Perinatal management and long-term cardiac outcome in fetal arrhythmia

NARCIS (Netherlands)

Hahurij, N.D.; Blom, N.A.; Lopriore, E.; Aziz, M.I.; Nagel, H.T.; Rozendaal, L.; Vandenbussche, F.P.H.A.

2011-01-01

BACKGROUND: cardiac arrhythmias are commonly observed in the fetus, however, may have major consequences for fetal development and post natal life. AIMS: to evaluate the perinatal management and cardiac outcome of fetuses with tachy- or bradyarrhythmia. STUDY DESIGN: perinatal management, outcome

The Scandinavian Cooperative Advantage

DEFF Research Database (Denmark)

Strand, Robert; Freeman, R. Edward

In this article we clarify the historical roots of stakeholder theory to establish that a much larger role was played by Scandinavian thinkers in its development than is currently acknowledged. We show that important contributions to the stakeholder concept were being made by Eric Rhenman and his...... Scandinavian contemporaries in parallel to the contributions from the Stanford Research Institute (SRI) in the early 1960s and thereafter and thus are not a “historical trail” as they are currently labeled. Therefore we offer a significant modification to the historical narrative as presented in Strategic...... Management: A Stakeholder Approach (Freeman, 1984). These important Scandinavian contributions include the first publication and description of the expression „stakeholder‟ in management literature accessible to scholars throughout the world and the introduction of the first stakeholder map to the management...

Worldwide access to evidence-based mental health literature: how useful is PubMed in Anglo-Saxon and non-Anglo-Saxon countries?

Science.gov (United States)

Morlino, Massimo; Polese, Daniela; Bruni, Andrea; Renato, Bellinello

2005-10-01

The aim of this study was to verify the presence of cultural variety among the psychiatric journals available on PubMed, the major online tool for accessing literature. Data for analysis were taken from a survey of the world psychiatric journals indexed in Index Medicus 1999 (IM), the alphabetical list used by PubMed, and from the mean impact factor (IF) values of the journals. Approximately 80% of international psychiatric literature available on PubMed is published in Anglo-Saxon countries, especially in the USA (59.8% of the total). The widespread use of the English language (94.9% of all the journals) further stresses the dominance of the Anglo-Saxon cultural model, as do the mean IF values of Anglo-Saxon journals compared to non-Anglo-Saxon publications (3.252 vs. 1.693; P=0.0079). The under-representation of non-Anglo-Saxon cultural models on PubMed plays a negative role for bringing about a truly multicultural literature in psychiatry.

Approaches to Scandinavian Crime Fiction

DEFF Research Database (Denmark)

Agger, Gunhild

2010-01-01

as the approach of genre typology and the concept of evil – seemingly disparate concepts and approaches, but all related to the complex processes in the borderlands between crime fiction and society. Using examples from Scandinavian crime fiction, I discuss whether the growing proximity to international genres......The working paper discusses some of the major approaches to Scandinavian crime fiction in the light of the dominant features of crime culture, e.g. the broad exposure of crime fiction via different platforms and media. In this connection, the concept of mediatization is considered as well......, ways of production and standards increasingly removes Scandinavian crime fiction from its original attractions or not....

Energy and cooperation among the Scandinavian countries

Energy Technology Data Exchange (ETDEWEB)

Milas, R

1984-11-01

The Scandinavian countries have a long experience of functional cooperation in the field of energy. The oil crisis has been largely attenuated for Norway since the exploitation of the North Sea oil deposits. The future will be oil or nuclear, this is the characteristic of energy cooperation on the Scandinavian, European and international levels. In this connection, no level excludes another and the Scandinavian countries are going to patiently attempt to benefit from their Scandinavian dimension over the short range, their European vocation for research and development and their free trade ideology for the surveillance of markets on the level of international agencies.

The Routledge Handbook of Scandinavian Politics

DEFF Research Database (Denmark)

Scandinavian politics today through a series of cutting-edge chapters. It will be a key reference point both for advanced-level students developing knowledge about the subject, as well as researchers producing new material in the area and beyond. It brings geographical scope and depth, with comparative...... chapters contributed by experts across the region. Methodologically and theoretically pluralistic, the handbook is in itself a reflection of the field of political science in Scandinavia and the diversity of the issues covered in the volume. The Routledge Handbook of Scandinavian Politics......The Routledge Handbook of Scandinavian Politics is a comprehensive overview of Scandinavian politics provided by leading experts in the field and covering the polity, the politics and the policy of Scandinavia. Coherently structured with a multi-level thematic approach, it explains and details...

Do Scandinavian Care about international law?

DEFF Research Database (Denmark)

Wind, Marlene

2016-01-01

Although Scandinavians are often celebrated as the vanguards of human rights and international law, we know little about whether courts and judges in these countries have embraced those international courts and conventions that they themselves helped establish after the Second World War....... This article presents original and comprehensive data on three Scandinavian courts' citation practice. It demonstrates that not only do Scandinavian Supreme Courts engage surprisingly little with international law, but also that there is great variation in the degree to which they have domesticated...... international law and courts by citing their case law. Building on this author's previous research, it is argued that Norway sticks out as much more engaged internationally due to a solid judicial review tradition at the national level. It is also argued that Scandinavian legal positivism has influenced a much...

Brazilian experience in electricity auctions: Comparing outcomes from new and old energy auctions as well as the application of the hybrid Anglo-Dutch design

International Nuclear Information System (INIS)

Rego, Erik Eduardo; Parente, Virginia

2013-01-01

Since 2004, the Government of Brazil (GoB) has acted as an intermediary between distribution and generator companies in the energy procurement sector. The GoB procures energy from generator companies through auctions of long-term energy contracts. After an auction, the winning generator companies sign contracts directly with distribution companies. In particular, the GoB runs two different auctions: one for energy from existing power plants (i.e., old energy) and another for energy from power plants that have not yet been built (i.e., new energy). This paper describes these auctions and compares the outcomes from the old and new energy auctions from 2004 to 2010 using final auction prices. The Brazilian case is particularly interesting, not only because energy is predominantly supplied by hydropower plants but also because new energy auctions reach prices below those for old energy. Therefore, it is likely that it is not necessary to run the two different energy auctions. As a secondary objective, this article analyze whether the Anglo-Dutch hybrid auction model is a better design for electricity procurement in Brazil. - Highlights: ► We analyze the outcomes from the Brazilian old and new energy auctions. ► We evaluate the Anglo-Dutch auction design. ► Outcomes from both kind of auctions reveal that the prices are statistically similar. ► One kind of auction increase competition and minimize Eletrobras' market power

Contribution of cardiac and extra-cardiac disease burden to risk of cardiovascular outcomes varies by ejection fraction in heart failure

DEFF Research Database (Denmark)

Wolsk, Emil; Claggett, Brian; Køber, Lars

2018-01-01

AIMS: Patients with heart failure (HF) often have multiple co-morbidities that contribute to the risk of adverse cardiovascular (CV) and non-CV outcomes. We assessed the relative contribution of cardiac and extra-cardiac disease burden and demographic factors to CV outcomes in HF patients...... Association class, systolic blood pressure, time since HF diagnosis, HF medication use), extra-cardiac (body mass index, creatinine, diabetes mellitus, chronic obstructive pulmonary disease, smoker), and demographic (age, gender) categories, and calculated subscores for each patient representing the burden......EF patients (PAR: 76% cardiac disease vs. 58% extra-cardiac disease, P vs. 49% extra-cardiac disease, P

The Scandinavian Cooperative Advantage

OpenAIRE

Strand, Robert; Freeman, R. Edward

2013-01-01

In this article we clarify the historical roots of stakeholder theory to establish that a much larger role was played by Scandinavian thinkers in its development than is currently acknowledged. We show that important contributions to the stakeholder concept were being made by Eric Rhenman and his Scandinavian contemporaries in parallel to the contributions from the Stanford Research Institute (SRI) in the early 1960s and thereafter and thus are not a “historical trail” as they ...

Cardiac asthma in elderly patients: incidence, clinical presentation and outcome

Directory of Open Access Journals (Sweden)

Ray Patrick

2007-05-01

Full Text Available Abstract Background Cardiac asthma is common, but has been poorly investigated. The objective was to compare the characteristics and outcome of cardiac asthma with that of classical congestive heart failure (CHF in elderly patients. Methods Prospective study in an 1,800-bed teaching hospital. Results Two hundred and twelve consecutive patients aged ≥ 65 years presenting with dyspnea due to CHF (mean age of 82 ± 8 years were included. Findings of cardiac echocardiography and natriuretic peptides levels were used to confirm CHF. Cardiac asthma patients were defined as a patient with CHF and wheezing reported by attending physician upon admission to the emergency department. The CHF group (n = 137 and the cardiac asthma group (n = 75, differed for tobacco use (34% vs. 59%, p 2 (47 ± 15 vs. 41 ± 11 mmHg, p Conclusion Patients with cardiac asthma represented one third of CHF in elderly patients. They were more hypercapnic and experienced more distal airway obstruction. However, outcomes were similar.

Quality assurance policies and practices in Scandinavian higher education systems: convergence or different paths?

DEFF Research Database (Denmark)

Kalpazidou Schmidt, Evanthia

2017-01-01

Because there is close cooperation on quality assurance in the Scandinavian countries, one would expect there to be convergence of quality assurance policies and practices in Scandinavian higher education. Few studies have analysed these quality assurance policies and practices from a comparative...... quality assurance. The debate is compelling with regard to the Swedish case in particular, with its ‘one size fits all’ approach and exclusive focus on outcomes which has been heavily criticised by the higher education institutions and has turned out to be controversial from the European viewpoint....... viewpoint. Based on empirical evidence produced in connection with studies of recent quality reforms in Scandinavia and an approach based on linking diffusion and translation theories with institutionalist perspectives focusing on path dependency, the paper contributes to the current debate on Scandinavian...

Cardiac surgery with cardiopulmonary bypass: does aprotinin affect outcome?

NARCIS (Netherlands)

van der Linden, P. J.; Hardy, J.-F.; Daper, A.; Trenchant, A.; de Hert, S. G.

2007-01-01

BACKGROUND: Aprotinin, a non-specific serine protease inhibitor, has been used for two decades to reduce perioperative blood loss and the risk for allogeneic transfusion in cardiac surgery. This study evaluated the effects of aprotinin on outcome (mortality, cardiac events, renal failure, and

Dental treatment in Anglo-Saxon England.

Science.gov (United States)

Anderson, T

2004-09-11

Anglo-Saxon medical literature suggests that care of the teeth was largely limited to non-invasive treatment. Cures, mainly for toothache, were based on herbal remedies, charms and amulets. Herbal potions also treated oral problems as diverse as caries and facial deformities. However, surgical intervention for cleft lip is mentioned in the later documents. Skeletal evidence confirms that cleft lip and palate was definitely known to the Anglo-Saxons. A possible dentist's grave has been identified.

Scandinavian clinical practice guidelines for therapeutic hypothermia and post-resuscitation care after cardiac arrest

DEFF Research Database (Denmark)

Castrén, M; Silfvast, T; Rubertsson, S

2009-01-01

BACKGROUND AND AIM: Sudden cardiac arrest survivors suffer from ischaemic brain injury that may lead to poor neurological outcome and death. The reperfusion injury that occurs is associated with damaging biochemical reactions, which are suppressed by mild therapeutic hypothermia (MTH). In several...... of Anaesthesiology and Intensive Care Medicine (SSAI). METHODS: Relevant studies were identified after two consensus meetings of the SSAI Task Force on Therapeutic Hypothermia (SSAITFTH) and via literature search of the Cochrane Central Register of Controlled Trials and Medline. Evidence was assessed and consensus...

Cardiac complications in diphtheria and predictors of outcomes.

Science.gov (United States)

Samdani, Sunil; Jain, Avani; Meena, Vinod; Meena, C B

2018-01-01

To study the cardiac complications in diphtheria patients and to study the predictors of outcomes. Single centre prospective analysis of cardiac complications in diphtheria patients. In this study, there were 60 patients diagnosed with diphtheria with ECG changes. The ECG changes seen were sinus tachycardia (68.3%), T wave inversion (20%), ST segment depression (13.3%), right bundle branch block (5%), multiple atrial ectopics (3.3%). The case fatality rate in our study was 25% (15 patients). High CPK-MB, myoglobulin and cardiac troponin levels were associated with cardiac mortality. In our study, cardiac troponin T had the highest sensitivity (80%) and CK-MB had the highest specificity (95.56%). Cardiac involvement is a common complication of infection with C. diphtheria and is associated with high mortality. As diphtheria can be prevented by adequate vaccination, efforts should be maximized for high vaccine coverage with booster doses. Copyright © 2017. Published by Elsevier B.V.

Archival Education in Scandinavian Countries

Directory of Open Access Journals (Sweden)

Muhammet Hanefi Kutluoğlu

2008-03-01

Full Text Available Every country has responsibilities to provide the necessary personnel needed for their archival inheritance by education. Education can be shaped through tradition, historical inheritance and scientifi c necessities by defi ning the right educational method. Scandinavian countries have determined different education models based on their tradition, historical inheritance and requirements. In this article we focused on the formation of archival tradition, application of archival education in Scandinavian countries and the infl uence of the developments taking place in Europe on these countries. The relation between the archival education in European and Scandinavian countries is evaluated through a comparative method, and similarities to other countries are also evaluated. Finally, the present situation of archival education and the measures needed in this fi eld are taken into consideration.

Scandinavian links

DEFF Research Database (Denmark)

Matthiessen, Christian Wichmann; Knowles, Richard D.

2014-01-01

are impressive mega structures spanning international waterways. These waterways between the Baltic Sea and the North Sea have played major roles in history. The length of each of the crossings are around 20 km. The fixed links closes gaps between the Scandinavian and European motorway and rail networks...

Randomised controlled trials in Scandinavian educational research

DEFF Research Database (Denmark)

Pontoppidan, Maiken; Keilow, Maria; Dietrichson, Jens

2018-01-01

of this paper is to examine the history of randomised controlled trials in Scandinavian compulsory schools (grades 0–10; pupil ages 6-15). Specifically, we investigate drivers and barriers for randomised controlled trials in educational research and the differences between the three Scandinavian countries...... crucial for the implementation of RCTs and are likely more important in smaller countries such as the Scandinavian ones. Supporting institutions have now been established in all three countries, and we believe that the use of RCTs in Scandinavian educational research is likely to continue....... or more interventions were randomly assigned to groups of students and carried out in a school setting with the primary aim of improving the academic performance of children aged 6-15 in grades 0–10 in Denmark, Norway, or Sweden. We included both conducted and ongoing trials. Publications that seemed...

Modern Radiation Therapy and Cardiac Outcomes in Breast Cancer

Energy Technology Data Exchange (ETDEWEB)

Boero, Isabel J.; Paravati, Anthony J.; Triplett, Daniel P.; Hwang, Lindsay; Matsuno, Rayna K.; Gillespie, Erin F.; Yashar, Catheryn M.; Moiseenko, Vitali; Einck, John P.; Mell, Loren K. [Department of Radiation Medicine and Applied Sciences, Moores Cancer Center, University of California, San Diego, La Jolla, California (United States); Parikh, Sahil A. [University Hospitals Case Medical Center, Harrington Heart and Vascular Institute, and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Murphy, James D., E-mail: j2murphy@ucsd.edu [Department of Radiation Medicine and Applied Sciences, Moores Cancer Center, University of California, San Diego, La Jolla, California (United States)

2016-03-15

Purpose: Adjuvant radiation therapy, which has proven benefit against breast cancer, has historically been associated with an increased incidence of ischemic heart disease. Modern techniques have reduced this risk, but a detailed evaluation has not recently been conducted. The present study evaluated the effect of current radiation practices on ischemia-related cardiac events and procedures in a population-based study of older women with nonmetastatic breast cancer. Methods and Materials: A total of 29,102 patients diagnosed from 2000 to 2009 were identified from the Surveillance, Epidemiology, and End Results–Medicare database. Medicare claims were used to identify the radiation therapy and cardiac outcomes. Competing risk models were used to assess the effect of radiation on these outcomes. Results: Patients with left-sided breast cancer had a small increase in their risk of percutaneous coronary intervention (PCI) after radiation therapy—the 10-year cumulative incidence for these patients was 5.5% (95% confidence interval [CI] 4.9%-6.2%) and 4.5% (95% CI 4.0%-5.0%) for right-sided patients. This risk was limited to women with previous cardiac disease. For patients who underwent PCI, those with left-sided breast cancer had a significantly increased risk of cardiac mortality with a subdistribution hazard ratio of 2.02 (95% CI 1.23-3.34). No other outcome, including cardiac mortality for the entire cohort, showed a significant relationship with tumor laterality. Conclusions: For women with a history of cardiac disease, those with left-sided breast cancer who underwent radiation therapy had increased rates of PCI and a survival decrement if treated with PCI. The results of the present study could help cardiologists and radiation oncologists better stratify patients who need more aggressive cardioprotective techniques.

Modern Radiation Therapy and Cardiac Outcomes in Breast Cancer

International Nuclear Information System (INIS)

Boero, Isabel J.; Paravati, Anthony J.; Triplett, Daniel P.; Hwang, Lindsay; Matsuno, Rayna K.; Gillespie, Erin F.; Yashar, Catheryn M.; Moiseenko, Vitali; Einck, John P.; Mell, Loren K.; Parikh, Sahil A.; Murphy, James D.

2016-01-01

Purpose: Adjuvant radiation therapy, which has proven benefit against breast cancer, has historically been associated with an increased incidence of ischemic heart disease. Modern techniques have reduced this risk, but a detailed evaluation has not recently been conducted. The present study evaluated the effect of current radiation practices on ischemia-related cardiac events and procedures in a population-based study of older women with nonmetastatic breast cancer. Methods and Materials: A total of 29,102 patients diagnosed from 2000 to 2009 were identified from the Surveillance, Epidemiology, and End Results–Medicare database. Medicare claims were used to identify the radiation therapy and cardiac outcomes. Competing risk models were used to assess the effect of radiation on these outcomes. Results: Patients with left-sided breast cancer had a small increase in their risk of percutaneous coronary intervention (PCI) after radiation therapy—the 10-year cumulative incidence for these patients was 5.5% (95% confidence interval [CI] 4.9%-6.2%) and 4.5% (95% CI 4.0%-5.0%) for right-sided patients. This risk was limited to women with previous cardiac disease. For patients who underwent PCI, those with left-sided breast cancer had a significantly increased risk of cardiac mortality with a subdistribution hazard ratio of 2.02 (95% CI 1.23-3.34). No other outcome, including cardiac mortality for the entire cohort, showed a significant relationship with tumor laterality. Conclusions: For women with a history of cardiac disease, those with left-sided breast cancer who underwent radiation therapy had increased rates of PCI and a survival decrement if treated with PCI. The results of the present study could help cardiologists and radiation oncologists better stratify patients who need more aggressive cardioprotective techniques.

Size as Leading Indicator among Scandinavian Constructor Compagnies

DEFF Research Database (Denmark)

Bentzen, Eric

This paper studies predictability of stock marked prices in the Scandinavian constructor market.......This paper studies predictability of stock marked prices in the Scandinavian constructor market....

Outcome of out-of-hospital cardiac arrest--why do physicians withhold resuscitation attempts?

DEFF Research Database (Denmark)

Horsted, Tina I; Rasmussen, Lars S; Lippert, Freddy K

2004-01-01

To describe the outcome of out-of-hospital cardiac arrest (OHCA) with a focus on why physicians withhold resuscitation attempts.......To describe the outcome of out-of-hospital cardiac arrest (OHCA) with a focus on why physicians withhold resuscitation attempts....

Teamwork, communication, formula-one racing and the outcomes of cardiac surgery.

Science.gov (United States)

Merry, Alan F; Weller, Jennifer; Mitchell, Simon J

2014-03-01

Most cardiac units achieve excellent results today, but the risk of cardiac surgery is still relatively high, and avoidable harm is common. The story of the Green Lane Cardiothoracic Unit provides an exemplar of excellence, but also illustrates the challenges associated with changes over time and with increases in the size of a unit and the complexity of practice today. The ultimate aim of cardiac surgery should be the best outcomes for (often very sick) patients rather than an undue focus on the prevention of error or adverse events. Measurement is fundamental to improving quality in health care, and the framework of structure, process, and outcome is helpful in considering how best to achieve this. A combination of outcomes (including some indicators of important morbidity) with key measures of process is advocated. There is substantial evidence that failures in teamwork and communication contribute to inefficiency and avoidable harm in cardiac surgery. Minor events are as important as major ones. Six approaches to improving teamwork (and hence outcomes) in cardiac surgery are suggested. These are: 1) subspecialize and replace tribes with teams; 2) sort out the leadership while flattening the gradients of authority; 3) introduce explicit training in effective communication; 4) use checklists, briefings, and debriefings and engage in the process; 5) promote a culture of respect alongside a commitment to excellence and a focus on patients; 6) focus on the performance of the team, not on individuals.

Teamwork, Communication, Formula-One Racing and the Outcomes of Cardiac Surgery

Science.gov (United States)

Merry, Alan F.; Weller, Jennifer; Mitchell, Simon J.

