
Resumo:
A simple and reliable ashing procedure is proposed for the preparation of used lubricating oil samples for the determination of Zn, Fe, Pb, Ni and Cu by the flame atomic absorption spectrometry technique. Sulphanilic acid was added to oil samples, the mixture coked and the coke ashed at 550 ºC. The solutions of the ash were analysed by flame AAS for these metals. The quantification limits were 38.250 µg g-1 for Zn, 4.550 µg g-1 for Fe, 1.562 µg g-1 for Pb, 1.450 µg g-1 for Ni, and 0.439 µg g-1 for Cu. The determinations, in lubricating oil, showed good precision and accuracy with recoveries between 90 and 110 %, indicating a negligible matrix effect in the experiments using addition of analyte, with relative standard deviation lower than 5%. The results for analysis of wastewater contamined by theses lubricants showed a very high relative standard deviation.
Resumo:
El estreptococo del grupo B (EGB) constituye la principal causa de morbimortalidad neonatal y de morbilidad materna durante el embarazo y el posparto. Coloniza el aparato digestivo y el genitourinario en un 10-30% de las gestantes, con una tasa de transmisión vertical del 50%. De entre los recién nacidos colonizados, un 1-2% desarrollará una sepsis grave precoz. Se ha realizado una revisión bibliográfica con el objetivo de conocer las estrategias de prevención de la infección neonatal por EGB. Los resultados ponen de manifiesto que las recomendaciones para su prevención consisten en el cribado universal prenatal de colonización por EGB mediante cultivo vaginorrectal a las 35-37 semanas, y la administración de profilaxis antibiótica intraparto a todas las embarazadas portadoras.
Resumo:
El estreptococo del grupo B (EGB) constituye la principal causa de morbimortalidad neonatal y de morbilidad materna durante el embarazo y el posparto. Coloniza el aparato digestivo y el genitourinario en un 10-30% de las gestantes, con una tasa de transmisión vertical del 50%. De entre los recién nacidos colonizados, un 1-2% desarrollará una sepsis grave precoz. Se ha realizado una revisión bibliográfica con el objetivo de conocer las estrategias de prevención de la infección neonatal por EGB. Los resultados ponen de manifiesto que las recomendaciones para su prevención consisten en el cribado universal prenatal de colonización por EGB mediante cultivo vaginorrectal a las 35-37 semanas, y la administración de profilaxis antibiótica intraparto a todas las embarazadas portadoras.
Resumo:
El fracaso renal agudo afecta entre un 1 y un 25% de los pacientes ingresados en unidades de cuidados intensivos, cifras que varían según la población y los criterios estudiados. Las complicaciones derivadas del fracaso renal agudo (hipervolemia, acidosis metabólica, hiperpotasemia, hemorragias) se tratan pero la mortalidad sigue siendo elevada a pesar de los avances tecnológicos de los últimos años ya que, habitualmente, el fracaso renal agudo está asociado a sepsis, insuficiencia respiratoria, heridas graves, complicaciones quirúrgicas o coagulopatías de consumo. El rango de mortalidad va desde un 30 a un 90%. Aunque no disponemos de una definición universalmente aceptada, la clasificación RIFLE aporta una herramienta operativa tanto para definir el grado de fracaso renal agudo como para homogeneizar el inicio de las técnicas de depuración extrarrenal y evaluar los resultados obtenidos. En consecuencia, las enfermeras que trabajan en una unidad de cuidados intensivos deben estar familiarizadas con esta afección, con su tratamiento (farmacológico o sustitutivo) y con la prevención de las posibles complicaciones. De igual manera han de ser capaces de detectar las manifestaciones de dependencia de cada una de las necesidades básicas e identificar los problemas de colaboración para conseguir un plan de cuidados individualizado.
Resumo:
Polysialic acid is a carbohydrate polymer which consist of N-acetylneuraminic acid units joined by alpha2,8-linkages. It is developmentally regulated and has an important role during normal neuronal development. In adults, it participates in complex neurological processes, such as memory, neural plasticity, tumor cell growth and metastasis. Polysialic acid also constitutes the capsule of some meningitis and sepsis-causing bacteria, such as Escherichia coli K1, group B meningococci, Mannheimia haemolytica A2 and Moraxella nonliquefaciens. Polysialic acid is poorly immunogenic; therefore high affinity antibodies against it are difficult to prepare, thus specific and fast detection methods are needed. Endosialidase is an enzyme derived from the E. coli K1 bacteriophage, which specifically recognizes and degrades polysialic acid. In this study, a novel detection method for polysialic acid was developed based on a fusion protein of inactive endosialidase and the green fluorescent protein. It utilizes the ability of the mutant, inactive endosialidase to bind but not cleave polysialic acid. Sequencing of the endosialidase gene revealed that amino acid substitutions near the active site of the enzyme differentiate the active and inactive forms of the enzyme. The fusion protein was applied for the detection of polysialic acid in bacteria and neuroblastoma. The results indicate that the fusion protein is a fast, sensitive and specific reagent for the detection of polysialic acid. The use of an inactive enzyme as a specific molecular tool for the detection of its substrate represents an approach which could potentially find wide applicability in the specific detection of diverse macromolecules.