2014-01-01

Abstract: Most cardiac units achieve excellent results today, but the risk of cardiac surgery is still relatively high, and avoidable harm is common. The story of the Green Lane Cardiothoracic Unit provides an exemplar of excellence, but also illustrates the challenges associated with changes over time and with increases in the size of a unit and the complexity of practice today. The ultimate aim of cardiac surgery should be the best outcomes for (often very sick) patients rather than an undue focus on the prevention of error or adverse events. Measurement is fundamental to improving quality in health care, and the framework of structure, process, and outcome is helpful in considering how best to achieve this. A combination of outcomes (including some indicators of important morbidity) with key measures of process is advocated. There is substantial evidence that failures in teamwork and communication contribute to inefficiency and avoidable harm in cardiac surgery. Minor events are as important as major ones. Six approaches to improving teamwork (and hence outcomes) in cardiac surgery are suggested. These are: 1) subspecialize and replace tribes with teams; 2) sort out the leadership while flattening the gradients of authority; 3) introduce explicit training in effective communication; 4) use checklists, briefings, and debriefings and engage in the process; 5) promote a culture of respect alongside a commitment to excellence and a focus on patients; 6) focus on the performance of the team, not on individuals. PMID:24779113

Cardiac stress test as a risk-stratification tool for posttransplant cardiac outcomes in diabetic kidney transplant recipients.

Science.gov (United States)

Singh, Neeraj; Parikh, Samir; Bhatt, Udayan; Vonvisger, Jon; Nori, Uday; Hasan, Ayesha; Samavedi, Srinivas; Andreoni, Kenneth; Henry, Mitchell; Pelletier, Ronald; Rajab, Amer; Elkhammas, Elmahdi; Pesavento, Todd

2012-12-27

The utility of cardiac stress testing as a risk-stratification tool before kidney transplantation remains debatable owing to discordance with coronary angiography and outcome yields at different centers. We conducted a retrospective study of 273 diabetic kidney transplant recipients from 2006 to 2010. By protocol, all diabetic patients underwent pharmacological radionucleotide stress test or dobutamine stress echocardiography before transplant. We compared the 1-year cardiac outcomes between those with negative stress test results and those with positive stress test results. Patients with a positive stress test result (n=67) underwent coronary angiogram, and significant coronary artery disease (≥70% coronary stenosis) was found in 35 (52.2%) patients. Of the latter, 32 (91.4%) underwent cardiac revascularization (24 underwent cardiac stenting and 8 underwent coronary artery bypass grafting). The rest (n=35) were treated medically. Within 1 year after transplant, the group with positive stress test results experienced more cardiac events (34.3% vs. 3.9%, P<0.001) including acute myocardial infarction (22.4% vs. 3.4%, P<0.001) and ventricular arrhythmias (8.9% vs. 0.05%, P=0.001), higher all-cause mortality (19.4% vs. 4.8%, P<0.001), and cardiac mortality (17.9% vs. 0.9%, P<0.001) compared with the group with negative stress test results. In this diabetic population, stress testing showed positive and negative predictive values of 34.3% and 96.1%, respectively. Pharmacological cardiac stress testing provided excellent risk stratification in diabetic kidney transplant recipients.

Do Scandinavians Care about International Law?

DEFF Research Database (Denmark)

Wind, Marlene

2016-01-01

Although Scandinavians are often celebrated as the vanguards of human rights and international law, we know little about whether courts and judges in these countries have embraced those international courts and conventions that they themselves helped establish after the Second World War. This art......Although Scandinavians are often celebrated as the vanguards of human rights and international law, we know little about whether courts and judges in these countries have embraced those international courts and conventions that they themselves helped establish after the Second World War...... international law and courts by citing their case law. Building on this author’s previous research, it is argued that Norway sticks out as much more engaged internationally due to a solid judicial review tradition at the national level. It is also argued that Scandinavian legal positivism, has influenced a much...

Scandinavian Semantics and the Human Body

DEFF Research Database (Denmark)

Levisen, Carsten

2015-01-01

, it is demonstrated that Scandinavian and English systems differ significantly in some aspects of the way in which the construe the human body with words. The study ventures an innovative combination of methods, pairing the Natural Semantic Metalanguage (NSM) approach to linguistic and conceptual analysis......This paper presents an ethnolinguistic analysis of how the space between the head and the body is construed in Scandinavian semantic systems vis-a-vis the semantic system of English. With an extensive case study of neck-related meanings in Danish, and with cross-Scandinavian reference...... with empirical evidence from the Evolution of Semantic Systems (EoSS) project. This combination of empirical and interpretative tools helps to integrate evidence from semantics and semiotics, pinning out in great detail the intricacies of the meanings of particular body words. The paper concludes that body words...

Gaimar, Wace e gli altri autori. La traduzione alle origini della letteratura anglo-normanna

Directory of Open Access Journals (Sweden)

Margherita Lecco

2015-05-01

Full Text Available L’articolo traccia un breve profilo del passaggio dall’impiego della lingua latina ed anglo-sassone presso le corti dei re Normanni d’Inghilterra alla lingua anglo-normanna per la stesura di opere dapprima storiche, poi propriamente letterarie. L’uso del volgare, che si avvia con Geffrei Gaimar intorno al 1140, viene mediato dalla traduzione dei testi che egli fa traendo la propria materia dalle opere degli storiografi attivi nel decennio precedente (Guillaume de Malmesbury e Geoffrey de Monmouth ma anche l’Anglo-Saxon Chronicle. Da latino a volgare, e da volgare (anglo-sassone e gallese a volgare, la letteratura anglo-normanna, attraverso l’incrocio e la traduzione da più lingue, viene definendo un corpus di tradizioni e di testi davvero cospicuo nell’età medievale europea. Dalla tradizione anglo-normanna, tuttavia, una letteratura ulteriore viene ad avviarsi, quella middle-english, che riprende l’english poco praticato in età normanna, pronto a risorgere come lingua non solo popolare ma anche letteraria, benché attraverso la ripresa, con un ulteriore processo di traduzione, di temi e testi anglo-normanni. This article briefly outlines the passage from the use of Latin and Anglo-Saxon to the Anglo-Norman language for writing first historical, then also literary works, at the court of the Norman kings of England. The vernacular was first used for literary creation by Geffrei Gaimar (around 1140, who took inspiration from and translated part of the Anglo-Saxon Chronicle and other works of historiographers active in the previous decade (Guillaume de Malmesbury and Geoffrey de Monmouth. The corpus of texts and traditions of Anglo-Norman literature – which is rather conspicuous when compared to others of medieval European literature – generated from intersections and translations of several languages: mainly Latin, Anglo-Saxon and Welsh. The Anglo-Norman literary tradition would, in its turn, pave the way for a new

Relationship between chest compression rates and outcomes from cardiac arrest.

Science.gov (United States)

Idris, Ahamed H; Guffey, Danielle; Aufderheide, Tom P; Brown, Siobhan; Morrison, Laurie J; Nichols, Patrick; Powell, Judy; Daya, Mohamud; Bigham, Blair L; Atkins, Dianne L; Berg, Robert; Davis, Dan; Stiell, Ian; Sopko, George; Nichol, Graham

2012-06-19

Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions per minute. Animal and human studies have reported that blood flow is greatest with chest compression rates near 120/min, but few have reported rates used during out-of-hospital (OOH) cardiopulmonary resuscitation or the relationship between rate and outcome. The purpose of this study was to describe chest compression rates used by emergency medical services providers to resuscitate patients with OOH cardiac arrest and to determine the relationship between chest compression rate and outcome. Included were patients aged ≥ 20 years with OOH cardiac arrest treated by emergency medical services providers participating in the Resuscitation Outcomes Consortium. Data were abstracted from monitor-defibrillator recordings during cardiopulmonary resuscitation. Multiple logistic regression analysis assessed the association between chest compression rate and outcome. From December 2005 to May 2007, 3098 patients with OOH cardiac arrest were included in this study. Mean age was 67 ± 16 years, and 8.6% survived to hospital discharge. Mean compression rate was 112 ± 19/min. A curvilinear association between chest compression rate and return of spontaneous circulation was found in cubic spline models after multivariable adjustment (P=0.012). Return of spontaneous circulation rates peaked at a compression rate of ≈ 125/min and then declined. Chest compression rate was not significantly associated with survival to hospital discharge in multivariable categorical or cubic spline models. Chest compression rate was associated with return of spontaneous circulation but not with survival to hospital discharge in OOH cardiac arrest.

2-year patient-related versus stent-related outcomes

DEFF Research Database (Denmark)

Jensen, Lisette Okkels; Thayssen, Per; Christiansen, Evald Høj

2012-01-01

years were further assessed with specific focus on patient-related composite (all death, all MI, or any revascularization) and stent-related composite outcomes (cardiac death, target vessel MI, or symptom-driven target lesion revascularization). A total of 1,390 patients were assigned to receive the EES......, and 1,384 patients were assigned to receive the SES. RESULTS: At 2 years, the composite primary endpoint occurred in 8.3% in the EES group and in 8.7% in the SES group (hazard ratio [HR]: 0.94, 95% confidence interval [CI]: 0.73 to 1.22). The patient-related outcome: 15.0% in the EES group versus 15.......80). CONCLUSIONS: At 2-year follow-up, the EES was found to be noninferior to the SES with regard to both patient-related and stent-related clinical outcomes. (Scandinavian Organization for Randomized Trials With Clinical Outcome IV [SORT OUT IV]; NCT00552877)....

The new Scandinavian Donations and Transfusions database (SCANDAT2)

DEFF Research Database (Denmark)

Edgren, Gustaf; Rostgaard, Klaus; Vasan, Senthil K

2015-01-01

: It is possible to create a binational, nationwide database with almost 50 years of follow-up of blood donors and transfused patients for a range of health outcomes. We aim to use this database for further studies of donor health, transfusion-associated risks, and transfusion-transmitted disease....... AND METHODS: We have previously created the anonymized Scandinavian Donations and Transfusions (SCANDAT) database, containing data on blood donors, blood transfusions, and transfused patients, with complete follow-up of donors and patients for a range of health outcomes. Here we describe the re......-creation of SCANDAT with updated, identifiable data. We collected computerized data on blood donations and transfusions from blood banks covering all of Sweden and Denmark. After data cleaning, two structurally identical databases were created and the entire database was linked with nationwide health outcomes...

Role of cardiac biomarkers (troponin I and CK-MB as predictors of quality of life and long-term outcome after cardiac surgery

Directory of Open Access Journals (Sweden)

Bignami Elena

2009-01-01

Full Text Available Perioperative and postoperative morbidity and mortality associated with cardiac surgery affect both the outcome and quality of life. Markers such as troponin effectively predict short-term outcome. In a prospective cohort study in a University Hospital we assessed the role of cardiac biomarkers, also as predictors of long-term outcome and life quality after cardiac surgery with a three-year follow-up after conventional heart surgery. Patients were interviewed via phone calls with a structured questionnaire examining general health, functional status, activities of daily living, perception of life quality and need for hospital readmission. Descriptive statistics and multivariate analysis were performed. Out of 252 consecutive patients, 8 (3.2% died at the three years follow up: 7 for cardiac complications and 1 for cancer. Thirty-six patients (13.5% had hospital readmission for cardiac causes (mostly for atrial fibrillation or other arrhythmias (9.3%, but none needed cardiac surgical reintervention; 21 patients (7.9% were hospitalised for non-cardiac causes. No limitation in function activities of daily living was reported by most patients (94%, 92% perceived their general health as excellent, very good or good and none considered it insufficient; 80% were NYHA I, 17% NYHA II, 3% NYHA III and none NYHA IV. Multivariate analysis indicated preoperative treatment with digitalis or nitrates, and postoperative cardiac biomarkers release was independently associated to death. Elevated cardiac biomarker release and length of hospital stay were the only postoperative independent predictors of death in this study.

A Scandinavian Public Transport Model? Reform Changes in Denmark, Sweden and Norway

DEFF Research Database (Denmark)

Hansson, Lisa; Lissandrello, Enza; Næss, Petter

2017-01-01

Scandinavian public transport, especially aspects of how the Scandinavian countries (i.e., Sweden, Denmark, and Norway) have created governing structures for a cohesive public transport system, is often cited positively in international research. Scandinavia is often treated as a homogeneous unit...... in public transport research, which sometimes refers to the “Scandinavian model of public transport”. It is not uncommon for conclusions regarding Scandinavian countries to be based on analyses of just one country. Is there actually such a thing as a Scandinavian model of public transport? All around Europe...... the public transport sector is changing, taking public transport governance in various directions. This paper provides an overview of the changes and similarities in public transport governance in Scandinavian countries from the 1970s to 2012, discussing whether it is justifiable to speak of a Scandinavian...

Cardiac Arrest in Patients Managed for Convulsive Status Epilepticus: Characteristics, Predictors, and Outcome.

Science.gov (United States)

Legriel, Stephane; Bresson, Edouard; Deye, Nicolas; Grimaldi, David; Sauneuf, Bertrand; Lesieur, Olivier; Lascarrou, Jean-Baptiste; Argaud, Laurent; Chelly, Jonathan; Beuret, Pascal; Schnell, David; Chateauneuf, Anne-Laure; Holleville, Mathilde; Perier, François; Lemiale, Virginie; Bruel, Cedric; Cronier, Pierrick; Pichon, Nicolas; Mongardon, Nicolas; de-Prost, Nicolas; Dumas, Florence; Cariou, Alain

2018-05-08

Cardiac arrest is a catastrophic event that may arise during the management of convulsive status epilepticus. We aimed to report the clinical characteristics, outcomes, and early predictors of convulsive status epilepticus-related cardiac arrest. Retrospective multicenter study. Seventeen university or university affiliated participating ICUs in France and Belgium. Consecutive patients admitted to the participating ICUs for management of successfully resuscitated out-of-hospital cardiac arrest complicating the initial management of convulsive status epilepticus between 2000 and 2015. Patients were compared with controls without cardiac arrest identified in a single-center registry of convulsive status epilepticus patients, regarding characteristics, management, and outcome. None. We included 49 cases with convulsive status epilepticus-cardiac arrest and 235 controls. In the cases, median time from medical team arrival to cardiac arrest was 25 minutes (interquartile range, 5-85 min). First recorded rhythm was asystole in 25 patients (51%) and pulseless electrical activity in 13 patients (27%). A significantly larger proportion of patients had a favorable 1-year outcome (Glasgow Outcome Scale score of 5) among controls (90/235; 38%) than among cases (10/49; 21%; p = 0.02). By multivariate analysis, independent predictors of cardiac arrest were pulse oximetry less than 97% on scene (odds ratio, 2.66; 95% CI, 1.03-7.26; p = 0.04), drug poisoning as the cause of convulsive status epilepticus (odds ratio, 4.13; 95% CI, 1.27-13.53; p = 0.02), and complications during early management (odds ratio, 11.98; 95% CI, 4.67-34.69; p status epilepticus, relative hypoxemia, on-scene management complications, and drug poisoning as the cause of convulsive status epilepticus were strong early predictors of cardiac arrest, suggesting areas for improvement.

Impact of the viral respiratory season on postoperative outcomes in children undergoing cardiac surgery.

Science.gov (United States)

Spaeder, Michael C; Carson, Kathryn A; Vricella, Luca A; Alejo, Diane E; Holmes, Kathryn W

2011-08-01

To compare postoperative outcomes in children undergoing cardiac surgery during the viral respiratory season and nonviral season at our institution. This was a retrospective cohort study and secondary matched case-control analysis. The setting was an urban academic tertiary-care children's hospital. The study was comprised of all patients <18 years of age who underwent cardiac surgery at Johns Hopkins Hospital from October 2002 through September 2007. Patients were stratified by season of surgery, complexity of cardiac disease, and presence or absence of viral respiratory infection. Measurements included patient characteristics and postoperative outcomes. The primary outcome was postoperative length of stay (LOS). A total of 744 patients were included in the analysis. There was no difference in baseline characteristics or outcomes, specifically, no difference in postoperative LOS, intensive care unit (ICU) LOS, and mortality, among patients by seasons of surgery. Patients with viral respiratory illness were more likely to have longer postoperative LOS (p < 0.01) and ICU LOS (p < 0.01) compared with matched controls. We identified no difference in postoperative outcomes based on season in patients undergoing cardiac surgery. Children with viral respiratory infection have significantly worse outcomes than matched controls, strengthening the call for universal administration of influenza vaccination and palivizumab to appropriate groups. Preoperative testing for respiratory viruses should be considered during the winter months for children undergoing elective cardiac surgery.

Age of transfused blood is not associated with increased postoperative adverse outcome after cardiac surgery.

LENUS (Irish Health Repository)

McKenny, M

2011-05-01

This study investigated the hypothesis that storage age of transfused red blood cells (RBCs) is associated with adverse outcome after cardiac surgery, and examined association between volume of RBC transfusions and outcome after cardiac surgery.

Modifying risks to improve outcome in cardiac surgery: An anesthesiologist's perspective

Directory of Open Access Journals (Sweden)

Murali Chakravarthy

2017-01-01

Full Text Available Challenging times are here for cardiac surgical and anesthesia team. The interventional cardiologist seem to have closed the flow of 'good cases' coming up for any of the surgery,; successful percutaneous interventions seem to be offering reasonable results in these patients, who therefore do not knock on the doors of the surgeons any more . It is a common experience among the cardiac anesthesiologists and surgeons that the type of the cases that come by now are high risk. That may be presence of comorbidities, ongoing medical therapies, unstable angina, uncontrolled heart failure and rhythm disturbances; and in patients with ischemic heart disease, the target coronaries are far from ideal. Several activities such as institution of preoperative supportive circulatory, ventilatory, and systemic disease control maneuvers seem to have helped improving the outcome of these 'high risk ' patients. This review attempts to look at various interventions and the resulting improvement in outcomes. Several changes have happened in the realm of cardiac surgery and several more are en route. At times, for want of evidence, maximal optimization may not take place and the patient may encounter unfavorable outcomes.. This review is an attempt to bring the focus of the members of the cardiac surgical team on the value of preoperative optimization of risks to improve the outcome. The cardiac surgical patients may broadly be divided into adults undergoing coronary artery bypass graft surgery, valve surgery and pediatric patients undergoing repair/ palliation of congenital heart ailments. Optimization of risks appear to be different in each genre of patients. This review also brings less often discussed issues such as anemia, nutritional issues and endocrine problems. The review is an attempt to data on ameliorating modifiable risk factors and altering non modifiable ones.

Teaching Scandinavian Interaction Design in West Africa

DEFF Research Database (Denmark)

Sørensen, Jannick Kirk

2016-01-01

Methods for interaction design have emerged and established themselves first in a Scandinavian context, later in US context and in the rest of the developed world. While good usability and good user experiences are important to all users of ICT, the question is whether the methods and techniques ...... Scandinavian Participatory design can be used to localize the learning process and make interaction design methods sensitive to the West African context. The paper is based on the author’s reflection on his experiences teaching interaction design in West Africa.......Methods for interaction design have emerged and established themselves first in a Scandinavian context, later in US context and in the rest of the developed world. While good usability and good user experiences are important to all users of ICT, the question is whether the methods and techniques...

Prolonged cardiopulmonary resuscitation and outcomes after out-of-hospital cardiac arrest

DEFF Research Database (Denmark)

Rajan, Shahzleen; Folke, Fredrik; Kragholm, Kristian

2016-01-01

AIM: It is unclear whether prolonged resuscitation can result in successful outcome following out-of-hospital cardiac arrests (OHCA). We assessed associations between duration of pre-hospital resuscitation on survival and functional outcome following OHCA in patients achieving pre-hospital return...

Neonatal outcomes in fetuses with cardiac anomalies and the impact of delivery route.

Science.gov (United States)

Parikh, Laura I; Grantz, Katherine L; Iqbal, Sara N; Huang, Chun-Chih; Landy, Helain J; Fries, Melissa H; Reddy, Uma M

2017-10-01

Congenital fetal cardiac anomalies compromise the most common group of fetal structural anomalies. Several previous reports analyzed all types of fetal cardiac anomalies together without individualized neonatal morbidity outcomes based on cardiac defect. Mode of delivery in cases of fetal cardiac anomalies varies greatly as optimal mode of delivery in these complex cases is unknown. We sought to determine rates of neonatal outcomes for fetal cardiac anomalies and examine the role of attempted route of delivery on neonatal morbidity. Gravidas with fetal cardiac anomalies and delivery >34 weeks, excluding stillbirths and aneuploidies (n = 2166 neonates, n = 2701 cardiac anomalies), were analyzed from the Consortium on Safe Labor, a retrospective cohort study of electronic medical records. Cardiac anomalies were determined using International Classification of Diseases, Ninth Revision codes and organized based on morphology. Neonates were assigned to each cardiac anomaly classification based on the most severe cardiac defect present. Neonatal outcomes were determined for each fetal cardiac anomaly. Composite neonatal morbidity (serious respiratory morbidity, sepsis, birth trauma, hypoxic ischemic encephalopathy, and neonatal death) was compared between attempted vaginal delivery and planned cesarean delivery for prenatal and postnatal diagnosis. We used multivariate logistic regression to calculate adjusted odds ratio for composite neonatal morbidity controlling for race, parity, body mass index, insurance, gestational age, maternal disease, single or multiple anomalies, and maternal drug use. Most cardiac anomalies were diagnosed postnatally except hypoplastic left heart syndrome, which had a higher prenatal than postnatal detection rate. Neonatal death occurred in 8.4% of 107 neonates with conotruncal defects. Serious respiratory morbidity occurred in 54.2% of 83 neonates with left ventricular outflow tract defects. Overall, 76.3% of pregnancies with fetal

Maternal and fetal outcome in pregnant and parturient women with cardiac disease

International Nuclear Information System (INIS)

Arif, S.; Baqar, S.; Arif, A.

2013-01-01

Objective: To study the maternal and fetal outcome in pregnant and parturient women with cardiac disease admitted in Armed Forces Institute of Cardiology Rawalpindi. Type of Study: Cross sectional descriptive study. Place and Duration: Armed Forces Institute of Cardiology Rawalpindi Jan 2008 to June 2008. Patients and Methods: All pregnant patients beyond 28 weeks gestation with cardiac disease diagnosed before pregnancy or during the index pregnancy admitted for delivery or with cardiac complications were included in the study. All neonates less than 2.5 kg were taken as low birth weight and deliveries between 28 and 37 weeks were considered preterm. Cardiac patients with pregnancy less than 28 weeks were excluded from the study. Results: Maternal mortality was 5% with 31% mortality in NYHA Class III and IV. Perinatal mortality was 9% and low birth weight babies were 17%.Perinatal mortality was 0% in NYHA Class I and II and 60% in NYHA class III and IV. There was no maternal mortality in booked patients. All patients who expired were unbooked. Conclusion: Functional cardiac status is the most important factor affecting maternal and perinatal outcome. Antenatal booking status of the patient is the next important factor. (author)

Comparative Study of Financial Statements in Anglo-Saxon and Romanian Accounting

OpenAIRE

Nicolae ECOBICI

2010-01-01

The two accounting systems, the French and Anglo-Saxon, tend to harmonize. We will present the financial statements of Romania, subject to OMFP 3055/2009, in parallel with the Anglo-Saxon accounting system. The issues considered are related to the reference period and the shape, structure and content of financial statements.

Comprehensive cardiac rehabilitation improves outcome for patients with implantable cardioverter defibrillator

DEFF Research Database (Denmark)

Berg, Selina Kikkenborg; Pedersen, Preben Ulrich; Zwisler, Ann-Dorthe

2015-01-01

year of psycho-educational follow-up focusing on modifiable factors associated with poor outcomes. Two primary outcomes, general health score (Short Form-36 (SF-36)) and peak oxygen uptake (VO2), were used. Post-hoc analyses included SF-36 and ICD therapy history.Results:Comprehensive cardiac...

Boer-uitbeeldings in Franse jeugliteratuur tydens die Anglo-Boereoorlog

OpenAIRE

J.E.T. Steyn

2010-01-01

Representations of the Boer in French youth literature duringthe Anglo Boer War Representations of the “other” or alterity are to a large extent influenced by the historical context of the onlooker. When this historical context changes, it often happens that the representation of the “other” is adapted accordingly. This article provides a short overview of the way in which French representations of the Boers in youth novels written before the Anglo-Boer War differ from youth novels about the ...

The Semantics of Englishes and Creoles

DEFF Research Database (Denmark)

Levisen, Carsten; Priestley, Carol; Nicholls, Sophie

2017-01-01

of these basic meanings across our sample. Secondly, we utilize phylogenetic networks for visualizing our results and as a tool for forming new hypotheses. Our results provide counter-evidence to the claim that Melanesian and Australian creoles are “varieties of English”. In our sample, we find three basic types...... of relations. “Shared-core” types (Australian English v. New Zealand English); “closely related core” types (Hawai’i Creole v. Anglo Englishes); and “distantly related core” types (Tok Pisin v. Anglo English, Kriol v. Anglo English, or Yumplatok v. Anglo English). We measure our results against Scandinavian...

Boer-uitbeeldings in Franse jeugliteratuur tydens die Anglo-Boereoorlog

Directory of Open Access Journals (Sweden)

J.E.T. Steyn

2010-07-01

Full Text Available Representations of the Boer in French youth literature duringthe Anglo Boer War Representations of the “other” or alterity are to a large extent influenced by the historical context of the onlooker. When this historical context changes, it often happens that the representation of the “other” is adapted accordingly. This article provides a short overview of the way in which French representations of the Boers in youth novels written before the Anglo-Boer War differ from youth novels about the war. Before the war the Boer is described as a Dutch descendant living in utmost, almost barbaric, simplicity. When the Anglo- Boer War breaks out, the Boer becomes an alter ego for the French who indirectly continue the French struggle against the British. This article discusses the way in which the French adapt their representation of the Boers in order for young French readers to identify with the Boers.

Patient-reported mental and physical health outcomes are independent predictors of one-year mortality and cardiac events across cardiac diagnoses. Findings from the national DenHeart survey."

DEFF Research Database (Denmark)

Berg, Selina Kikkenborg; Thorup, Charlotte Brun; Borregaard, Britt

2018-01-01

-reported outcomes at hospital discharge as a predictor of mortality and cardiac events. Design: A cross-sectional survey with register follow-up. Methods: Participants: All patients discharged from April 2013 to April 2014 from five national heart centres in Denmark. Main outcomes: Patient-reported outcomes......Aims: Patient-reported quality of life and anxiety/depression scores provide important prognostic information independently of traditional clinical data. The aims of this study were to describe: (a) mortality and cardiac events one year after hospital discharge across cardiac diagnoses; (b) patient...

Academic season does not influence cardiac surgical outcomes at US Academic Medical Centers.

Science.gov (United States)

Lapar, Damien J; Bhamidipati, Castigliano M; Mery, Carlos M; Stukenborg, George J; Lau, Christine L; Kron, Irving L; Ailawadi, Gorav

2011-06-01

Previous studies have demonstrated the influence of academic season on outcomes in select surgical populations. However, the influence of academic season has not been evaluated nationwide in cardiac surgery. We hypothesized that cardiac surgical outcomes were not significantly influenced by time of year at both cardiothoracic teaching hospitals and non-cardiothoracic teaching hospitals nationwide. From 2003 to 2007, a weighted 1,614,394 cardiac operations were evaluated using the Nationwide Inpatient Sample database. Patients undergoing cardiac operations at cardiothoracic teaching and non-cardiothoracic teaching hospitals were identified using the Association of American Medical College's Graduate Medical Education Tracking System. Hierarchic multivariable logistic regression analyses were used to estimate the effect of academic quarter on risk-adjusted outcomes. Mean patient age was 65.9 ± 10.9 years. Women accounted for 32.8% of patients. Isolated coronary artery bypass grafting was the most common operation performed (64.7%), followed by isolated valve replacement (19.3%). The overall incidence of operative mortality and composite postoperative complication rate were 2.9% and 27.9%, respectively. After accounting for potentially confounding risk factors, timing of operation by academic quarter did not independently increase risk-adjusted mortality (p = 0.12) or morbidity (p = 0.24) at academic medical centers. Risk-adjusted mortality and morbidity for cardiac operations were not associated with time of year in the US at teaching and nonteaching hospitals. Patients should be reassured of the safety of performance of cardiac operations at academic medical centers throughout a given academic year. Copyright © 2011 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

COMPARATIVE STUDY OF FINANCIAL STATEMENTS IN ANGLO-SAXON AND ROMANIAN ACCOUNTING

Directory of Open Access Journals (Sweden)

Nicolae ECOBICI

2010-06-01

Full Text Available The two accounting systems, the French and Anglo-Saxon, tend to harmonize. We will present the financial statements of Romania, subject to OMFP 3055/2009, in parallel with the Anglo-Saxon accounting system. The issues considered are related to the reference period and the shape, structure and content of financial statements.

Blunt traumatic cardiac rupture: therapeutic options and outcomes.

Science.gov (United States)

Nan, Yu-Yun; Lu, Ming-Shian; Liu, Kuo-Sheng; Huang, Yao-Kuang; Tsai, Feng-Chun; Chu, Jaw-Ji; Lin, Pyng Jing

2009-09-01

Cardiac rupture following blunt thoracic trauma is rarely encountered by clinicians, since it commonly causes death at the scene. With advances in traumatology, blunt cardiac rupture had been increasingly disclosed in various ways. This study reviews our experience of patients with suspected blunt traumatic cardiac rupture and proposes treatment protocols for the same. This is a 5-year retrospective study of trauma patients confirmed with blunt traumatic cardiac rupture admitted to a university-affiliated tertiary trauma referral centre. The following information was collected from the patients: age, sex, mechanism of injury, initial effective diagnostic tool used for diagnosing blunt cardiac rupture, location and size of the cardiac injury, associated injury and injury severity score (ISS), reversed trauma score (RTS), survival probability of trauma and injury severity scoring (TRISS), vital signs and biochemical lab data on arrival at the trauma centre, time elapsed from injury to diagnosis and surgery, surgical details, hospital course and final outcome. The study comprised 8 men and 3 women with a median age of 39 years (range: 24-73 years) and the median follow-up was 5.5 months (range: 1-35 months). The ISS, RTS, and TRISS scores of the patients were 32.18+/-5.7 (range: 25-43), 6.267+/-1.684 (range: 2.628-7.841), and 72.4+/-25.6% (range: 28.6-95.5%), respectively. Cardiac injuries were first detected using focused assessment with sonography for trauma (FAST) in 4 (36.3%) patients, using transthoracic echocardiography in 3 (27.3%) patients, chest CT in 1 (9%) patient, and intra-operatively in 3 (27.3%) patients. The sites of cardiac injury comprised the superior vena cava/right atrium junction (n=4), right atrial auricle (n=1), right ventricle (n=4), left ventricular contusion (n=1), and diffuse endomyocardial dissection over the right and left ventricles (n=1). Notably, 2 had pericardial lacerations presenting as a massive haemothorax, which initially masked

Scandinavian exceptionalism in anti-doping within sport

DEFF Research Database (Denmark)

Tangen, Jan Ove; Møller, Verner

2017-01-01

Why are Scandinavian countries so committed to the cause of antidoping? In this paper, we propose that the Scandinavian mentality, formed by paternalistic welfare models, is a useful framework for understanding anti-doping. We focus on anti-doping policy and work in Norway and Denmark. We start w......: the Norwegian self-image and its impact on politics, and Danish amateurism and corrupt idealism. We conclude that Nordic antidoping is pursued with rigour and determination, and suggest this is rooted in the Nordic countries’ exceptional social-welfare ideology and strong paternalism....

Acoustic rhinometry of the Indian and Anglo-Saxon nose.

Science.gov (United States)

Gurr, P; Diver, J; Morgan, N; MacGregor, F; Lund, V

1996-09-01

The internal and external geometry of the nose has previously been shown to differ between Anglo-Saxon, Chinese, and Negro noses. It is therefore important to define the normal geometric nasal parameters of a given race, so as to detect the abnormal nose. We present acoustic rhinometric data, with height-adjusted figures, examining the nasal minimum cross-sectional area (MCA), the distance to the nostril from the MCA, and the MCA between 0-6 cm. These data show no significant differences between Indian and Anglo-Saxon noses.

Evidence for an apartheid-like social structure in early Anglo-Saxon England.

Science.gov (United States)

Thomas, Mark G; Stumpf, Michael P H; Härke, Heinrich

2006-10-22

The role of migration in the Anglo-Saxon transition in England remains controversial. Archaeological and historical evidence is inconclusive, but current estimates of the contribution of migrants to the English population range from less than 10000 to as many as 200000. In contrast, recent studies based on Y-chromosome variation posit a considerably higher contribution to the modern English gene pool (50-100%). Historical evidence suggests that following the Anglo-Saxon transition, people of indigenous ethnicity were at an economic and legal disadvantage compared to those having Anglo-Saxon ethnicity. It is likely that such a disadvantage would lead to differential reproductive success. We examine the effect of differential reproductive success, coupled with limited intermarriage between distinct ethnic groups, on the spread of genetic variants. Computer simulations indicate that a social structure limiting intermarriage between indigenous Britons and an initially small Anglo-Saxon immigrant population provide a plausible explanation of the high degree of Continental male-line ancestry in England.

Scandinavian Object Shift and Optimality Theory

DEFF Research Database (Denmark)

Engels, Eva; Vikner, Sten

This study presents an account of object shift, a word order phenomenon found in most of the Scandinavian languages where an object occurs unexpectedly to the left and not to the right of a sentential adverbial. The book examines object shift across many of the Scandinavian languages and dialects...... and original observations, this book is an important addition to the fields of phonology, optimality theory and theoretical syntax......., and analyses the variation, for example whether object shift is optional or obligatory, whether it applies only to pronouns or other objects as well, and whether it applies to adverbials. The authors show that optimality theory, traditionally used in phonology, is a useful framework for accounting...

Aerobic fitness of Anglo-Saxon and Indian students.

Science.gov (United States)

Hardy, C P; Eston, R G

1985-12-01

The purpose of this study was to compare the aerobic fitness of two groups of male college students: 32 Anglo-Saxon males (age range 16-18 years) with 27 Indian males, born in England, (age range 16-23 years), none of whom was highly active in any particular sport. Maximal oxygen uptake was estimated by submaximal test on a cycle ergometer and percent body fat was assessed by skinfold calipers. The Anglo-Saxon group had higher absolute and relative maximal oxygen consumption values and higher body weight. There was no difference in percent fat between the two groups. Strength data were also provided for descriptive purposes.

Optimizing survival outcomes for adult patients with nontraumatic cardiac arrest [digest].

Science.gov (United States)

Jung, Julianna; Zaurova, Milana

2016-10-22

Patient survival after cardiac arrest can be improved significantly with prompt and effective resuscitative care. This systematic review analyzes the basic life support factors that improve survival outcome, including chest compression technique and rapid defibrillation of shockable rhythms. For patients who are successfully resuscitated, comprehensive postresuscitation care is essential. Targeted temperature management is recommended for all patients who remain comatose, in addition to careful monitoring of oxygenation, hemodynamics, and cardiac rhythm. Management of cardiac arrest in circumstances such as pregnancy, pulmonary embolism, opioid overdose and other toxicologic causes, hypothermia, and coronary ischemia are also reviewed. [Points & Pearls is a digest of Emergency Medicine Practice].

Cardiac Myosin Binding Protein-C Autoantibodies are Potential Early Indicators of Cardiac Dysfunction and Patient Outcome in Acute Coronary Syndrome.

Science.gov (United States)

Lynch, Thomas L; Kuster, Diederik W D; Gonzalez, Beverly; Balasubramanian, Neelam; Nair, Nandini; Day, Sharlene; Calvino, Jenna E; Tan, Yanli; Liebetrau, Christoph; Troidl, Christian; Hamm, Christian W; Güçlü, Ahmet; McDonough, Barbara; Marian, Ali J; van der Velden, Jolanda; Seidman, Christine E; Huggins, Gordon S; Sadayappan, Sakthivel

2017-04-01

The degradation and release of cardiac myosin binding protein-C (cMyBP-C) upon cardiac damage may stimulate an inflammatory response and autoantibody (AAb) production. We determined whether the presence of cMyBP-C-AAbs associated with adverse cardiac function in CVD patients. Importantly, cMyBP-C-AAbs were significantly detected in ACS patient sera upon arrival to the emergency department, particularly in STEMI patients. Patients positive for cMyBP-C-AAbs had a reduced LVEF and elevated levels of clinical biomarkers of MI. We conclude that cMyBP-C-AAbs may serve as early predictive indicators of deteriorating cardiac function and patient outcome in ACS patients prior to the infarction.

Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest.

Science.gov (United States)

Kragholm, Kristian; Wissenberg, Mads; Mortensen, Rikke N; Hansen, Steen M; Malta Hansen, Carolina; Thorsteinsson, Kristinn; Rajan, Shahzleen; Lippert, Freddy; Folke, Fredrik; Gislason, Gunnar; Køber, Lars; Fonager, Kirsten; Jensen, Svend E; Gerds, Thomas A; Torp-Pedersen, Christian; Rasmussen, Bodil S

2017-05-04

The effect of bystander interventions on long-term functional outcomes among survivors of out-of-hospital cardiac arrest has not been extensively studied. We linked nationwide data on out-of-hospital cardiac arrests in Denmark to functional outcome data and reported the 1-year risks of anoxic brain damage or nursing home admission and of death from any cause among patients who survived to day 30 after an out-of-hospital cardiac arrest. We analyzed risks according to whether bystander cardiopulmonary resuscitation (CPR) or defibrillation was performed and evaluated temporal changes in bystander interventions and outcomes. Among the 2855 patients who were 30-day survivors of an out-of-hospital cardiac arrest during the period from 2001 through 2012, a total of 10.5% had brain damage or were admitted to a nursing home and 9.7% died during the 1-year follow-up period. During the study period, among the 2084 patients who had cardiac arrests that were not witnessed by emergency medical services (EMS) personnel, the rate of bystander CPR increased from 66.7% to 80.6% (Pbystander defibrillation increased from 2.1% to 16.8% (Pbystander CPR was associated with a risk of brain damage or nursing home admission that was significantly lower than that associated with no bystander resuscitation (hazard ratio, 0.62; 95% confidence interval [CI], 0.47 to 0.82), as well as a lower risk of death from any cause (hazard ratio, 0.70; 95% CI, 0.50 to 0.99) and a lower risk of the composite end point of brain damage, nursing home admission, or death (hazard ratio, 0.67; 95% CI, 0.53 to 0.84). The risks of these outcomes were even lower among patients who received bystander defibrillation as compared with no bystander resuscitation. In our study, we found that bystander CPR and defibrillation were associated with risks of brain damage or nursing home admission and of death from any cause that were significantly lower than those associated with no bystander resuscitation. (Funded by Tryg

Presentation of radioecology in the Scandinavian countries

International Nuclear Information System (INIS)

Agnedal, P.O.

1980-01-01

One of the working groups dealt with the activity of the committee and in its report it is said that three types for the joint Scandinavian work could be identified: 1. - Projects. 2. - Conferences and training-courses. 3. - Publications and information. Among projects 'Intercalibration' regarding sampling techniques and analytical methods. Transport models, consequences of large accidents, were mentioned and in other groups the same type of projects was given. Another working group dealt with international cooperation in the field of radioecology and in its report it was said that it is important to present the work performed in the Scandinavian countries

DEVELOPMENT AND WORLDWIDE DISTRIBUTION OF THE ANGLO NUBIAN GOAT

Directory of Open Access Journals (Sweden)

Angelika Stemmer

2009-06-01

Full Text Available The present study describes the formation of the Anglo Nubian breed in Britain and follows up the original transfer of the founder breeds to Britain in the 19th century. An overview on the worldwide spread of the Anglo Nubian from Britain to the USA and Canada, later to Africa and Asia as well as Latin America is given. Information was compiled through project reports, literature, statistical records where available and accessible and interviews with experts. It is concluded that the Anglo Nubian is an example of a breed developed by combining genetic resources from different parts of the world joining performance and adaptation to tropical conditions. The breed spread to all continents. Apart from being kept as purebreds, it is more often used in crossbreeding programmes in different regions of the world. The value of this genetic resource has been recognized a long time ago, but there seem to be no efforts to counteract the danger of loosing it by excessive use in uncontrolled crossbreeding.

Governing health equity in Scandinavian municipalities

DEFF Research Database (Denmark)

Scheele, Christian Elling; Little, Ingvild; Diderichsen, Finn

2018-01-01

AIMS: Local governments in the Scandinavian countries are increasingly committed to reduce health inequity through 'health equity in all policies' (HEiAP) governance. There exists, however, only very sporadic implementation evidence concerning municipal HEiAP governance, which is the focus...... of this study. METHODS: Data are based on qualitative thematic network analysis of 20 interviews conducted from 2014 to 2015 with Scandinavian political and administrative practitioners. RESULTS: We identify 24 factors located within three categories; political processes, where insufficient political commitment...... to health equity goals outside of the health sector and inadequate economic prioritization budget curbs implementation. Concerning evidence, there is a lack of epidemiological data, detailed evidence of health equity interventions as well as indicators relevant for monitoring implementation. Concerted...

Cardiac Surgery Outcomes in Patients With Chronic Lymphocytic Leukemia.