Resumo:
In the German academies of Nietzsche's period of writing, the Kantian tradition was largely displaced in favor of two independent schools that have since been labeled "Neo-Kantianism." This paper presents four key theses about philosophy of history from four Neo-Kantian thinkers, how they follow from their adaptation of the Kantian tradition, and how Nietzsche critically engaged the very same issues in the formation of his own historical theory. Although there is little direct influence between orthodox Neo-Kantianism and Nietzsche, their comparison on these points will illuminate their unique adaptations of the Kantian tradition.
Resumo:
The aim of this thesis is to gain new understanding of health based on the work Penseés (Thoughts) by Blaise Pascal. The research interest originates from the motive of the heart for the greatness of man in conjunction with his baseness. The study is hermeneutic and the purpose is to describe health formulated as new abductive theses based on the assumption that caring science and caring theology can be conjoined in the same ontology. The work Penseés is, in Gadamer’s sense, alive since the text is constantly being made use of and is in this occurence interpreted through the requirements made by caring science. Pascal’s arguments continue through the historically effected consciousness while the interpretation is confronted with the ontological model of health. In the initial horizon we find the understanding of the motion of health and the extension towards text materials which is undertaken by Pascal’s Penseés. to open up the perspective and be able to project the horizon of the text. In the encounter with the text, the core content will first be discussed in an interpretative part after which the understanding gained will be summarized into new abductive assumptions. On the basis of Gadamer’s emphasis on the applications of the interpretations, the merging of the horizons will identify health as something desired by man, what he is and what he wants to accomplish. The creation of health is the reason of the heart, and on the basis of what man wants to confide in, the rise of health will be established. The totality of greatness and baseness of man is achieved by the accomplishment of health. That man owns spiritual devotedness means health whereas unhealthy means that he is insecure of his character and leads a life with ill-considered amusements. When according to Pascal, man’s desires and thoughts are joined in the heart, a connecting relation will arise. Hence the spiritual edification that man will fail to secure if he puts too much of his confidence in transient reason is included, something that is insufficient when it comes to understand the meaning of health.
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The purpose of this thesis is to develop a theory model about some core concepts and phenomena within caritative ethics when patients' demands are existential. There are two research questions, (A) Which realities represent concepts such courage, responsibility, and sacrifice within the caritative ethics. (B) Which phenomena of ethical significance are made current and applicable when patients¿ demands are existential. This study takes as its point of departurecertain chosen theoretical perspectives that discuss some perspectives of the concepts of courage, responsibility, and sacrifice in terms of their significanceto the research questions A. This represents the study¿s theoretical data. The empirical data provide answers to the research question B. In the end, the thesis discusses synthesis of these two accesses of knowledge in order to formulate theses and create a theory model. Løgstrup's contribution and description of the ethical claim helps in understanding and interpreting the links between the substance of the caritative ethic and the concrete reality in the encounter with existential issues. This thesis is a study within the field of Caring Science. The nursing profession provides empirical data and reflects the study topic, by addressing issues of relevance to the application of the knowledge of Caring Sciencein light of the nursing profession's various daily challenges. This study proceeds from the basic assumption: "Caring relationships form the meaningful contextfor caring and derive from the ethos of love, responsibility, and sacrifice, i.e. a caritative ethics" (Eriksson 2001). This study attempts to explore and prove this statement in the light of theoretical and empirical data, in the light ofthe caring scientific perspective which is here linked particularly to the viewof man as a unity of body, mind, and soul, and to the ontological health model. Hermeneutics is the overall perspective for the interpretations proposed in this thesis. Through conversation and hermeneutic observations, I try to understandthe challenges of nursing performance in the encounter with existential issues. This constitutes the empirical data that was gathered on a ward treating cancerpatients. The discussion proceeds sequence by sequence, first by discussing theconditions of the caritative ethics when meeting the existential claims in the light of the concepts of courage, sacrifice, and responsibility. Then a thesis is formulated concerning the caritative ethics in the light of Caring Science. This is the foundation of the creation of the theory model. The resulting theses concern the chosen concepts and phenomena which promote caritative ethics when patients' claims are existential: Freedom is the hallmark of caritative ethics. Freedom is the basic category of caring. When attending to the patient's existential claims, it is of vital importance to secure human relationships as caring interpersonal communions, created by responsible persons who have shown courage and sacrifice. Courage and sacrifice constitute the ethos of caring communities (communions). Courage and sacrifice are then a part of the collective ethos of caring communities, because the patient is confirmed as the unity of body, mind, and soul.