Science.gov (United States)

Zhu, Yuanjia; Toth, Andrew J; Lowry, Ashley M; Blackstone, Eugene H; Hill, Brian T; Mick, Stephanie L

2018-04-01

Surgical outcomes of patients with chronic lymphocytic leukemia (CLL) undergoing cardiac surgery are limited. Our objectives were to investigate hospital morbidity and mortality after open cardiac surgery in CLL versus non-CLL patients. From May 1995 to May 2015, 157 patients with CLL and 55,917 without and older than 47 years underwent elective cardiac surgery at Cleveland Clinic. By Rai criteria, 79 CLL patients (56%) were low risk (class 0), 13 (9.1%) intermediate risk (classes I and II), and 38 (27%) high risk (classes III and IV); 12 (8.5%) were in remission. Mean age of CLL patients was 72 ± 9.0 years, and 18% were women. CLL patients were propensity-score matched to 3 non-CLL patients to compare surgical outcomes. High-risk CLL patients received more blood products than matched non-CLL patients (33/38 [87%] versus 74/114 [65%], p = 0.01), but were less likely to receive cryoprecipitate (0% versus 15/114 [13%], p = .02). Intermediate-risk CLL patients received more platelet units, mean 12 versus 4.6 (p = 0.008). Occurrence of deep sternal wound infection (0% versus 5/471 [1.1%]), septicemia (5/157 [3.2%] versus 14/471 [3.0%]), and hospital mortality (4/157 [2.5%] versus 14/471 [3.0%]) were similar (p > 0.3), independent of prior chemotherapy treatment for CLL. Although CLL patients did not have higher hospital mortality than non-CLL patients, high-risk CLL patients were more likely to receive blood products. Risks associated with transfusion should be considered when evaluating CLL patients for elective cardiac surgery. Appropriate preoperative management, such as blood product transfusions, and alternative treatment options that decrease blood loss, should be considered for high-risk patients. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

Directory of Open Access Journals (Sweden)

Aymen N Naguib

2015-01-01

Full Text Available Introduction: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. Materials and Methods: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1 st year of life. Cases were done from May 2011 to December 2013. Children were assessed using the Stanford-Binet Intelligence Scales (5 th edition. Multiple regression analysis was used to test different parental and perioperative factors that could significantly predict the different neurodevelopmental outcomes in the entire cohort of patients. Results: When comparing the three groups regarding the major cognitive scores, a high-dose fentanyl (HDF patients scored significantly higher than the low-dose fentanyl (LDF + dexmedetomidine (DEX (LDF + DEX group in the quantitative reasoning scores (106 ± 22 vs. 82 ± 15 P = 0.046. The bispectral index (BIS value at the end of surgery for the -LDF group was significantly higher than that in LDF + DEX group (P = 0.011. For the entire cohort, a strong correlation was seen between the standard verbal intelligence quotient (IQ score and the baseline adrenocorticotropic hormone level, the interleukin-6 level at the end of surgery and the BIS value at the end of the procedure with an R 2 value of 0.67 and P < 0.04. There was an inverse correlation between the cardiac Intensive Care Unit length of stay and the full-scale IQ score (R = 0.4675 and P 0.027. Conclusions: Patients in the HDF group demonstrated overall higher neurodevelopmental scores, although it did not reach statistical significance except in fluid reasoning scores. Our results may point to a possible correlation between blunting the stress response and improvement of the neurodevelopmental

A Social Poetics of Documentary: Grierson and the Scandinavian Documentary Tradition

DEFF Research Database (Denmark)

Bondebjerg, Ib

2014-01-01

This article deals with the influence of John Grierson on the development of the Scandinavian documentary film and television movement. Grierson's poetic for a new documentary had a strong influence on the Scandinavian documentary movement from the 1930s and on. The combination of a documentary...... format that combined a new aesthetic form with a social vision was developed in the early British class society but pointed towards a more democratic wellfare society. Key Scandinavian figures and institutions in this development of a modern, documentary movement is analysed....

Genetic evidence for a family-based Scandinavian settlement of Shetland and Orkney during the Viking periods.

Science.gov (United States)

Goodacre, S; Helgason, A; Nicholson, J; Southam, L; Ferguson, L; Hickey, E; Vega, E; Stefánsson, K; Ward, R; Sykes, B

2005-08-01

The Viking age witnessed the expansion of Scandinavian invaders across much of northwestern Europe. While Scandinavian settlements had an enduring cultural impact on North Atlantic populations, the nature and extent of their genetic legacy in places such as Shetland and Orkney is not clear. In order to explore this question further, we have made an extensive survey of both Y-chromosomal and mitochondrial DNA (mtDNA) variation in the North Atlantic region. Our findings indicate an overall Scandinavian ancestry of approximately 44% for Shetland and approximately 30% for Orkney, with approximately equal contributions from Scandinavian male and female subjects in both cases. This contrasts with the situation for the Western Isles, where the overall Scandinavian ancestry is less ( approximately 15%) and where there is a disproportionately high contribution from Scandinavian males. In line with previous studies, we find that Iceland exhibits both the greatest overall amount of Scandinavian ancestry (55%) and the greatest discrepancy between Scandinavian male and female components. Our results suggest that while areas close to Scandinavia, such as Orkney and Shetland, may have been settled primarily by Scandinavian family groups, lone Scandinavian males, who later established families with female subjects from the British Isles, may have been prominent in areas more distant from their homeland.

The Anglo-Iranian oil dispute

International Nuclear Information System (INIS)

Ferrier, R.W.

1988-01-01

This paper traces the history of the Anglo-Iranian oil dispute. It is short-sighted to consider the Anglo-Iranian oil dispute just as a contest between Musaddiq and the AIOC: it is of wider and greater significance. The dispute illustrates a transitional phase in the difficult process of the adjustment of relations between industrialized and less developed societies for the exploitation of raw materials. Oil was already becoming a political and economic factor at the end of the Qajar period and became important during the reign of Riza Shah with his emphasis on a national program of modernization. After more attention had been focused on it during the second world war it was inevitable that it would increase in influence. The issues of the oil dispute referred back to the concessional controversies of the late nineteenth century in tobacco, mining, communications, utilities, banking even gambling, with their political and social implications; and they referred forward to the issues of the sovereignty of national resources, the transfer of technology and economic growth in relation to the standard of living. These are aspects of the North-South debate, which have yet to be satisfactorily resolved

Impact of Early Vasopressor Administration on Neurological Outcomes after Prolonged Out-of-Hospital Cardiac Arrest.

Science.gov (United States)

Hubble, Michael W; Tyson, Clark

2017-06-01

Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest. Hypothesis The likelihood of favorable neurological outcome declines with increasing PPI. This investigation was a retrospective study of cardiac arrest using linked data from the Cardiac Arrest Registry to Enhance Survival (CARES) database (Centers for Disease Control and Prevention [Atlanta, Georgia USA]; American Heart Association [Dallas, Texas USA]; and Emory University Department of Emergency Medicine [Atlanta, Georgia USA]) and the North Carolina (USA) Prehospital Medical Information System. Adult patients suffering a bystander-witnessed, non-traumatic cardiac arrest between January 2012 and June 2014 were included. Logistic regression was used to calculate the adjusted odds ratio (OR) of neurological outcome as a function of PPI, while controlling for patient age, gender, and race; endotracheal intubation (ETI); shockable rhythm; layperson cardiopulmonary resuscitation (CPR); and field hypothermia. Of the 2,100 patients meeting inclusion criteria, 913 (43.5%) experienced ROSC, 618 (29.4%) survived to hospital admission, 187 (8.9%) survived to hospital discharge, and 155 (7.4%) were discharged with favorable neurological outcomes (CPC 1 or 2). Favorable neurological outcome was less likely with increasing PPI (OR=0.90; PCPR, and ETI were not independent predictors of favorable neurological outcome. In this evaluation, time to vasopressor administration was significantly associated with

From national allegory to cosmopolitanism: Transformations in contemporary Anglo-Indian and Turkish novels

NARCIS (Netherlands)

Doğangün, S.A.

2014-01-01

In this study, I explore the transformation of contemporary Turkish and Anglo-Indian novels from national allegories to sites of multiple belongings by way of a comparative analysis. I analyse ten novels by Turkish and Anglo-Indian novelists that were published between 1973 and 2010: Adalet

Religion in Scandinavian Crime Fiction

DEFF Research Database (Denmark)

Hansen, Kim Toft

Scandinavian media where religion has become mediatized. Consumers of popular culture no longer endorse confidence in institutionalized religion, but that does not mean that people are losing faith: Faith only seem to adjust itself and tiptoe into popular media and popular fiction. Hence, this paper seeks...

Iron Age and Anglo-Saxon genomes from East England reveal British migration history.

Science.gov (United States)

Schiffels, Stephan; Haak, Wolfgang; Paajanen, Pirita; Llamas, Bastien; Popescu, Elizabeth; Loe, Louise; Clarke, Rachel; Lyons, Alice; Mortimer, Richard; Sayer, Duncan; Tyler-Smith, Chris; Cooper, Alan; Durbin, Richard

2016-01-19

British population history has been shaped by a series of immigrations, including the early Anglo-Saxon migrations after 400 CE. It remains an open question how these events affected the genetic composition of the current British population. Here, we present whole-genome sequences from 10 individuals excavated close to Cambridge in the East of England, ranging from the late Iron Age to the middle Anglo-Saxon period. By analysing shared rare variants with hundreds of modern samples from Britain and Europe, we estimate that on average the contemporary East English population derives 38% of its ancestry from Anglo-Saxon migrations. We gain further insight with a new method, rarecoal, which infers population history and identifies fine-scale genetic ancestry from rare variants. Using rarecoal we find that the Anglo-Saxon samples are closely related to modern Dutch and Danish populations, while the Iron Age samples share ancestors with multiple Northern European populations including Britain.

Les Anglo-americanismes du "Petit Larousse Illustre 1979" (Anglo-Americanisms in the 1979 "Petit Larousse Illustre").

Science.gov (United States)

Trescases, Pierre

1979-01-01

Based on the 1979 edition of the "Petit Larousse Illustre," English or American loan words are evaluated as to their actual usage in modern French. It is concluded that anglo-americanisms have a greater impact on technical French than on everyday French. A list of 57 words that have become part of French usage is provided for pedagogical…

Evaluating the Feasibility and Intercorrelation of Measurements on the Functioning of Residents Living in Scandinavian Nursing Homes

DEFF Research Database (Denmark)

Andresen, Mette; Frändin, Kerstin; Grönstedt, Helena

2010-01-01

Background. The purpose of this study is to investigate the feasibility of measurements of muscle strength, balance, cognitive function, mobility, activities of daily living (ADL), and physical activity for use in a Scandinavian nursing home population and to examine intercorrelations between the......, functional independence measure, physiotherapy clinical outcome variables, and the Nursing Home Life Space...

The impact of a multidisciplinary blood conservation protocol on patient outcomes and cost after cardiac surgery.

Science.gov (United States)

Ad, Niv; Holmes, Sari D; Patel, Jay; Shuman, Deborah J; Massimiano, Paul S; Choi, Elmer; Fitzgerald, David; Halpin, Linda; Fornaresio, Lisa M

2017-03-01

Although associations between transfusion and inferior outcomes have been documented, there is a lack of blood transfusion standardization in cardiac surgery. At the Inova Heart and Vascular Institute, a multidisciplinary, criterion-driven algorithm for transfusion management was implemented. We examined the effect of our blood conservation protocol on transfusion rates and outcomes after cardiac surgery and on stability of transfusion over time. Patients undergoing first-time cardiac surgery from 2006 (full year before protocol) were compared with those in 2009 (after protocol) and propensity score matched to improve balance. Data were prospectively collected. Stability of transfusion incidence also was compared (2005-2006 vs 2008-2014). After matching, 890 patients from each year were included. Use of blood products decreased from 54% in 2006 to 25% in 2009 (P platelets (P conservation program can significantly control blood transfusion rates, improve outcomes, and be sustained over time. Efforts are needed to implement evidence-based protocols to standardize and decrease blood use in cardiac surgery to improve outcomes and reduce cost. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

The Globalization of Qualitative Research: Challenging Anglo-American Domination and Local Hegemonic Discourse

Directory of Open Access Journals (Sweden)

Ping-Chun Hsiung

2012-01-01

Full Text Available Over the past decades, scholarly interest has led to publications on the practices and development of qualitative research (QR in countries outside of the Anglo-American core. Much of the writing is descriptive, providing an overview of the QR path and development in a particular country. Recently, qualitative researchers in the periphery have begun to articulate a collective professional identity in relation to the Anglo-American core by questioning both the dominance of the Anglo-American core and the current divide between QR in the core and the periphery. To date, insufficient effort has been made to develop this collective professional identity in order to overcome Anglo-American domination in the periphery and to indigenize QR. In this article, I propose a globally-informed, locally-situated analytical framework as a means of developing a globalized QR (GQR. I argue that qualitative scholars in the periphery must simultaneously confront Anglo-American domination and local hegemonic discourses. I discuss what scholars in the core and periphery can do to lead to a shift in the current division of labor that sees scholarship in the core producing theory and methods while those in the periphery consume and reproduce it. More attention needs to be paid to the indigenization of QR in the periphery. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1201216

The Infinitive Marker across Scandinavian

DEFF Research Database (Denmark)

Christensen, Ken Ramshøj

2007-01-01

In this paper I argue that the base-position of the infinitive marker in the Scandinavian languages and English share a common origin site. It is inserted as the top-most head in the VP-domain. The cross-linguistic variation in the syntactic distribution of the infinitive marker can be accounted...

Successful anglo-american entrepreneurs and the american dream. A narrative analysis

OpenAIRE

Keijzer, Marian; Liñán, Francisco (Coordinador); Guzmán Cuevas, Joaquín J. (Coordinador)

2011-01-01

Some of the most successful entrepreneurs in the Anglo-American world have written their autobiographies. A narrative analysis of these autobiographies reveal the influence of the American Dream on their life and on the way they tell their lifestories. An emphasis on moral correctness as well as on working hard, perseverance and discipline justifies the success of the narrators. The American Myth seems to be a reality – at least for white, Anglo-American, male entrepreneur...

Beyond Fashoda: Anglo-French security cooperation in Africa since St-Malo

OpenAIRE

Chafer, Tony; Cumming, G.

2010-01-01

This article focuses on Anglo-French security and defence collaboration. It begins by setting out the lack of UK-French security cooperation in Africa from the colonial to the early post-Cold War era. It then shows how there has been a degree of institutionalization of Anglo-French relations, alongside greater cooperation in terms of European Security and Defence Policy missions and the training of African peacekeepers. Next, this study explains the recent evolution of UK-French security rela...

Early Head CT Findings Are Associated With Outcomes After Pediatric Out-of-Hospital Cardiac Arrest.

Science.gov (United States)

Starling, Rebecca M; Shekdar, Karuna; Licht, Dan; Nadkarni, Vinay M; Berg, Robert A; Topjian, Alexis A

2015-07-01

Head CT after out-of-hospital cardiac arrest is often obtained to evaluate intracranial pathology. Among children admitted to the PICU following pediatric out-of-hospital cardiac arrest, we hypothesized that loss of gray-white matter differentiation and basilar cistern and sulcal effacement are associated with mortality and unfavorable neurologic outcome. Retrospective, cohort study. Single, tertiary-care center PICU. Seventy-eight patients less than 18 years old who survived out-of-hospital cardiac arrest to PICU admission and had a head CT within 24 hours of return of spontaneous circulation were evaluated from July 2005 through May 2012. None. Median time to head CT from return of spontaneous circulation was 3.3 hours (1.0, 6.0). Median patient age was 2.3 years (0.4, 9.5). Thirty-nine patients (50%) survived, of whom 29 (74%) had favorable neurologic outcome. Nonsurvivors were more likely than survivors to have 1) loss of gray-white matter differentiation (Hounsfield unit ratios, 0.96 [0.88, 1.07] vs 1.1 [1.07, 1.2]; p pediatric out-of-hospital cardiac arrest. Select patients may have favorable outcomes despite these findings.

Effectiveness of massage therapy on post-operative outcomes among patients undergoing cardiac surgery: A systematic review

Directory of Open Access Journals (Sweden)

C. Ramesh

2015-09-01

Full Text Available The incidence and prevalence of cardiovascular disease (CVD are increasing rapidly in developing countries. Most patients with CVD do not respond to medical treatment and have to undergo cardiac surgery. This highly stressful experience results in increased levels of anxiety for patients. The objective of this review was to evaluate the efficacy of massage therapy on postoperative outcomes among patients undergoing cardiac surgery. A comprehensive literature search was made on PubMed-Medline, CINAHL, Science Direct, Scopus, Web of Science and the Cochrane library databases for original research articles published between 2000 and 2015. Original articles that reported the efficacy of massage therapy in patients undergoing cardiac surgery were included. The Cochrane data extraction form was used to extract data. A total of 297 studies were identified in the literature search. However, only seven studies were eligible for analysis. Of the seven studies, six studies demonstrated the effects of massage therapy on improving post-operative outcomes of patients, while one study found no evidence of improvement. Although the methods varied considerably, most of the studies included in this review reported positive results. Therefore, there is some evidence that massage therapy can lead to positive postoperative outcomes. Evidence of the effectiveness of massage therapy in patients undergoing cardiac surgery remains inconclusive. Additional research is needed to provide a strong evidence base for the use of massage therapy to improve post-operative outcomes and recovery among cardiac surgery patients

Revisiting blood transfusion and predictors of outcome in cardiac surgery patients: a concise perspective.

Science.gov (United States)

Arias-Morales, Carlos E; Stoicea, Nicoleta; Gonzalez-Zacarias, Alicia A; Slawski, Diana; Bhandary, Sujatha P; Saranteas, Theodosios; Kaminiotis, Eva; Papadimos, Thomas J

2017-01-01

In the United States, cardiac surgery-related blood transfusion rates reached new highs in 2010, with 34% of patients receiving blood products. Patients undergoing both complex (coronary artery bypass grafting [CABG] plus valve repair or replacement) and non-complex (isolated CABG) cardiac surgeries are likely to have comorbidities such as anemia. Furthermore, the majority of patients undergoing isolated CABG have a history of myocardial infarction. These characteristics may increase the risk of complications and blood transfusion requirement. It becomes difficult to demonstrate the association between transfusions and mortality because of the fact that most patients undergoing cardiac surgery are also critically ill. Transfusion rates remain high despite the advances in perioperative blood conservation, such as the intraoperative use of cell saver in cardiac surgery. Some recent prospective studies have suggested that the use of blood products, even in low-risk patients, may adversely affect clinical outcomes. In light of this information, we reviewed the literature to assess the clinical outcomes in terms of 30-day and 1-year morbidity and mortality in transfused patients who underwent uncomplicated CABG surgery.

Standardised Testing and Assessment in Comprehensive School in Scandinavian Countries

DEFF Research Database (Denmark)

Andreasen, Karen Egedal; Eva, Hjörne,

Assessments can be considered to be an integrated part of formal educational settings, in different forms and used for different purposes. In this contribution we will discuss and analyse the use of assessments in comprehensive school in Scandinavian countries through time, as we will include....... If the comprehensive school is based on the general idea of a school for all, how can different ways of practising assessment support or work against this idea? What conclusions can be drawn from the experiences in the Scandinavian countries?...... different kinds of documentary and empirical studies in the argumentation. We will focus on which kinds of assessments has been used, for which purposes and the role of this in the perspective of society. More contemporary trends will be discussed, specially the use of standardised testing. Scandinavian...

Cardiac Risk Assessment, Morbidity Prediction, and Outcome in the Vascular Intensive Care Unit.

LENUS (Irish Health Repository)

Dover, Mary

2013-09-17

Objectives: The aim of this study is to examine the predictive value of the Lee revised cardiac risk index (RCRI) for a standard vascular intensive care unit (ICU) population as well as assessing the utility of transthoracic echocardiography and the impact of prior coronary artery disease (CAD) and coronary revascularization on patient outcome. Design: This is a retrospective review of prospectively maintained Vascubase and prospectively collected ICU data. Materials and Methods: Data from 363 consecutive vascular ICU admissions were collected. Findings were used to calculate the RCRI, which was then correlated with patient outcomes. All patients were on optimal medical therapy (OMT) in the form of cardioselective β-blocker, aspirin, statin, and folic acid. Results: There was no relationship found between a reduced ejection fraction and patient outcome. Mortality was significantly increased for patients with left ventricular hypertrophy (LVH) as identified on echo (14.9% vs 6.5%, P = .028). The overall complication rates were significantly elevated for patients with valvular dysfunction. Discrimination for the RCRI on receiver-operating characteristic analysis was poor, with an area under the receiver-operating characteristic curve of .621. Model calibration was reasonable with an Hosmer-Lemeshow Ĉ statistic of 2.726 (P = .256). Of those with known CAD, 41.22% of the patients receiving best medical treatment developed acute myocardial infarction (AMI) compared to 35.3% of those who previously underwent percutaneous cardiac intervention and 23.5% of those who had undergone coronary artery bypass grafting. There was 3-fold increase in major adverse clinical events in patients with troponin rise and LVH. Conclusions: The RCRI\\'s discriminatory capacity is low, and this raises difficulties in assessing cardiac risk in patients undergoing vascular intervention. The AMI is highest in the OMT group without prior cardiac intervention, which mandates protocols to

Diversity Management and the Scandinavian Model

DEFF Research Database (Denmark)

Romani, Laurence; Holck, Lotte; Holgersson, Charlotte

2017-01-01

This chapter presents the principal interpretations that took place in Denmark and Sweden regarding the discourse on ‘Diversity Management’. We organise our presentation around three major themes that are central to the local Scandinavian context: gender equality, migration and moral grounds. Thi...

Prevalence and causes of visual impairment and blindness among 9980 Scandinavian adults

DEFF Research Database (Denmark)

Buch, Helena; Vinding, Troels; La Cour, Morten

2004-01-01

To investigate the age-specific prevalence and causes of visual impairment and blindness in an epidemiologic study of an adult Scandinavian population.......To investigate the age-specific prevalence and causes of visual impairment and blindness in an epidemiologic study of an adult Scandinavian population....

The World's Best Anglo-American Universities' Knowledge Management Attributes

Science.gov (United States)

Tower, Greg; Plummer, Julie; Ridgewell, Brenda; Goforth, Emily; Tower, Spence

2009-01-01

Key knowledge management attributes of the world's most prestigious Anglo-American universities are surprisingly under-reported especially by best ranked USA institutions. This leads to calls for more transparency.

Scandinavian neuroscience during the Nazi era

DEFF Research Database (Denmark)

Kondziella, Daniel; Hansen, Klaus; Zeidman, Lawrence A

2013-01-01

Although Scandinavian neuroscience has a proud history, its status during the Nazi era has been overlooked. In fact, prominent neuroscientists in German-occupied Denmark and Norway, as well as in neutral Sweden, were directly affected. Mogens Fog, Poul Thygesen (Denmark) and Haakon Sæthre (Norway...

Physical activity and sedentary behaviour among Asian and Anglo-Australian adolescents.

Science.gov (United States)

Strugnell, Claudia; M N Renzaho, Andre; Ridley, Kate; Burns, Cate

2015-08-01

Evidence suggests that physical activity (PA) and sedentary behaviour (SB) participation varies among culturally and linguistically diverse (CALD) adolescents. The present study examined differences in PA and SB among a CALD sample of Chinese Australian, South-east Asian and Anglo-Australian adolescents. Data from 286 adolescents aged 12-16 years involved in the Chinese and Australian Adolescent Health Survey in metropolitan Melbourne, Australia, were analysed. Accelerometry outcomes included median activity counts per minute (counts x min(-1)) and minutes per day (min x day(-1)) spent in light-intensity PA (LPA), moderate-to-vigorous-intensity PA (MVPA) and sedentary time (ST). Kruskal-Wallis one-way analysis of variance and sequential multiple hierarchical linear regressions were used to examine CALD differences in PA and ST. Multivariate analyses of accelerometry data found Chinese Australian and South-east Asian adolescents engaged in significantly less daily MVPA (5-8 min x day(-1)) and LPA (50-58 min x day(-1); P Asian adolescents compared with Anglo-Australian adolescents. These findings have important public health implications in furthering our understanding of CALD differences in PA and SB. SO WHAT? An understanding of the CALD differences in physical activity and sedentary behaviour among Australian adolescents has important implications for intervention planning and delivery as well as the wider health implications of these behaviours. This article furthers the current understanding of CALD adolescents' participation in physical activity and sedentary behaviour, of which limited information is available.

76 FR 63701 - Culturally Significant Objects Imported for Exhibition Determinations: “Anglo-Saxon Hoard: Gold...

Science.gov (United States)

2011-10-13

... DEPARTMENT OF STATE [Public Notice 7640] Culturally Significant Objects Imported for Exhibition Determinations: ``Anglo-Saxon Hoard: Gold From England's Dark Ages'' SUMMARY: Notice is hereby given of the... exhibition ``Anglo-Saxon Hoard: Gold From England's Dark Ages,'' imported from abroad for temporary...

Cardiac Myosin Binding Protein-C Autoantibodies Are Potential Early Indicators of Cardiac Dysfunction and Patient Outcome in Acute Coronary Syndrome

Directory of Open Access Journals (Sweden)

Thomas L. Lynch, IVPhD

2017-04-01

Full Text Available Summary: The degradation and release of cardiac myosin binding protein-C (cMyBP-C upon cardiac damage may stimulate an inflammatory response and autoantibody (AAb production. We determined whether the presence of cMyBP-C-AAbs associated with adverse cardiac function in cardiovascular disease patients. Importantly, cMyBP-C-AAbs were significantly detected in acute coronary syndrome patient sera upon arrival to the emergency department, particularly in ST-segment elevation myocardial infarction patients. Patients positive for cMyBP-C-AAbs had reduced left ventricular ejection fraction and elevated levels of clinical biomarkers of myocardial infarction. We conclude that cMyBP-C-AAbs may serve as early predictive indicators of deteriorating cardiac function and patient outcome in acute coronary syndrome patients prior to the infarction. Key Words: acute myocardial infarction, autoantibodies, cardiac myosin binding protein-c, cardiomyopathy

The Scandinavian baltic pancreatic club (SBPC) database

DEFF Research Database (Denmark)

Olesen, Søren S; Poulsen, Jakob Lykke; Drewes, Asbjørn M

2017-01-01

OBJECTIVES: Chronic pancreatitis (CP) is a multifaceted disease associated with several risk factors and a complex clinical presentation. We established the Scandinavian Baltic Pancreatic Club (SBPC) Database to characterise and study the natural history of CP in a Northern European cohort. Here......, we describe the design of the database and characteristics of the study cohort. METHODS: Nine centres from six different countries in the Scandinavian-Baltic region joined the database. Patients with definitive or probable CP (M-ANNHEIM diagnostic criteria) were included. Standardised case report...... forms were used to collect several assessment variables including disease aetiology, duration of CP, preceding acute pancreatitis, as well as symptoms, complications, and treatments. The clinical stage of CP was characterised according to M-ANNNHEIM. Yearly follow-up is planned for all patients. RESULTS...

Genomic signals of migration and continuity in Britain before the Anglo-Saxons.

Science.gov (United States)

Martiniano, Rui; Caffell, Anwen; Holst, Malin; Hunter-Mann, Kurt; Montgomery, Janet; Müldner, Gundula; McLaughlin, Russell L; Teasdale, Matthew D; van Rheenen, Wouter; Veldink, Jan H; van den Berg, Leonard H; Hardiman, Orla; Carroll, Maureen; Roskams, Steve; Oxley, John; Morgan, Colleen; Thomas, Mark G; Barnes, Ian; McDonnell, Christine; Collins, Matthew J; Bradley, Daniel G

2016-01-19

The purported migrations that have formed the peoples of Britain have been the focus of generations of scholarly controversy. However, this has not benefited from direct analyses of ancient genomes. Here we report nine ancient genomes (∼ 1 ×) of individuals from northern Britain: seven from a Roman era York cemetery, bookended by earlier Iron-Age and later Anglo-Saxon burials. Six of the Roman genomes show affinity with modern British Celtic populations, particularly Welsh, but significantly diverge from populations from Yorkshire and other eastern English samples. They also show similarity with the earlier Iron-Age genome, suggesting population continuity, but differ from the later Anglo-Saxon genome. This pattern concords with profound impact of migrations in the Anglo-Saxon period. Strikingly, one Roman skeleton shows a clear signal of exogenous origin, with affinities pointing towards the Middle East, confirming the cosmopolitan character of the Empire, even at its northernmost fringes.

Scandinavian women's experiences in connection with "abortion on request": a systematic review protocol

DEFF Research Database (Denmark)

Petersen, Mille Nyboe; Fandt Hansen, Christl

2014-01-01

The objective of this review is to investigate Scandinavian women’s experiences in connection with "abortion on request”. Types of participants: This review will consider studies that include adult women from age 18 living in (but not necessarily legal citizens of) Scandinavia, defined as Denmark...... and after the intervention - an abortion on request and in investigating possible and self-reported psychosocial or psychological health consequences following the abortion. Types of context: This review will focus on Scandinavian women who have had a legal abortion on request in a Scandinavian hospital......, Sweden and Norway, who have experienced an induced (medical or surgical) abortion without a medical reason, described here as an “abortion on request”. Phenomena of interest: The objective of this review is to investigate Scandinavian women’s experiences in connection with – meaning before, during...

The Puzzle of the Scandinavian Welfare State and Social Trust

DEFF Research Database (Denmark)

Svendsen, Gunnar Lind Haase; Svendsen, Gert Tinggaard

2015-01-01

The Scandinavian welfare model is a puzzle to economists: It works economically, even though free-riding should prevail with its explosive cocktail of high taxation and high social benefits. One overlooked solution to the puzzle could be the unique stock of social trust present in Scandinavia. Here......, the four Scandinavian countries (Norway, Denmark, Sweden, and Finland) form the top three with scores above 60 percent social trust on a ranking that covers 94 countries from all over the world....

Outcome among patients suffering from in-hospital cardiac arrest

Directory of Open Access Journals (Sweden)

Trpković Sladjana

2014-01-01

Full Text Available Introduction. In relation to pre-hospital treatment of patients with cardiac arrest (CA in the field where resuscitation is often started by nonprofessionals, resuscitation in hospital is most commonly performed by well-trained personnel. Objective. The aim was to define the factors associated with an improved outcome among patients suffering from the inhospital CA (IHCA. Methods. The prospective study included a total of 100 patients in the Emergency Center over two-year period. The patterns by the Utstein-Style guidelines recorded the following: age, sex, reason for hospital admission, comorbidity, cause and origin of CA, continuous monitoring, time of arrival of the medical emergency team and time of delivery of the first defibrillation shock (DC. Results. Most patients (61% had cardiac etiology. Return of spontaneous circulation (ROSC was achieved in 58% of patients. ROSC was more frequently achieved in younger patients (57.69±11.37, (p<0.05, non-surgical patients (76.1%, (p<0.01 and in patients who were in continuous monitoring (66.7% (p<0.05. The outcome of CPR was significantly better in patients who received advanced life support (ALS (76.6% (p<0.01. Time until the delivery of the first DC shock was significantly shorter in patients who achieved ROSC (1.67±1.13 min, (p<0.01. A total of 5% of IHCA patients survived to hospital discharge. Conclusion. In our study, the outcome of CPR was better in patients who were younger and with non-surgical diseases, which are prognostic factors that we cannot control. Factors associated with better outcome of IHCA patients were: continuous monitoring, shorter time until the delivery of the first DC and ALS. This means that better education of medical staff, better organization and up-to-dated technical equipment are needed.

Anglo-Americanisms in the French Sporting Vocabulary.

Science.gov (United States)

Rosoff, Gary H.

1981-01-01

Singles out sports as the area where the influence of Anglo-American culture on the French language has been most pronounced, illustrating the means by which these exchanges have taken place over the years. In particular, discusses the changes in meaning, form, and function that loan words have undergone in the process. (Author/MES)

Lupines, manganese, and devil-sickness: an Anglo-Saxon medical response to epilepsy.

Science.gov (United States)

Dendle, P

2001-01-01

The most frequently prescribed herb for "devil-sickness" in the vernacular medical books from Anglo-Saxon England, the lupine, is exceptionally high in manganese. Since manganese depletion has been linked with recurring seizures in both clinical and experimental studies, it is possible that lupine administration responded to the particular pathophysiology of epilepsy. Lupine is not prescribed for seizures in classical Mediterranean medical sources, implying that the Northern European peoples (if not the Anglo-Saxons themselves) discovered whatever anticonvulsive properties the herb may exhibit.

Reduction in cardiovascular events with atorvastatin in 2,532 patients with type 2 diabetes: Anglo-Scandinavian Cardiac Outcomes Trial--lipid-lowering arm (ASCOT-LLA)

DEFF Research Database (Denmark)

Sever, Peter S; Poulter, Neil R; Dahlöf, Björn

2005-01-01

This study aims to establish the benefits of lowering cholesterol in diabetic patients with well-controlled hypertension and average/below-average cholesterol concentrations, but without established coronary disease....

Outcome of children with Pentalogy of Cantrell following cardiac surgery.

LENUS (Irish Health Repository)

O'Gorman, Clodagh S

2012-02-01

Although single individual reports have documented outcomes in children with pentalogy of are few data available for postoperative outcome of this cohort of patients after cardiac surgery. The aim of this study was to retrospectively review the clinical details of patients with pentalogy of Cantrell managed at two centers. Two cardiac surgical institutions retrospectively studied all patients with pentalogy of Cantrell and significant congenital heart disease who underwent surgical intervention, excluding PDA ligation, between 1992 and 2004. Seven children with pentalogy of Cantrell underwent surgical intervention at a median age of 60 days (range, 1-11 months). Three patients had tetralogy of Fallot, two double outlet right ventricle, one patient had tricuspid atresia, and one patient a perimembranous ventricular septal defect. The mean duration of postoperative ventilation was 112.8 days (range, 4-335 days) but three patients required ventilation for more than 100 days. Patients who had a preoperative diaphragmatic plication required a longer duration of ventilation (mean = 186.5 days [range, 100-273 days] compared with mean = 132 days [range, 4-335 days]). Four patients survived, with three patients weaned from ventilation. Three patients had withdrawal of care following failure to wean from ventilation, following multisystem organ failure, and at the request of their parents. In conclusion, the postoperative care of children with pentalogy of Cantrell after cardiac surgery is often complicated by prolonged need for ventilatory support and multiple postoperative complications. Earlier surgical intervention does not necessarily reduce morbidity and mortality. These data may help in the counseling of parents prior to surgical intervention.

The Anglo-Saxon model of employment in the current economic context. The case of United Kingdom

Directory of Open Access Journals (Sweden)

Mirela Ionela ACELEANU

2012-11-01

Full Text Available The Anglo-Saxon model of employment has certain features that derive from the specificity of the political and economic system of Great Britain. The labour market policies in the United Kingdom were different depending on the historical and political period; however, the Anglo-Saxon model is characterized mainly by high flexibility but low security. This paper presents the main features of the Anglo-Saxon model of employment, compared to the Nordic and the Mediterranean model and shows Britain's economic situation before and after the crisis.

Cardiac Magnetic Resonance Imaging Predictors of Short-Term Outcomes after High Risk Coronary Surgery.

Science.gov (United States)

Sheriff, Mohammed J; Mouline, Omar; Hsu, Chijen; Grieve, Stuart M; Wilson, Michael K; Bannon, Paul G; Vallely, Michael P; Puranik, Rajesh

2016-06-01

The euroSCORE II is a widely used pre-coronary artery bypass graft surgery (CAGS) risk score, but its predictive power lacks the specificity to predict outcomes in high-risk patients (surgery case mix, revascularisation techniques and related outcomes in recent years. We investigated the utility of Cardiac Magnetic Resonance Imaging (CMRI) in predicting immediate and six-week outcomes after CAGS. Fifty-two consecutive patients with high euroSCORE II (>16) and left ventricular (LV) dysfunction (magnetic resonance imaging parameters were assessed in patients who either had complications immediately post-surgery (n=35), six weeks post-surgery (n=20) or were uncomplicated. The average age of patients recruited was 69±5 years with high euroSCORE II (22±4) and low 2D-echocardiography LV ejection fraction (38%±2%). Cardiac magnetic resonance imaging results demonstrated that those with immediate complications had higher LV scar/infarct burden as a proportion of LV mass (17±3% vs 10±3%; p=0.04) with lower circumferential relaxation index (2.5±0.46 vs 2.8±0.56; p=0.05) compared to those with no complications. Early mortality from surgery was 17% (n=9) and was associated with lower RV stroke volume (55±12 vs 68±18; p=0.03) and higher LV infarct scar/burden (18±2% vs 10±2%, p=0.04). Cardiac magnetic resonance imaging showed patients with complications at six weeks post-surgery had higher LV scar/infarct burden (14.5±2% vs 6.8±2%, p=0.03) compared to those without complications. Cardiac magnetic resonance imaging preoperative LV and RV parameters are valuable in assessing the likelihood of successful outcomes from CAGS in high-risk patients with LV dysfunction. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

Anglo-Saxon pharmacopoeia revisited: a potential treasure in drug discovery.

Science.gov (United States)

Watkins, Frances; Pendry, Barbara; Corcoran, Olivia; Sanchez-Medina, Alberto

2011-12-01

Three of the four major Anglo-Saxon collections reporting medicinal formulations in England from the 10th century, the Old English Herbarium, Bald's Leechbook and the Lacnunga, could contain leads and insights into new medicinal uses. Previous pharmacological studies of medicinal plants mentioned in Anglo-Saxon medical texts suggested that some were effective and led to the identification and isolation of natural compounds. For example, matricin from yarrow Achillea millefolium L., is a proprionic acid analogue that yields chamazulene carboxylic acid with cyclooxygenase-2 activity similar to that of ibuprofen. As we discuss here, multidisciplinary projects could further explore historical texts to discover additional plant metabolites with potential pharmacological applications. Copyright © 2011 Elsevier Ltd. All rights reserved.

A Scandinavian Model of Innovative Product Development

DEFF Research Database (Denmark)

McAloone, Timothy Charles; Andreasen, Mogens Myrup; Boelskifte, Per

2007-01-01

The educational systems in the small Scandinavian countries are open to experiments and new education programmes. This paper presents such an initiative from Denmark, showing new interpretations of industrial needs, research insights, educational ideas and identification of core innovative compet...

Living on the edge: making and moving iron from the ‘outside’ in Anglo-Saxon England

DEFF Research Database (Denmark)

Birch, Thomas

2011-01-01

The production of iron in Anglo-Saxon England is little understood due to the lack of evidence. There are less than a dozen iron smelting sites known. This is a distinct contrast to the wealth of evidence of iron smelting during the Roman period. Should we believe that the Anglo-Saxon world......-west Europe emphasises how marginal they were in society, along with their goods. The value of items coming from the ‘outside’ was heightened as they came from the distant unknown, the unfamiliar. In order to understand the dynamic role of iron in Anglo Saxon society, we must review the negative evidence...... of iron smelting, and the evidence for smithing. This should be considered with reference to the literary evidence available to us in the context of the Migration period in northwest Europe. Iron production in early Anglo-Saxon England should also be sought after using archaeological prospection...

Neurosyphilis in Anglo-American Composers and Jazz Musicians.

Science.gov (United States)

Breitenfeld, Darko; Kust, Davor; Breitenfeld, Tomislav; Prpić, Marin; Lucijanić, Marko; Zibar, Davor; Hostić, Vedran; Franceschi, Maja; Bolanča, Ante

2017-09-01

Syphilis is a sexually transmitted, systemic disease caused by the spirochete bacterium Treponema pallidum. The most common mechanism of transmission is sexual intercourse. Although there are several hypotheses, the exact origin of the disease remains unknown. Newly published evidence suggests that the hypothesis supporting the theory of the American origin of the disease is the valid one. Among 1500 analyzed pathographies of composers and musicians, data on ten Anglo-American composers and jazz musicians having suffered from neurosyphilis (tertiary stage of the disease) were extracted for this report. In this group of Anglo-American composers and musicians, most of them died from progressive paralysis while still in the creative phase of life. Additionally, diagnoses of eleven other famous neurosyphilitic composers, as well as basic biographic data on ten less known composers that died from neurosyphilis-progressive paralysis are also briefly mentioned. In conclusion, neurosyphilis can cause serious neurological damage, as well as permanent disability or death, preventing further work and skill improvement.

Action research: Scandinavian Experiences

DEFF Research Database (Denmark)

Rasmussen, Lauge Baungaard

2004-01-01

The article focus on paradigms, methods and ethics of action research in the Scandinavian countries. The special features of the action research paradigm is identified. A historical overview follows of some main action research projects in Norway, Sweden and Denmark. The tendency towards upsclae...... action research projects from organisational or small community projects yo large-scale, regional based network apporaches are also outlined and discussed. Finally, a synthesised approach of the classical, socio-technical action research approach and the large-scale network and holistic approaches...

The impact of Zero Energy Buildings on the Scandinavian energy system

International Nuclear Information System (INIS)

Seljom, Pernille; Lindberg, Karen Byskov; Tomasgard, Asgeir; Doorman, Gerard; Sartori, Igor

2017-01-01

This paper investigates how an extensive implementation of net Zero Energy Buildings (ZEBs) affects cost-optimal investments in the Scandinavian energy system towards 2050. Analyses are done by a stochastic TIMES model with an explicit representation of the short-term uncertainty related to electricity supply and heat demand in buildings. We define a nearly ZEB to be a highly efficient building with on-site PV production. To evaluate the flexibility requirement of the surrounding energy system, we consider no use of energy storage within the ZEBs. The results show that ZEBs reduce the investments in non-flexible hydropower, wind power and Combined Heat and Power, and increase the use of direct electric heating and electric boilers. With building integrated PV production of 53 TWh in 2050, ZEBs increase the Scandinavian electricity generation by 16 TWh and increase the net electricity export by 19 TWh. Although the increased production reduces the electricity prices, the low heat demand in ZEBs gives a drop in the electricity consumption by 4 TWh in 2050. Finally, the results demonstrate that the Scandinavian energy system is capable of integrating a large amount of ZEBs with intermittent PV production due to the flexible hydropower in Norway and Sweden. - Highlights: • We analyse cost-optimal integration of ZEBs in the Scandinavian energy system. • We capture impact of short-term uncertainty on long-term investment decisions. • ZEBs reduce the investments in the electricity and heating sector. • The Scandinavian electricity sector is capable of integrating ZEBs with PV. • The operation of the flexible hydropower is changed with ZEBs.

The role of the men's hall in the development of the Anglo-Saxon superego.

Science.gov (United States)

Earl, J W

1983-05-01

This paper is a historical study of ritual space--a bit of psychoanalytic anthropology applied to a particular case, the evolution of the men's hall among the early Anglo-Saxons. I focus particularly on the ritual functions of poetry in the hall, the same poetry which is our major evidence regarding the hall, especially the epic Beowulf. I define the hall as a cultural institution, and redefine the native poetic tradition in relation to the hall's varied ritual life, with which the poetry is so occupied. Though my argument is focused on the hall, it includes a framework of theoretical concerns. Early Anglo-Saxon culture is of anthropological interest chiefly because of its rapid and dramatic emergence from Germanic tribal prehistory into a leading role in the civilization of Christian Europe. The conquest of Britain by the Anglo-Saxons in the fifth and sixth centuries, and their conversion soon afterward, is a case history of the transformations of a tribal society suddenly introduced to the special forces of civilization and the higher religions that control them. The Anglo-Saxons are fascinating in this regard because of the fortuitous developments that prepared for this transformation and made it so successful.

The Relationship Between Preoperative Hemoglobin Concentration, Use of Hospital Resources, and Outcomes in Cardiac Surgery.