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Background. Multiple myeloma (MM) is the second most common hematologic malignancy after lymphomas In Finland: the annual incidence of MM is approximately 200. For three decades the median survival remained at 3 to 4 years from diagnosis until high-dose melphalan treatment supported by autologous stem cell transplantation (ASCT) became the standard of care for newly diagnosed MM since the mid 1990’s and the median survival increased to 5 – 6 years. This study focuses on three important aspects of ASCT, namely 1) stem cell mobilization, 2) single vs. double ASCT as initial treatment, and 3) the role of minimal residual disease (MRD) for longterm outcome. Aim. The aim of this series of studies was to evaluate the outcomes of MM patients and the ASCT procedure at the Turku University Central Hospital, Finland. First, we tried to identify which factors predict unsuccessful mobilization of autologous stem cells. Second, we compared the use of short-acting granulocyte-colony stimulating factor (GCSF) with long-acting G-CSF as mobilization agents. Third, one and two successive ASCTs were compared in 100 patients with MM. Fourth, for patients in complete response (CR) after stem cell transplantation (SCT), patient-specific probes for quantitative allele-specific oligonucleotide polymerase-chain reaction (qASO-PCR) measurements were designed to evaluate MRD and its importance for long-term outcome. Results. The quantity of previous chemotherapy and previous interferon use were significant pre-mobilization factors that predicted mobilization failure, together with some factors related to mobilization therapy itself, such as duration and degree of cytopenias and occurrence of sepsis. Short-acting and long-acting G-CSF combined with chemotherapy were comparable as stem cells mobilizers. The progression free (PFS) and overall survival (OS) tended to be longer after double ASCT than after single ASCT with a median follow-up time of 4 years, but this difference disappeared as the follow-up time increased. qASO-PCR was a good and sensitive divider of the CR patients into two prognostic groups: MRD low/negative (≤ 0.01%) and MRD high (>0.01%) groups with a significant difference in PFS and suggestively also in OS. Conclusions. When the factors prediciting a poor outcome of stem cell mobilization prevail, it is possible to identify those patients who need specific efforts to maximize the mobilization efficacy. Long-acting pegfilgrastim is a practical and effective alternative to short-acting filgrastim for mobilization therapy. There is no need to perform double ASCT on all eligible patients. MRD assessment with qASO-PCR is a sensitive method for evaluation of the depth of the CR response and can be used to predict long-term outcome after ACST.
Resumo:
ABSTRACT When Hume, in the Treatise on Human Nature, began his examination of the relation of cause and effect, in particular, of the idea of necessary connection which is its essential constituent, he identified two preliminary questions that should guide his research: (1) For what reason we pronounce it necessary that every thing whose existence has a beginning should also have a cause and (2) Why we conclude that such particular causes must necessarily have such particular effects? (1.3.2, 14-15) Hume observes that our belief in these principles can result neither from an intuitive grasp of their truth nor from a reasoning that could establish them by demonstrative means. In particular, with respect to the first, Hume examines and rejects some arguments with which Locke, Hobbes and Clarke tried to demonstrate it, and suggests, by exclusion, that the belief that we place on it can only come from experience. Somewhat surprisingly, however, Hume does not proceed to show how that derivation of experience could be made, but proposes instead to move directly to an examination of the second principle, saying that, "perhaps, be found in the end, that the same answer will serve for both questions" (1.3.3, 9). Hume's answer to the second question is well known, but the first question is never answered in the rest of the Treatise, and it is even doubtful that it could be, which would explain why Hume has simply chosen to remove any mention of it when he recompiled his theses on causation in the Enquiry concerning Human Understanding. Given this situation, an interesting question that naturally arises is to investigate the relations of logical or conceptual implication between these two principles. Hume seems to have thought that an answer to (2) would also be sufficient to provide an answer to (1). Henry Allison, in his turn, argued (in Custom and Reason in Hume, p. 94-97) that the two questions are logically independent. My proposal here is to try to show that there is indeed a logical dependency between them, but the implication is, rather, from (1) to (2). If accepted, this result may be particularly interesting for an interpretation of the scope of the so-called "Kant's reply to Hume" in the Second Analogy of Experience, which is structured as a proof of the a priori character of (1), but whose implications for (2) remain controversial.
Resumo:
Several recent works in history and philosophy of science have re-evaluated the alleged opposition between the theses put forth by logical empiricists such as Carnap and the so-called "post-positivists", such as Kuhn. Although the latter came to be viewed as having seriously challenged the logical positivist views of science, recent authors (e.g., Friedman, Reisch, Earman, Irzik and Grünberg) maintain that some of the most notable theses of the Kuhnian view of science have striking similarities with some aspects of Carnap's philosophy. Against that reading, Oliveira and Psillos argue that within Carnap's philosophy there is no place for the Kuhnian theses of incommensurability, holism, and theory-ladenness of observations. This paper presents each of those readings and argues that Carnap and Kuhn have non-opposing views on holism, incommensurability, the theory-ladenness of observations, and scientific revolutions. We note at the very end - without dwelling on the point, however - that they come apart on other matters, such as their views on metaphysics and on the context of discovery/justification distinction.