Science.gov (United States)

Hallward, George; Balani, Nikhail; McCorkell, Stuart; Roxburgh, James; Cornelius, Victoria

2016-08-01

Preoperative anemia is an established risk factor associated with adverse perioperative outcomes after cardiac surgery. However, limited information exists regarding the relationship between preoperative hemoglobin concentration and outcomes. The aim of this study was to investigate how outcomes are affected by preoperative hemoglobin concentration in a cohort of patients undergoing cardiac surgery. A retrospective, observational cohort study. A single-center tertiary referral hospital. The study comprised 1,972 adult patients undergoing elective and nonelective cardiac surgery. The independent relationship of preoperative hemoglobin concentration was explored on blood transfusion rates, return to the operating room for bleeding and/or cardiac tamponade, postoperative intensive care unit (ICU) and in-hospital length of stay, and mortality. The overall prevalence of anemia was 32% (629/1,972 patients). For every 1-unit increase in hemoglobin (g/dL), blood transfusion requirements were reduced by 11%, 8%, and 3% for red blood cell units, platelet pools, and fresh frozen plasma units, respectively (adjusted incident rate ratio 0.89 [95% CI 0.87-0.91], 0.92 [0.88-0.97], and 0.97 [0.96-0.99]). For each 1-unit increase in hemoglobin (g/dL), the probability (over time) of discharge from the ICU and hospital increased (adjusted hazard ratio estimates 1.04 [1.00-1.08] and 1.12 [1.12-1.16], respectively). A lower preoperative hemoglobin concentration resulted in increased use of hospital resources after cardiac surgery. Each g/dL unit fall in preoperative hemoglobin concentration resulted in increased blood transfusion requirements and increased postoperative ICU and hospital length of stay. Copyright © 2016 Elsevier Inc. All rights reserved.

Shifting Authenticities in Scandinavian Music Education

Science.gov (United States)

Dyndahl, Petter; Nielsen, Siw Graabraek

2014-01-01

There has been an ongoing tendency, taking place in the Scandinavian countries from the late 1970s onwards, to expand the repertoires and resources of music as an educational matter, an academic field, as well as an area for support and funding from cultural authorities, organisations and institutions. Here, popular music, jazz, folk music and…

Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33°C and 36°C

DEFF Research Database (Denmark)

Borgquist, Ola; Wise, Matt P; Nielsen, Niklas

2017-01-01

OBJECTIVES: Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes...... of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. DESIGN: Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category." SETTING: Thirty-six sites in Europe...... and Australia. PATIENTS: All 939 patients with out-of-hospital cardiac arrest of presumed cardiac cause that had been included in the TTM-trial. INTERVENTIONS: Targeted temperature management at 33°C or 36°C. MEASUREMENTS AND MAIN RESULTS: Nonparametric tests as well as multiple logistic regression and mixed...

Nearshoring Practices of Scandinavian MNCs in Central and Eastern Europe

DEFF Research Database (Denmark)

Slepniov, Dmitrij; Brazinskas, Sigitas; Wæhrens, Brian Vejrum

2012-01-01

The principal objective of this paper is to unravel and assess current nearshoring practices of Scandinavian MNCs. In addressing this issue, we draw on the literature within the areas of offshoring and outsourcing. We use mixed methods of enquiry involving case studies, survey techniques as well...... as secondary statistical data. To provide a more refined view on the practices and processes of nearshoring, we complement the case studies of Scandinavian manufacturers with a survey of 55 Lithuanian vendor companies and other statistical data. The paper outlines the main drivers of nearshoring...

Pre-LBA Anglo-Brazilian Amazonian Climate Observation Study (ABRACOS) Data

Data.gov (United States)

National Aeronautics and Space Administration — The data set presents the principal data from the Anglo-BRazilian Amazonian Climate Observation Study (ABRACOS) (Gash et al. 1996) and provides quality controlled...

Pre-LBA Anglo-Brazilian Amazonian Climate Observation Study (ABRACOS) Data

Data.gov (United States)

National Aeronautics and Space Administration — ABSTRACT: The data set presents the principal data from the Anglo-BRazilian Amazonian Climate Observation Study (ABRACOS) (Gash et al. 1996) and provides quality...

Anglo-American views of Gavrilo Princip

Directory of Open Access Journals (Sweden)

Markovich Slobodan G.

2015-01-01

Full Text Available The paper deals with Western (Anglo-American views on the Sarajevo assassination/attentat and Gavrilo Princip. Articles on the assassination and Princip in two leading quality dailies (The Times and The New York Times have particularly been analysed as well as the views of leading historians and journalists who covered the subject including: R. G. D. Laffan, R. W. Seton-Watson, Winston Churchill, Sidney Fay, Bernadotte Schmitt, Rebecca West, A. J. P. Taylor, Vladimir Dedijer, Christopher Clark and Tim Butcher. In the West, the original general condemnation of the assassination and its main culprits was challenged when Rebecca West published her famous travelogue on Yugoslavia in 1941. Another Brit, the remarkable historian A. J. P. Taylor, had a much more positive view on the Sarajevo conspirators and blamed Germany and Austria-Hungary for the outbreak of the Great War. A turning point in Anglo-American perceptions was the publication of Vladimir Dedijer’s monumental book The Road to Sarajevo (1966, which humanised the main conspirators, a process initiated by R. West. Dedijer’s book was translated from English into all major Western languages and had an immediate impact on the understanding of the Sarajevo assassination. The rise of national antagonisms in Bosnia gradually alienated Princip from Bosnian Muslims and Croats, a process that began in the 1980s and was completed during the wars of the Yugoslav succession. Although all available sources clearly show that Princip, an ethnic Serb, gradually developed a broader Serbo-Croat and Yugoslav identity, he was ethnified and seen exclusively as a Serb by Bosnian Croats and Bosniaks and Western journalists in the 1990s. In the past century imagining Princip in Serbia and the West involved a whole spectrum of views. In interwar Anglo-American perceptions he was a fanatic and lunatic. He became humanised by Rebecca West (1941, A. J. P. Taylor showed understanding for his act (1956, he was fully

Convergence and conflict perspectives in Scandinavian studies of the legal profession

DEFF Research Database (Denmark)

Hammerslev, Ole

2010-01-01

This article focuses on classic Scandinavian studies of the legal profession. These classic studies, which followed World War II and the development of the Scandinavian welfare states, focused on national developments in the legal profession and its relevance to the development of the states....... It demonstrates how the two research traditions, despite their different theoretical perspectives, build their research on comparatively the same kind of empirical data and methodology and how they reach some of the same conclusions....

Dress in Scandinavian Iconography of the 5-10th centuries AD

DEFF Research Database (Denmark)

Mannering, Ulla

2004-01-01

In the Scandinavian Late Iron Age costume studies plays an important role. The many new finds of gold sheet images comprise an until now unexploited source that can enlight the often fragmented and degraded textile remains.......In the Scandinavian Late Iron Age costume studies plays an important role. The many new finds of gold sheet images comprise an until now unexploited source that can enlight the often fragmented and degraded textile remains....

Scandinavian Symposium on Reactor Waste

International Nuclear Information System (INIS)

1981-09-01

More than 100 delegates forom the Scandinavian countries were gathered for a symposium on September 14-16 1981 at Kungaelv Sweden to discuss nuclear reactor waste. The organisation for the handling of radioactive waste at different countries was presented and the principles of radioactive safety were discussed. The planning of the deposition and storage of waste was described. The proceedings are reproduced on some twenty papers, a number of them written in English. (G.B.)

Mindfulness-based cognitive therapy is effective as relapse prevention for patients with recurrent depression in Scandinavian primary health care.

Science.gov (United States)

Lilja, Josefine L; Zelleroth, Clara; Axberg, Ulf; Norlander, Torsten

2016-10-01

This study examined the effectiveness of mindfulness-based cognitive therapy (MBCT) in primary care for patients with recurrent depression (major depressive disorder: MDD). According to the World Health Organization (WHO), MDD is now the leading cause of disease burden in middle- and high-income countries. Patients (N = 45) with three or more previous depressive episodes were recruited to participate in MBCT as a preventative intervention. Using a benchmarking approach, outcome data was compared with data from a recent efficacy study. The methodology is a rigorous approach to assessing effectiveness when evidence-based UK protocols are transferred into the existing Scandinavian service delivery. Additionally, a person-centred methodological approach was used to assess clinical significance on the Reliable Change Index (RCI). The analysis revealed comparable or larger effects from pre-test to post-test in reduced psychiatric symptoms, increased quality of life and level of mindfulness, and the effects were maintained over 14 months. Analysis of the relapse rate in the current study (16%) compared to the TAU in the efficacy study (68%) yielded an h value of 0.78, a moderate effect size. Only 13% dropped out of the treatment. According to the RCI findings, 65% to 67% of participants in the clinical group improved, no individual worsened, and women showed a significantly greater improvement of depression and anxiety than men. Therapeutic alliance and motivation had no impact on the outcome. The overall result suggests that MBCT can be implemented successfully in Scandinavian primary health care as a preventive intervention for patients with recurrent depression. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Future needs for Nursing Talents in Scandinavian countries

DEFF Research Database (Denmark)

Jakobsen, Randi Kjelde; Herholdt-Lomholdt, Sine Maria

2017-01-01

Review question/objective: The aim of this review is to systematically identify, appraise and synthesize available text and opinion papers from policy-makers and trade unions in Scandinavian countries (Denmark, Sweden and Norway) containing information about nursing talent needed in healthcare...... systems for the future. The overall objective is to identify and synthesize the opinions of various stakeholders of what they believe is required in terms of nursing talent in Scandinavia. In this review, ‘‘nursing talent’’ refers to certain skills or competencies that are essential within nursing to meet...... the challenges and demands of future health care. The purpose of this review is to provide knowledge about the opinions of two key stakeholders (policy-makers and trade unions) on nursing talent needed in future Scandinavian healthcare systems....

Serum uric acid level predicts adverse outcomes after myocardial revascularization or cardiac valve surgery.

Science.gov (United States)

Lazzeroni, Davide; Bini, Matteo; Camaiora, Umberto; Castiglioni, Paolo; Moderato, Luca; Bosi, Davide; Geroldi, Simone; Ugolotti, Pietro T; Brambilla, Lorenzo; Brambilla, Valerio; Coruzzi, Paolo

2018-01-01

Background High levels of serum uric acid have been associated with adverse outcomes in cardiovascular diseases such as myocardial infarction and heart failure. The aim of the current study was to evaluate the prognostic role of serum uric acid levels in patients undergoing cardiac rehabilitation after myocardial revascularization and/or cardiac valve surgery. Design We performed an observational prospective cohort study. Methods The study included 1440 patients with available serum uric acid levels, prospectively followed for 50 ± 17 months. Mean age was 67 ± 11 years; 781 patients (54%) underwent myocardial revascularization, 474 (33%) cardiac valve surgery and 185 (13%) valve-plus-coronary artery by-pass graft surgery. The primary endpoints were overall and cardiovascular mortality while secondary end-points were combined major adverse cardiac and cerebrovascular events. Results Serum uric acid level mean values were 286 ± 95 µmol/l and elevated serum uric acid levels (≥360 µmol/l or 6 mg/dl) were found in 275 patients (19%). Overall mortality (hazard ratio = 2.1; 95% confidence interval: 1.5-3.0; p uric acid levels, even after adjustment for age, gender, arterial hypertension, diabetes, glomerular filtration rate, atrial fibrillation and medical therapy. Moreover, strong positive correlations between serum uric acid level and probability of overall mortality ( p uric acid levels predict mortality and adverse cardiovascular outcome in patients undergoing myocardial revascularization and/or cardiac valve surgery even after the adjustment for age, gender, arterial hypertension, diabetes, glomerular filtration rate and medical therapy.

Attitudes toward Suicide among Mexican American and Anglo Youth.

Science.gov (United States)

Domino, George

1981-01-01

There were statistically significant differences between answers of 76 Anglo and 76 Mexican American youth on 35 of 100 opinion questionnaire items. Items centered on religion, psychopathology, aggression-impulsivity, acceptability of suicide, the "cry for help" dimension, and emotional impact. (Author/CM)

Long-term outcomes and cost effectiveness of high-dose dexamethasone for cardiac surgery : A randomised trial

NARCIS (Netherlands)

Dieleman, J. M.; de Wit, G. A.; Nierich, A. P.; Rosseel, P. M.; van der Maaten, J. M.; Hofland, J.; Diephuis, J. C.; de Lange, F.; Boer, C.; Neslo, R. E.; Moons, K. G.; van Herwerden, L. A.; Tijssen, J. G.; Kalkman, C. J.; van Dijk, D.

Prophylactic intra-operative administration of dexamethasone may improve short-term clinical outcomes in cardiac surgical patients. The purpose of this study was to evaluate long-term clinical outcomes and cost effectiveness of dexamethasone versus placebo. Patients included in the multicentre,

Long-term outcomes and cost effectiveness of high-dose dexamethasone for cardiac surgery: a randomised trial

NARCIS (Netherlands)

Dieleman, J. M.; de Wit, G. A.; Nierich, A. P.; Rosseel, P. M.; van der Maaten, J. M.; Hofland, J.; Diephuis, J. C.; de Lange, F.; Boer, C.; Neslo, R. E.; Moons, K. G.; van Herwerden, L. A.; Tijssen, J. G.; Kalkman, C. J.; van Dijk, D.

2017-01-01

Prophylactic intra-operative administration of dexamethasone may improve short-term clinical outcomes in cardiac surgical patients. The purpose of this study was to evaluate long-term clinical outcomes and cost effectiveness of dexamethasone versus placebo. Patients included in the multicentre,

Anglo-Saxon Landscape and Economy: using portable antiquities to study Anglo-Saxon and Viking Age England

Directory of Open Access Journals (Sweden)

Julian D. Richards

2009-04-01

Full Text Available In the last fifteen years the role of metal-detected objects in archaeological research has greatly increased through reporting to the Portable Antiquities Scheme (PAS and the Early Medieval Corpus (EMC. There are now thousands more artefacts and coins known than a decade ago which, in conjunction with fieldwork, have the potential to revolutionise our understanding of the early medieval period. This is the first time that these data have been examined on a national scale. Such an approach enables the detailed analysis of the nature of portable antiquities data, the bias within such datasets and the relationship between patterns of recovery and historic settlement (Sections 2 and 3. In the light of these new interpretations of the overall datasets, the most artefact- and coin-rich sites, known as 'productive sites', can be analysed within a new framework of understanding (Section 4. This article is a major outcome of the Viking and Anglo-Saxon Landscape and Economy (VASLE project, funded by AHRC research grant APN18370. In addition to the narrative elements of the article, readers are able to access the original datasets to draw their own maps, and to call up charts of the artefact assemblages for over 60 'productive sites'. The secondary datasets developed for the project are also available from the Archaeology Data Service.

Cleft lip surgery in Anglo-Saxon Britain: the Leech Book (circa A.D. 920).

Science.gov (United States)

Vrebos, J

1986-05-01

The Leech Book, the oldest known Anglo-Saxon herbarium, probably written in Winchester, circa A.D. 920, by Cyril Bald or at his special request, contains a short chapter on the surgical treatment of the cleft lip; this chapter apparently represents the first record in a medical manuscript of this treatment. The original Anglo-Saxon text is presented together with transcriptions into more modern English. The general value of the Leech Book is briefly studied.

Impact of Medicaid Expansion on Cardiac Surgery Volume and Outcomes.

Science.gov (United States)

Charles, Eric J; Johnston, Lily E; Herbert, Morley A; Mehaffey, J Hunter; Yount, Kenan W; Likosky, Donald S; Theurer, Patricia F; Fonner, Clifford E; Rich, Jeffrey B; Speir, Alan M; Ailawadi, Gorav; Prager, Richard L; Kron, Irving L

2017-10-01

Thirty-one states approved Medicaid expansion after implementation of the Affordable Care Act. The objective of this study was to evaluate the effect of Medicaid expansion on cardiac surgery volume and outcomes comparing one state that expanded to one that did not. Data from the Virginia (nonexpansion state) Cardiac Services Quality Initiative and the Michigan (expanded Medicaid, April 2014) Society of Thoracic and Cardiovascular Surgeons Quality Collaborative were analyzed to identify uninsured and Medicaid patients undergoing coronary bypass graft or valve operations, or both. Demographics, operative details, predicted risk scores, and morbidity and mortality rates, stratified by state and compared across era (preexpansion: 18 months before vs postexpansion: 18 months after), were analyzed. In Virginia, there were no differences in volume between eras, whereas in Michigan, there was a significant increase in Medicaid volume (54.4% [558 of 1,026] vs 84.1% [954 of 1,135], p Medicaid patients, there were no differences in predicted risk of morbidity or mortality or postoperative major morbidities. In Michigan Medicaid patients, a significant decrease in predicted risk of morbidity or mortality (11.9% [8.1% to 20.0%] vs 11.1% [7.7% to 17.9%], p = 0.02) and morbidities (18.3% [102 of 558] vs 13.2% [126 of 954], p = 0.008) was identified. Postexpansion was associated with a decreased risk-adjusted rate of major morbidity (odds ratio, 0.69; 95% confidence interval, 0.51 to 0.91; p = 0.01) in Michigan Medicaid patients. Medicaid expansion was associated with fewer uninsured cardiac surgery patients and improved predicted risk scores and morbidity rates. In addition to improving health care financing, Medicaid expansion may positively affect patient care and outcomes. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Challenging Scandinavian employment relations

DEFF Research Database (Denmark)

Ibsen, Christian Lyhne; Larsen, Trine Pernille; Madsen, Jørgen Steen

2011-01-01

and employment relations in the Danish, Norwegian and Swedish public sector. In this paper, we argue that although differences exist across the Scandinavian countries, it is evident that they have managed to adopt and implement NPM-inspired reforms without dismantling their universal welfare services and strong......Building on the convergence/divergence approach, this paper examines whether recent new public management (NPM) inspired reforms entailing inter alia cutbacks in the public sector, marketisation and management by performance measures have had significant implications for service provision...... traditions of collective bargaining in the public sector. However, this restructuring is taking its toll on the work environment....

Whole grain foods and health - A Scandinavian perspective

DEFF Research Database (Denmark)

Frølich, Wenche; Aman, Per; Tetens, Inge

2013-01-01

and health effects of the final whole grain products. Future research should consider the specific properties of each cereal and its processing methods to further identify the uniqueness and health potentials of whole grain products. This would enable the authorities to provide more specific food......The food-based dietary guidelines in the Scandinavian countries that recommend an intake of minimum 75 g whole grain per 10 MJ (2,388 kcal) per day are mainly derived from prospective cohort studies where quantitative but little qualitative details are available on whole grain products....... The objective of the current paper is to clarify possible differences in nutritional and health effects of the types of whole grain grown and consumed in the Scandinavian countries. A further objective is to substantiate how processing may influence the nutritional value and potential health effects...

Experiences of Scandinavian nurses in discussing sexuality with patients, clients and residents

DEFF Research Database (Denmark)

Laursen, Birgitte Schantz; Rasmussen, Philippa; Conroy, Tiffany

2017-01-01

REVIEW QUESTION/OBJECTIVE:: The objective of this review is to critically appraise, synthesize, and present the best available evidence to address the question: How do Scandinavian nurses experience discussing sexual issues with patients, residents and clients?......REVIEW QUESTION/OBJECTIVE:: The objective of this review is to critically appraise, synthesize, and present the best available evidence to address the question: How do Scandinavian nurses experience discussing sexual issues with patients, residents and clients?...

A Scandinavian Experience of Register Collaboration: The Nordic Arthroplasty Register Association (NARA)

DEFF Research Database (Denmark)

Havelin, Leif I; Robertsson, Otto; Fenstad, Anne M

2011-01-01

The Nordic (Scandinavian) countries have had working arthroplasty registers for several years. However, the small numbers of inhabitants and the conformity within each country with respect to preferred prosthesis brands and techniques have limited register research.......The Nordic (Scandinavian) countries have had working arthroplasty registers for several years. However, the small numbers of inhabitants and the conformity within each country with respect to preferred prosthesis brands and techniques have limited register research....

Pragmatism: A bridge between Anglo-American and Contintental Philosophy?

NARCIS (Netherlands)

Grube, D.M.

2003-01-01

In this paper, I will restrict myself to interpreting certain features of Margolis’ rich argument. I will discuss only those features that have a direct bearing on his thesis that pragmatism wins the three-sided contest between Anglo-American Philosophy, continental philosophy and pragmatism and, as

Feeding Practices and Expectations among Middle-Class Anglo and Puerto Rican Mothers of 12-Month-Old Infants.

Science.gov (United States)

Schulze, Pamela A.; Harwood, Robin L.; Schoelmerich, Axel

2001-01-01

Investigated differences in beliefs and practices about infant feeding among middle class Anglo and Puerto Rican mothers. Interviews and observations indicated that Anglo mothers reported earlier attainment of self-feeding and more emphasis on child rearing goals related to self-maximization. Puerto Rican mothers reported later attainment of…

Socioeconomic factors associated with outcome after cardiac arrest in patients under the age of 65.

Science.gov (United States)

Uray, Thomas; Mayr, Florian B; Fitzgibbon, James; Rittenberger, Jon C; Callaway, Clifton W; Drabek, Tomas; Fabio, Anthony; Angus, Derek C; Kochanek, Patrick M; Dezfulian, Cameron

2015-08-01

In a prior study of seven North American cities Pittsburgh had the highest crude rate of cardiac arrest deaths in patients 18 to 64 years of age, particularly in neighborhoods with lower socioeconomic status (SES). We hypothesized that lower SES, associated poor health behaviors (e.g., illicit drug use) and pre-existing comorbid conditions (grouped as socioeconomic factors [SE factors]) could affect the type and severity of cardiac arrest, thus outcomes. We retrospectively identified patients aged 18 to 64 years treated for in-hospital (IHCA) and out-of hospital arrest (OHCA) at two Pittsburgh hospitals between January 2010 and July 2012. We abstracted data on baseline demographics and arrest characteristics like place of residence, insurance and employment status. Favorable cerebral performance category [CPC] (1 or 2) was our primary outcome. We examined the associations between SE factors, cardiac arrest variables and outcome as well as post-resuscitation care. Among 415 subjects who met inclusion criteria, unfavorable CPC were more common in patients who were unemployed, had a history of drug abuse or hypertension. In OHCA, favorable CPC was more often associated with presentation with ventricular fibrillation/tachycardia (OR 3.53, 95% CI 1.43-8.74, p = 0.006) and less often associated with non-cardiovascular arrest etiology (OR 0.22, 95% CI 0.08-0.62, p = 0.004). We found strong associations between specific SE factors and arrest factors associated with outcome in OHCA patients only. Significant differences in post-resuscitation care existed based on injury severity, not on SES. SE factors strongly influence type and severity of OHCA but not IHCA resulting in an association with outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Age- and Gender-Specific Unemployment in Scandinavian Countries: An Analysis based on Okun’s Law

DEFF Research Database (Denmark)

Stadtmann, Georg; Hutengs, Oliver

2014-01-01

The paper investigates Scandinavian countries and their male and female unemployment rates. Okun’s law is used to estimate age cohort and gender-specific Okun coefficients to make inference about the business-cycle dependence of young peoples’ unemployment across Scandinavian countries. Results...

Chicano-Mexican Cultural Assimilation and Anglo-Saxon Cultural Dominance.

Science.gov (United States)

Menchaca, Martha

1989-01-01

Examines cultural assimilation in a Mexican and Chicano community in Santa Paula, California. Argues that the assumption of Anglo-Saxon superiority ascribed inferior social positions to Mexican-origin groups and generated conflict among these groups at times, but promoted intergroup unity when social conditions became intolerable. Contains 39…

Bystander efforts and 1-year outcomes in out-of-hospital cardiac arrest

DEFF Research Database (Denmark)

Kragholm, Kristian; Wissenberg, Mads; Mortensen, Rikke N.

2017-01-01

changes in bystander interventions and outcomes. RESULTS Among the 2855 patients who were 30-day survivors of an out-of-hospital cardiac arrest during the period from 2001 through 2012, a total of 10.5% had brain damage or were admitted to a nursing home and 9.7% died during the 1-year follow-up period...

Motivation of Scandinavian Knowledge Workers : a survey of methods and their effectiveness

OpenAIRE

Rasmussen, Frode A S Storesund and Janus G

2011-01-01

The aim of this thesis was to identify and examine contemporary motivational theories and see how they fit to the Scandinavian knowledge worker. Two theories (SDT and 4-drive) were selected for empirical research. One survey of a total of 139 respondents from organisations located in Scandinavia showed that the SDT theory cannot be considered more effective than other motivational theories when it comes to motivation of Scandinavian knowledge workers. It was further shown that 4-drive theory ...

Incremental value of normal adenosine perfusion cardiac magnetic resonance: Long-term outcome.

Science.gov (United States)

Sozzi, Fabiola B; Iacuzio, Laura; Civaia, Filippo; Canetta, Ciro; Berthier, Frederic; Rusek, Stephane; Rossi, Philippe; Lombardi, Federico; Dreyfus, Gilles; Dor, Vincent

2015-06-01

The purpose of the study was to determine the long-term prognostic value of normal adenosine stress cardiac magnetic resonance imaging (CMR) in patients referred for evaluation of myocardial ischemia. We reviewed 300 consecutive patients (age 65 ± 11 years, 74% male) with suspected or known coronary disease and normal wall motion who had undergone adenosine stress CMR negative for ischemia and scar. Most patients were at intermediate risk of coronary artery disease. The end points studied were all causes of mortality and major adverse cardiac events, including cardiac death, myocardial infarction, revascularization, and hospitalization for unstable angina. During a mean follow-up of 5.5 years (mean = 5.4 ± 1.1), 16 patients died because of various causes (cardiac death in 5 patients). Three patients had a nonfatal myocardial infarction, 7 patients were hospitalized for revascularization, and 11 were medically treated for unstable angina. The annual cardiac event rate was 1.3% (0.78% in the first 3 years and 1.9% between the fourth and sixth years). The predictors of major adverse cardiac events in a multivariate analysis model were as follows: advanced age (hazard ratio [HR] 1.15, 95% confidence interval [95% CI] 1.02-1.30), diabetes (HR 17.5, 95% CI 2.2-140), and the habit of smoking (HR 5.9, 95% CI 1.0-35.5). For all causes of mortality, the only predictor was diabetes (HR 11.4, 95% CI 1.76-74.2). Patients with normal stress CMR had an excellent outcome during the 3 years after the study. The cardiac event rate was higher between the fourth and sixth years. Over a 5.5-year period, a low event rate and excellent prognosis occurred in patients with normal adenosine stress CMR. Low- to intermediate-risk patients with a normal CMR are at low risk for subsequent cardiac events. Copyright © 2015 Elsevier Inc. All rights reserved.

Scandinavian SSAI clinical practice guideline on choice of first-line vasopressor for patients with acute circulatory failure

DEFF Research Database (Denmark)

Møller, M H; Claudius, C; Junttila, E

2016-01-01

BACKGROUND: Adult critically ill patients often suffer from acute circulatory failure, necessitating use of vasopressor therapy. The aim of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force for Acute Circulatory Failure was to present clinically relevant...... to recommendations. We assessed the following subpopulations of patients with acute circulatory failure: 1) shock in general, 2) septic shock, 3) cardiogenic shock, 4) hypovolemic shock and 5) other types of shock, including vasodilatory shock. We assessed patient-important outcome measures, including mortality...

Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

Energy Technology Data Exchange (ETDEWEB)

Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)

2014-09-15

Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

The Socio-Cultural Environment for Entrepreneurship: A Comparison Between East Asian and Anglo-Saxon Countries

OpenAIRE

Thomas M Begley; Wee-Liang Tan

2001-01-01

This study uses a theory of face to identify predictors of interest in entrepreneurship in six East Asian and four Anglo-Saxon countries. At the cultural level, social status of entrepreneurship and shame from business failure predict interest in entrepreneurship better in East Asian than Anglo countries. At the individual level, social status predicts interest in entrepreneurship in the entire sample.© 2001 JIBS. Journal of International Business Studies (2001) 32, 537–553

Ethnographic assessment of pain coping responses

DEFF Research Database (Denmark)

Moore, R.

1990-01-01

of these Ss. ((c) 1997 APA/PsycINFO, all rights reserved). Medline: A sample consisting of 54 patients and 31 dentists of Chinese, Anglo-American, and Scandinavian ethnic origin were interviewed about their ways of coping with pain. Instruments designed to assess pain coping were constructed from...

Blood glucose level and outcome after cardiac arrest: insights from a large registry in the hypothermia era.

Science.gov (United States)

Daviaud, Fabrice; Dumas, Florence; Demars, Nadège; Geri, Guillaume; Bouglé, Adrien; Morichau-Beauchant, Tristan; Nguyen, Yên-Lan; Bougouin, Wulfran; Pène, Frédéric; Charpentier, Julien; Cariou, Alain

2014-06-01

The influence of blood glucose (BG) level during the post-resuscitation period after out-of-hospital cardiac arrest (OHCA) is still debated. To evaluate the relationship between blood glucose level and outcome, we included the median glycemia and its maximal amplitude over the first 48 h following ICU admission in an analysis of outcome predictors. We conducted a database study in a cardiac arrest center in Paris, France. Between 2006 and 2010, we included 381 patients who were all resuscitated from an OHCA. A moderate glycemic control was applied in all patients. The median glycemia and the largest change over the first 48 h were included in a multivariate analysis that was performed to determine parameters associated with a favorable outcome. Of the 381 patients, 136 (36 %) had a favorable outcome (CPC 1-2). Median BG level was 7.6 mmol/L (6.3-9.8) in patients with a favorable outcome compared to 9.0 mmol/L (IQR 7.1-10.6) for patients with an unfavorable outcome (p level variation was 7.1 (4.2-11) and 9.6 (5.9-13.6) mmol/L in patients with and without a favorable outcome, respectively (p level over the first 48 h was found to be an independent predictor of poor issue [OR = 0.43; 95 % CI (0.24-0.78), p = 0.006]. Finally a progressive increase in median BG level was associated with a progressive increase in the proportion of patients with a poor outcome. We observed a relationship between high blood glucose level and outcome after cardiac arrest. These results suggest the need to test a strategy combining both control of glycemia and minimization of glycemic variations for its ability to improve post-resuscitation care.

The Extent of Myocardial Injury During Prolonged Targeted Temperature Management After Out-of-Hospital Cardiac Arrest

DEFF Research Database (Denmark)

Grejs, Anders Morten; Gjedsted, Jakob; Thygesen, Kristian

2017-01-01

AIM: The aim of this study is to evaluate the extent of myocardial injury by cardiac biomarkers during prolonged targeted temperature management of 24 hours vs 48 hours after out-of-hospital cardiac arrest. METHODS: This randomized Scandinavian multicenter study compares the extent of myocardial...... injury estimated by hs-cTnTAUC of prolonged targeted temperature management of 48 hours vs 24 hours, although the CK-MBAUC was significantly higher during 48 hours vs 24 hours. Hence, it seems unlikely that the duration of targeted temperature management has a beneficial effect on the extent...... injury quantified by area under the curve (AUC) of cardiac biomarkers during prolonged targeted temperature management at 33°C ± 1°C of 24 hours and 48 hours, respectively. Through a period of 2.5 years, 161 comatose out-of-hospital cardiac arrest patients were randomized to targeted temperature...

Neurological prognostication of outcome in patients in coma after cardiac arrest.

Science.gov (United States)

Rossetti, Andrea O; Rabinstein, Alejandro A; Oddo, Mauro

2016-05-01

Management of coma after cardiac arrest has improved during the past decade, allowing an increasing proportion of patients to survive, thus prognostication has become an integral part of post-resuscitation care. Neurologists are increasingly confronted with raised expectations of next of kin and the necessity to provide early predictions of long-term prognosis. During the past decade, as technology and clinical evidence have evolved, post-cardiac arrest prognostication has moved towards a multimodal paradigm combining clinical examination with additional methods, consisting of electrophysiology, blood biomarkers, and brain imaging, to optimise prognostic accuracy. Prognostication should never be based on a single indicator; although some variables have very low false positive rates for poor outcome, multimodal assessment provides resassurance about the reliability of a prognostic estimate by offering concordant evidence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial

DEFF Research Database (Denmark)

Sever, Peter S; Dahlöf, Björn; Poulter, Neil R

2003-01-01

The lowering of cholesterol concentrations in individuals at high risk of cardiovascular disease improves outcome. No study, however, has assessed benefits of cholesterol lowering in the primary prevention of coronary heart disease (CHD) in hypertensive patients who are not conventionally deemed ...

Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial

DEFF Research Database (Denmark)

Sever, Peter S; Dahlöf, Björn; Poulter, Neil R

2004-01-01

The lowering of cholesterol concentrations in individuals at high risk of cardiovascular disease improves outcome. No study, however, has assessed benefits of cholesterol lowering in the primary prevention of coronary heart disease (CHD) in hypertensive patients who are not conventionally deemed ...

Renal Insufficiency and Early Bystander CPR Predict In-Hospital Outcomes in Cardiac Arrest Patients Undergoing Mild Therapeutic Hypothermia and Cardiac Catheterization: Return of Spontaneous Circulation, Cooling, and Catheterization Registry (ROSCCC Registry

Directory of Open Access Journals (Sweden)

Anjala Chelvanathan

2016-01-01

Full Text Available Objective. Out of hospital cardiac arrest (OHCA patients are a critically ill patient population with high mortality. Combining mild therapeutic hypothermia (MTH with early coronary intervention may improve outcomes in this population. The aim of this study was to evaluate predictors of mortality in OHCA patients undergoing MTH with and without cardiac catheterization. Design. A retrospective cohort of OHCA patients who underwent MTH with catheterization (MTH + C and without catheterization (MTH + NC between 2006 and 2011 was analyzed at a single tertiary care centre. Predictors of in-hospital mortality and neurologic outcome were determined. Results. The study population included 176 patients who underwent MTH for OHCA. A total of 66 patients underwent cardiac catheterization (MTH + C and 110 patients did not undergo cardiac catheterization (MTH + NC. Immediate bystander CPR occurred in approximately half of the total population. In the MTH + C and MTH + NC groups, the in-hospital mortality was 48% and 78%, respectively. The only independent predictor of in-hospital mortality for patients with MTH + C, after multivariate analysis, was baseline renal insufficiency (OR = 8.2, 95% CI 1.8–47.1, and p = 0.009. Conclusion. Despite early cardiac catheterization, renal insufficiency and the absence of immediate CPR are potent predictors of death and poor neurologic outcome in patients with OHCA.

Association between patient unconscious or not alert conditions and cardiac arrest or high-acuity outcomes within the Medical Priority Dispatch System "Falls" protocol.

Science.gov (United States)

Clawson, Jeff; Olola, Christopher; Scott, Greg; Schultz, Bryon; Pertgen, Richard; Robinson, Don; Bagwell, Barry; Patterson, Brett

2010-01-01

Falls are one of the most common types of complaints received by 9-1-1 emergency medical dispatch centers. They can be accidental or may be caused by underlying medical problems. Though "not alert" falls patients with severe outcomes mostly are "hot" transported to the hospital, some of these cases may be due to other acute medical events (cardiac, respiratory, circulatory, or neurological), which may not always be apparent to the emergency medical dispatcher (EMD) during call processing. The objective of this study was to characterize the risk of cardiac arrest and "hot-transport" outcomes in patients with "not alert" condition, within the Medical Priority Dispatch System (MPDS®) Falls protocol descriptors. This retrospective study used 129 months of de-identified, aggregate, dispatch datasets from three US emergency communication centers. The communication centers used the Medical Priority Dispatch System version 11.3-OMEGA type (released in 2006) to interrogate Emergency Medical System callers, select dispatch codes assigned to various response configurations, and provide pre-arrival instructions. The distribution of cases and percentages of cardiac arrest and hot-transport outcomes, categorized by MPDS® code, was profiled. Assessment of the association between MPDS® Delta-level 3 (D-3) "not alert" condition and cardiac arrest and hot-transport outcomes then followed. Overall, patients within the D-3 and D-2 "long fall" conditions had the highest proportions (compared to the other determinants in the "falls" protocol) of cardiac arrest and hot-transport outcomes, respectively. "Not alert" condition was associated significantly with cardiac arrest and hot-transport outcomes (pdeterminant within the MPDS® "fall" protocol was associated significantly with severe outcomes for short falls (falls. As reported to 9-1-1, the complaint of a "fall" may include the presence of underlying conditions that go beyond the obvious traumatic injuries caused by the fall itself.

Words Make a Difference: The Effects of Greco-Latinate and Anglo-Saxon Lexical Variation on College Writing Instructors.

Science.gov (United States)

Maylath, Bruce

1996-01-01

Uses 90 postsecondary writing instructors and their rankings of 9 student essays to determine whether they have biases for a Greco-Latinate or Anglo-Saxon vocabulary. Raises questions about assessment practices, teaching methods, and possible effects on students who are exposed to teachers who variously favor a Greco-Latinate or an Anglo-Saxon…

Effect of maternal age and cardiac disease severity on outcome of pregnancy in women with congenital heart disease.

Science.gov (United States)

Furenäs, Eva; Eriksson, Peter; Wennerholm, Ulla-Britt; Dellborg, Mikael

2017-09-15

There is an increasing prevalence of women with congenital heart defects reaching childbearing age. In western countries women tend to give birth at a higher age compared to some decades ago. We evaluated the CARdiac disease in PREGnancy (CARPREG) and modified World Health Organization (mWHO) risk classifications for cardiac complications during pregnancies in women with congenital heart defects and analyzed the impact of age on risk of obstetric and fetal outcome. A single-center observational study of cardiac, obstetric, and neonatal complications with data from cardiac and obstetric records of pregnancies in women with congenital heart disease. Outcomes of 496 pregnancies in 232 women, including induced abortion, miscarriage, stillbirth, and live birth were analyzed regarding complications, maternal age, mode of delivery, and two risk classifications: CARPREG and mWHO. There were 28 induced abortions, 59 fetal loss, 409 deliveries with 412 neonates. Cardiac (14%), obstetric (14%), and neonatal (15%) complications were noted, including one maternal death and five stillbirths. The rate of cesarean section was 19%. Age above 35years was of borderline importance for cardiac complications (p=0.054) and was not a significant additional risk factor for obstetric or neonatal complications. Both risk classifications had moderate clinical utility, with area under the curve (AUC) 0.71 for CARPREG and 0.65 for mWHO on cardiac complications. Pregnancy complications in women with congenital heart disease are common but severe complications are rare. Advanced maternal age does not seem to affect complication rate. Existing risk classification systems are insufficient in predicting complications. Copyright © 2017 Elsevier B.V. All rights reserved.

Le modèle de la firme-réseau : innovation ou réinvention anglo-saxonne ? The Network Company Model: An Anglo-Saxon Innovation or just a Re-invention?

Directory of Open Access Journals (Sweden)

Olivier de Gromard

2009-10-01

Full Text Available Since the early 1980s, the network company has become more widespread as it is considered the most appropriate organisational structure in a global economy. It is commonly agreed that this type of organisation is an Anglo-Saxon model. The aim of this article is to give some insights into this current opinion, through two complementary analyses: the first one investigates the link between the innovative boost in Anglo-Saxon countries and the creation of the network company model; the second one considers the role of traditional Chinese capitalism in the exceptional economic success of Hong Kong under British sovereignty.

Is the Scandinavian Way of Organizing Challenged by the Growing Chinese Economy?

DEFF Research Database (Denmark)

Westenholz, Ann

2012-01-01

The institutional order of organizing in working life is very different in Scandinavia and China. When Scandinavian and Chinese managers and employees meet in concrete work relations they not only work together on a product they also become engaged in institutional work dealing with the inconsist......The institutional order of organizing in working life is very different in Scandinavia and China. When Scandinavian and Chinese managers and employees meet in concrete work relations they not only work together on a product they also become engaged in institutional work dealing...

Outcome for Fetuses with Prenatally Detected Congenital Heart Disease and Cardiac Arrhythmias in Taiwan

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Sheng-Mou Hsiao

2007-01-01

Conclusion: Outcome for fetuses with prenatally detected CHD remains poor, with the prognosis negatively influenced by the presence of complex heart defects as well as extracardiac and chromosomal anomalies. However, prognosis is good for fetuses with cardiac arrhythmia, except with long QT syndrome or hydrops fetalis.

The Beowulf manuscript reconsidered: Reading Beowulf in late Anglo-Saxon England

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L. Viljoen

2003-08-01

Full Text Available This article defines a hypothetical late Anglo-Saxon audience: a multi-layered Christian community with competing ideologies, dialects and mythologies. It discusses how that audience might have received the Anglo-Saxon poem Beowulf. The immediate textual context of the poem constitutes an intertextual microcosm for Beowulf. The five texts in the codex provide interesting clues to the common concerns, conflicts and interests of its audience. The organizing principle for the grouping of this disparate mixture of Christian and secular texts with Beowulf was not a sense of canonicity or the collating of monuments with an aesthetic autonomy from cultural conditions or social production. They were part of the so-called “popular culture” and provide one key to the “meanings” that interested the late Anglo-Saxon audience, who would delight in the poet=s alliteration, rhythms, word-play, irony and understatement, descriptions, aphorisms and evocation of loss and transience. The poem provided cultural, historical and spiritual data and evoked a debate about pertinent moral issues. The monsters, for instance, are symbolic of problems of identity construction and establish a polarity between “us” and the “Other”, but at the same time question such binary thinking. Finally, the poem works towards an audience identity whose values emerge from the struggle within the poem and therefore also encompass the monstrous, the potentially disruptive, the darkness within B that which the poem attempts to repress.

Continuing Disparities in Cardiovascular Risk Factors and Complications Between Aboriginal and Anglo-Celt Australians With Type 2 Diabetes

Science.gov (United States)

Davis, Timothy M.E.; Hunt, Kerry; McAullay, Daniel; Chubb, Stephen A.P.; Sillars, Brett A.; Bruce, David G.; Davis, Wendy A.

2012-01-01

OBJECTIVE To determine whether disparities in the nature and management of type 2 diabetes persist between Aboriginal and the majority Anglo-Celt patients in an urban Australian community. RESEARCH DESIGN AND METHODS Baseline data from the observational Fremantle Diabetes Study collected from 1993 to 1996 (phase I) and from 2008 to 2011 (phase II) were analyzed. Patients characterized as Aboriginal or Anglo-Celt by self-report and supporting data underwent comprehensive assessment, including questionnaires, examination, and biochemical testing in a single laboratory. Generalized linear modeling with age/sex adjustment was used to examine differences in changes in variables in the two groups between phases I and II. RESULTS The indigenous participants were younger at entry and at diabetes diagnosis than the Anglo-Celt participants in both phases. They were also less likely to be educated beyond primary level and were more likely to be smokers. HbA1c decreased in both groups over time (Aboriginal median 9.6% [interquartile range 7.8–10.7%] to 8.4% [6.6–10.6%] vs. Anglo-Celt median 7.1% [6.2–8.4%] to 6.7% [6.2–7.5%]), but the gap persisted (P = 0.65 for difference between phases I and II by ethnic group). Aboriginal patients were more likely to have microvascular disease in both phases. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.90 or lower-extremity amputation) increased in Aboriginal but decreased in Anglo-Celt participants (15.8–29.7 vs. 30.7–21.5%; P = 0.055). CONCLUSIONS Diabetes management has improved for Aboriginal and Anglo-Celt Australian patients, but disparities in cardiovascular risk factors and complications persist. PMID:22815295

Prenatally Diagnosis and Outcome of Fetuses with Cardiac Rhabdomyoma – Single Centre Experience

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Ramush Bejiqi

2017-03-01

CONCLUSIONS: Cardiac rhabdomyoma are benign from the cardiovascular standpoint in most affected fetuses. An early prenatal diagnosis may help for an adequate planning of perinatal monitoring and treatment with the involvement of a multidisciplinary team. Large tumour size, the number of tumours and localisation may cause hydrops, and they are significantly associated with poor neonatal outcome.

"Folkbildning" through Hip-Hop: How the Ideals of Three Rappers Parallel a Scandinavian Educational Tradition

Science.gov (United States)

Soderman, Johan

2011-01-01

The purpose of this article is to show how the rappers' talk about hip-hop and its connection to pedagogy and social activism parallel the Scandinavian tradition of folkbildning. Scandinavian folkbildning can be seen as a movement to provide voluntary education for the general population. It can also be the name of the process of learning in which…

Dagboeke as oorlogsdokumentasie: Johanna van Warmelo se dagboek en haar belewing van die Anglo-Boereoorlog

OpenAIRE

R. van der Merwe; J. Grobler

1999-01-01

Diaries as historical documentation: Jotianna van Warmelo’s diary and her experience of the Anglo-Boer War Johanna van Warmelo resided in Sunnyside, Pretoria, with her mother virtually throughout the Anglo-Boer War. She was 23 years old when the war broke out. Her fiancé, whom she later married, lived in Holland. Johanna started a diary immediately after the outbreak of the war In this she not only wrote down factual reports, but also her perceptions of the war and the belligerents. The di...

Coalitions and the Decision making Process on the Common Flexicurity Principles

DEFF Research Database (Denmark)

Simonsen, Mikkel Mailand

than the regimes and cut to some extent across the usual division of countries, in that Scandinavian and the Anglo-Saxon countries form the core of one of the coalitions, whereas a number of continental countries - Belgium, Luxembourg, Italy, Greece and Spain - are now found in the core of the other...

Referral to Cardiac Rehabilitation After Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery, and Valve Surgery: Data From the Clinical Outcomes Assessment Program.

Science.gov (United States)

Beatty, Alexis L; Bradley, Steven M; Maynard, Charles; McCabe, James M

2017-06-01

Despite guideline recommendations that patients undergoing percutaneous coronary intervention (PCI), coronary artery bypass surgery, or valve surgery be referred to cardiac rehabilitation, cardiac rehabilitation is underused. The objective of this study was to examine hospital-level variation in cardiac rehabilitation referral after PCI, coronary artery bypass surgery, and valve surgery. We analyzed data from the Clinical Outcomes Assessment Program, a registry of all nonfederal hospitals performing PCI and cardiac surgery in Washington State. We included eligible PCI, coronary artery bypass surgery, and valve surgery patients from 2010 to 2015. We analyzed PCI and cardiac surgery separately by performing multivariable hierarchical logistic regression for the outcome of cardiac rehabilitation referral at discharge, clustered by hospital. Patient-level covariates included age, sex, race/ethnicity, comorbidities, and procedure indication/status. Cardiac rehabilitation referral was reported in 48% (34 047/71 556) of PCI patients and 91% (21 831/23 972) of cardiac surgery patients. The hospital performing the procedure was a stronger predictor of referral than any individual patient characteristic for PCI (hospital referral range 3%-97%; median odds ratio, 5.94; 95% confidence interval, 4.10-9.49) and cardiac surgery (range 54%-100%; median odds ratio, 7.09; 95% confidence interval, 3.79-17.80). Hospitals having an outpatient cardiac rehabilitation program explained only 10% of PCI variation and 0% of cardiac surgery variation. Cardiac rehabilitation referral at discharge was less prevalent after PCI than cardiac surgery. The strongest predictor of cardiac rehabilitation referral was the hospital performing the procedure. Efforts to improve cardiac rehabilitation referral should focus on increasing referral after PCI, especially in low referral hospitals. © 2017 American Heart Association, Inc.

Identifying and Comparing Scandinavian Ethnography: Comparisons and Influences

Science.gov (United States)

Beach, Dennis

2010-01-01

In recent years, there has been a significant growth in the volume of research production in education ethnography in Scandinavia due partly to a regionally financed network. The present article makes some comparisons between Scandinavian and other education research contexts in relation to aspects of general ethnographic design to try to analyse…

Trust, Social Capital and the Scandinavian Welfare State

DEFF Research Database (Denmark)

Svendsen, Gunnar Lind Haase; Svendsen, Gert Tinggaard

personality is characterized both by cooperation in everyday life and the numerous ‘hard-riders’ who make extraordinary contributions. Applying Bourdieuconomics, the authors focus on contemporary case studies to explain how social capital and trust are used to counteract free-riding and enable the flight...... of the Scandinavian welfare state ‘bumblebee’....

AN AFRICAN THERMOPYLAE? THE BATTLES OF THE ANGLO-ZULU WAR, 1879

OpenAIRE

J. Murray

2012-01-01

A traveller to the battlefields of the Anglo-Zulu War in Northern KwaZulu-Natal will come across, at Isandlwana, a memorial to the Natal Carbineers, an infantry regiment that served on the side of the British during the war.

A primitive of Scandinavian Modern?

DEFF Research Database (Denmark)

Christensen, Line Hjorth

2018-01-01

In the web of publications, exhibitions etc. that outlines a Danish design history, Knud V. Engelhardt (1882-1931) takes up a paradoxical position: proclaimed a pioneer, who turned aside historicism and partly the national romanticism of ‘Skønvirke’, his work is said to inhabit a simplicity...... on the Cultural Canon; in this politically initiated context his “tight functionality and soft humanism” was regarded as “characteristic of Scandinavian Modern, the style that Denmark would later become so famous for”. Further, the sparse records and modest research carried out on Engelhardt’s work, are often...

The Impact of Hospital’s Cardiac Specialization on Outcomes after Coronary Artery Bypass Graft Surgery: Analysis of Medicare Claims Data

Science.gov (United States)

Girotra, Saket; Lu, Xin; Popescu, Ioana; Vaughan-Sarrazin, Mary; Horwitz, Phillip A.; Cram, Peter

2011-01-01

Background Hospital volume has been widely embraced as a proxy measure for hospital quality; little attention has been focused on an alternative quality measure-hospital specialization. Even though specialization occurs on a continuum, previous studies have only focused on a small number of highly specialized hospitals (single-specialty hospitals). Studies on the broad relationship between hospital specialization and outcomes after coronary artery bypass grafting (CABG) are limited. Methods and Results We conducted a retrospective cohort study of 705,084 Medicare patients (1130 hospitals) who underwent CABG during 2001-2005. We stratified hospitals into quintiles based on their degree of cardiac specialization (proportion of a hospital’s Medicare discharges classified as Major Diagnostic Category 5 – cardiovascular diseases). We compared patient and hospital characteristics and outcomes across quintiles of cardiac specialization. Patient characteristics were generally similar across quintiles, but mean annual CABG volume increased progressively from quintile 1 (least-specialized) to quintile 5 (most-specialized). Unadjusted 30-day mortality was similar at hospitals in quintiles 1-4 (4.8%), except quintile 5 where mortality was lower (4.3%). A strong inverse association was seen between hospital cardiac specialization and 30-day mortality after adjustment for patient characteristics (P trend=0.001). However, this was no longer significant after additional adjustment for CABG volume (P trend=0.65). Results were similar for other mortality outcomes and length of stay. Conclusions After accounting for patient characteristics and CABG volume, greater cardiac specialization was not associated with clinically significant improvement in patient outcomes. This study calls into question the benefit of cardiac specialization for the vast majority of CABG-performing U.S. hospitals. PMID:20923993

Revisiting blood transfusion and predictors of outcome in cardiac surgery patients: a concise perspective [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

Carlos E Arias-Morales

2017-02-01

Full Text Available In the United States, cardiac surgery-related blood transfusion rates reached new highs in 2010, with 34% of patients receiving blood products. Patients undergoing both complex (coronary artery bypass grafting [CABG] plus valve repair or replacement and non-complex (isolated CABG cardiac surgeries are likely to have comorbidities such as anemia. Furthermore, the majority of patients undergoing isolated CABG have a history of myocardial infarction. These characteristics may increase the risk of complications and blood transfusion requirement. It becomes difficult to demonstrate the association between transfusions and mortality because of the fact that most patients undergoing cardiac surgery are also critically ill. Transfusion rates remain high despite the advances in perioperative blood conservation, such as the intraoperative use of cell saver in cardiac surgery. Some recent prospective studies have suggested that the use of blood products, even in low-risk patients, may adversely affect clinical outcomes. In light of this information, we reviewed the literature to assess the clinical outcomes in terms of 30-day and 1-year morbidity and mortality in transfused patients who underwent uncomplicated CABG surgery.

The Language Environments of Exchange Students at some Scandinavian Universities

DEFF Research Database (Denmark)

Caudery, Tim; Petersen, Margrethe; Shaw, Philip

Language Environments of Exchange Students at Scandinavian Universities One aspect of, and one reason for, the internationalisation of Scandinavian universities is the increasing number of exchange students and postgraduates from outside Scandinavia attending courses here. Few of these students...... are primarily motivated by a desire to learn the local language. In fact it is widely believed that many of them live in a lingua-franca English-speaking environment, so that Erasmus contributes to linguistic homogenisation rather than plurilingualism. This paper reports results of an ongoing study...... of the language environment and language learning experiences of some hundred (so far) Erasmus exchange students in two institutions in Sweden and two in Denmark. Subjects had French, German and Spanish as mother tongues. This design is intended to enable the identification of language/culturespecific factors...

A Fragmentary Archive: Migratory Feelings in Early Anglo-Saxon Women's Letters.

Science.gov (United States)

Watt, Diane

2017-01-01

The letters by Anglo-Saxon women in the Boniface correspondence are connected by cultural practices and emotions centered on the conversion mission that functioned to maintain connections between the Anglo-Saxon diaspora. A striking recurring focus of these letters is on loss and isolation, which connects them to the Old English elegies. Many of the letters describe the writers' traumatic experiences that result from the death or absence of kin. These are women who endured the trauma of being left behind when others migrated overseas or who, in traveling away from their homeland, found themselves isolated in an alien environment, displaced in time as well as space. This article offers an analysis of the letters, focusing on the queer temporalities they explore, the queer emotions they evoke, and the queer kinships that they forge. It argues that the women's letters represent fragments of an early queer archive of migratory feelings.

Effect of preoperative angina pectoris on cardiac outcomes in patients with previous myocardial infarction undergoing major noncardiac surgery (data from ACS-NSQIP).

Science.gov (United States)

Pandey, Ambarish; Sood, Akshay; Sammon, Jesse D; Abdollah, Firas; Gupta, Ena; Golwala, Harsh; Bardia, Amit; Kibel, Adam S; Menon, Mani; Trinh, Quoc-Dien

2015-04-15

The impact of preoperative stable angina pectoris on postoperative cardiovascular outcomes in patients with previous myocardial infarction (MI) who underwent major noncardiac surgery is not well studied. We studied patients with previous MI who underwent elective major noncardiac surgeries within the American College of Surgeons-National Surgical Quality Improvement Program (2005 to 2011). Primary outcome was occurrence of an adverse cardiac event (MI and/or cardiac arrest). Multivariable logistic regression models evaluated the impact of stable angina on outcomes. Of 1,568 patients (median age 70 years; 35% women) with previous MI who underwent major noncardiac surgery, 5.5% had postoperative MI and/or cardiac arrest. Patients with history of preoperative angina had significantly greater incidence of primary outcome compared to those without anginal symptoms (8.4% vs 5%, p = 0.035). In secondary outcomes, reintervention rates (22.5% vs 11%, p angina. In multivariable analyses, preoperative angina was a significant predictor for postoperative MI (odds ratio 2.49 [1.20 to 5.58]) and reintervention (odds ratio 2.40 [1.44 to 3.82]). In conclusion, our study indicates that preoperative angina is an independent predictor for adverse outcomes in patients with previous MI who underwent major noncardiac surgery, and cautions against overreliance on predictive tools, for example, the Revised Cardiac Risk Index, in these patients, which does not treat stable angina and previous MI as independent risk factors during risk prognostication. Copyright © 2015 Elsevier Inc. All rights reserved.

Electroencephalography Predicts Poor and Good Outcomes After Cardiac Arrest: A Two-Center Study.

Science.gov (United States)

Rossetti, Andrea O; Tovar Quiroga, Diego F; Juan, Elsa; Novy, Jan; White, Roger D; Ben-Hamouda, Nawfel; Britton, Jeffrey W; Oddo, Mauro; Rabinstein, Alejandro A

2017-07-01

The prognostic role of electroencephalography during and after targeted temperature management in postcardiac arrest patients, relatively to other predictors, is incompletely known. We assessed performances of electroencephalography during and after targeted temperature management toward good and poor outcomes, along with other recognized predictors. Cohort study (April 2009 to March 2016). Two academic hospitals (Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Mayo Clinic, Rochester, MN). Consecutive comatose adults admitted after cardiac arrest, identified through prospective registries. All patients were managed with targeted temperature management, receiving prespecified standardized clinical, neurophysiologic (particularly, electroencephalography during and after targeted temperature management), and biochemical evaluations. We assessed electroencephalography variables (reactivity, continuity, epileptiform features, and prespecified "benign" or "highly malignant" patterns based on the American Clinical Neurophysiology Society nomenclature) and other clinical, neurophysiologic (somatosensory-evoked potential), and biochemical prognosticators. Good outcome (Cerebral Performance Categories 1 and 2) and mortality predictions at 3 months were calculated. Among 357 patients, early electroencephalography reactivity and continuity and flexor or better motor reaction had greater than 70% positive predictive value for good outcome; reactivity (80.4%; 95% CI, 75.9-84.4%) and motor response (80.1%; 95% CI, 75.6-84.1%) had highest accuracy. Early benign electroencephalography heralded good outcome in 86.2% (95% CI, 79.8-91.1%). False positive rates for mortality were less than 5% for epileptiform or nonreactive early electroencephalography, nonreactive late electroencephalography, absent somatosensory-evoked potential, absent pupillary or corneal reflexes, presence of myoclonus, and neuron-specific enolase greater than 75 µg/L; accuracy was highest for

Profiling vocabulary in psychology journal abstracts: A comparison between Iranian and Anglo-American journals

Directory of Open Access Journals (Sweden)

Is’haaq Akbarian

2017-01-01

Full Text Available Lexical profiling has yielded fruitful results for language description and pedagogy (Liu, 2014, and particularly highlighted the significance of academic vocabulary for EFL learners in this process. This investigation, likewise, attempts to comparatively profile the vocabulary, more particularly the academic vocabulary, in the ‘abstract’ section of scholarly articles in Iranian and Anglo-American refereed journals in psychology. Iranian journals under study publish articles in Persian but also include an English abstract whereas the latter publish papers in English. For this purpose, a corpus (consisting of 307,126 words, with two sub-corpora of almost similar size and characteristics, was collected from Iranian and Anglo-American journals and analyzed through the software Range. The analyses conducted show a coverage of over 15 percent and the use of over 500 words of the Academic Word List (AWL in both Iranian and Anglo-American sub-corpora. However, there are variations in academic and nonacademic vocabulary use in abstracts across the two sub-corpora above. Most of the academic words used belong to the beginning AWL sub-lists. Pedagogical implications are made for reading and writing, particularly in EAP contexts.

SCANDINAVIAN MIGRATION IN THE VIKING AGE

Directory of Open Access Journals (Sweden)

Wladyslaw Duczko

2011-01-01

Full Text Available Movements of Scandinavians in period between late 8th AD to middle of 11th AD, called Viking Age, were combined military actions-piracy – and migrations with goal to colonize territories in the West Europe – mainly Insular world of Atlantic and British isles, but also in East Europe, among Finno-Ugrians and Slavs. This activity is seen as the recent, and last, of the Migration Period, the time of great movements of Germanic people in the 4th century AD.

Seventh Scandinavian Conference on Artificial Intelligence

DEFF Research Database (Denmark)

Lund, Henrik Hautop; Mayoh, Brian Henry; Perram, John

2001-01-01

The book covers the seventh Scandinavian Conference on Artificial Intelligence, held at the Maersk Mc-Kinney Moller Institute for Production Technology at the University of Southern Denmark during the period 20-21 February, 2001. It continues the tradition established by SCAI of being one...... of the most important regional AI conferences in Europe, attracting high quality submissions from Scandinavia and the rest of the world, including the Baltic countries. The contents include robotics, sensor/motor intelligence, evolutionary robotics, behaviour-based systems, multi-agent systems, applications...

Risk-taking attitudes and their association with process and outcomes of cardiac care: a cohort study

Directory of Open Access Journals (Sweden)

Knudtson Merril L

2009-08-01

Full Text Available Abstract Background Prior research reveals that processes and outcomes of cardiac care differ across sociodemographic strata. One potential contributing factor to such differences is the personality traits of individuals within these strata. We examined the association between risk-taking attitudes and cardiac patients' clinical and demographic characteristics, the likelihood of undergoing invasive cardiac procedures and survival. Methods We studied a large inception cohort of patients who underwent cardiac catheterization between July 1998 and December 2001. Detailed clinical and demographic data were collected at time of cardiac catheterization and through a mailed survey one year post-catheterization. The survey included three general risk attitude items from the Jackson Personality Inventory. Patients' (n = 6294 attitudes toward risk were categorized as risk-prone versus non-risk-prone and were assessed for associations with baseline clinical and demographic characteristics, treatment received (i.e., medical therapy, coronary artery bypass graft (CABG surgery, percutaneous coronary intervention (PCI, and survival (to December 2005. Results 2827 patients (45% were categorized as risk-prone. Having risk-prone attitudes was associated with younger age (p Conclusion These exploratory findings suggest that patient attitudes toward risk taking may contribute to some of the documented differences in use of invasive cardiac procedures. An awareness of these associations could help healthcare providers as they counsel patients regarding cardiac care decisions.

Income inequality and income mobility in the Scandinavian countries compared to the United States

OpenAIRE

Aaberge, Rolf; Björklund, Anders; Jäntti, Markus; Palme, Mårten; Pedersen, Peder J.; Smith, Nina; Wennemo, Tom

1996-01-01

This paper compares income inequality and income mobility in the Scandinavian countries and the United States during the 1980's. The results demonstrate that inequality is greater in the United States than in the Scandinavian countries and that the ranking of countries with respect to inequality remains unchanged when the accounting period of income is extended from one to 11 years. The pattern of mobility turns out to be remarkably similar despite major differences in labor market and social...

The centrality of the nurse-patient relationship: A Scandinavian perspective.

Science.gov (United States)

Uhrenfeldt, Lisbeth; Sørensen, Erik Elgaard; Bahnsen, Iben Bøgh; Pedersen, Preben Ulrich

2018-04-06

To address aspects of importance in the nurse-patient relationship, as conceptualised within the Scandinavian healthcare context. An experiment in Beth Israel Hospital uncovered a set of core values (ontology) that were wiped away by stronger forces. Despite this, some of the ideas impacted the development of nursing thought and values in the Scandinavian countries, partly because they connected with deeper social values and also because investment was being put into explicitly identifying and understanding the core elements of nursing (ontology) and how to provide evidence that they found were important (epistemology). From that beginning and through the work of key thought leaders, Scandinavian nursing is ready to embark on a new phase, which could be helped by the Fundamentals of Care framework. This discursive position study offers insights from a public healthcare setting, influenced by values such as equal rights to equal care and/or cure. This study presents two complementing perspectives: an ontological and an epistemological, on establishing caring relationships. There are different pathways to follow in building person-oriented care; however, the nursing approach is both ontologically and epistemologically grounded and based on dialogue. Patients meet different nurses, the meeting may be short and, routine actions may be on the agenda. However, nurses must engage with patients' experiences and knowledge, in order to add to patients' present and future well-being with their person-oriented care. © 2018 John Wiley & Sons Ltd.

Development of a diagnosis- and procedure-based risk model for 30-day outcome after pediatric cardiac surgery.

Science.gov (United States)

Crowe, Sonya; Brown, Kate L; Pagel, Christina; Muthialu, Nagarajan; Cunningham, David; Gibbs, John; Bull, Catherine; Franklin, Rodney; Utley, Martin; Tsang, Victor T

2013-05-01

The study objective was to develop a risk model incorporating diagnostic information to adjust for case-mix severity during routine monitoring of outcomes for pediatric cardiac surgery. Data from the Central Cardiac Audit Database for all pediatric cardiac surgery procedures performed in the United Kingdom between 2000 and 2010 were included: 70% for model development and 30% for validation. Units of analysis were 30-day episodes after the first surgical procedure. We used logistic regression for 30-day mortality. Risk factors considered included procedural information based on Central Cardiac Audit Database "specific procedures," diagnostic information defined by 24 "primary" cardiac diagnoses and "univentricular" status, and other patient characteristics. Of the 27,140 30-day episodes in the development set, 25,613 were survivals, 834 were deaths, and 693 were of unknown status (mortality, 3.2%). The risk model includes procedure, cardiac diagnosis, univentricular status, age band (neonate, infant, child), continuous age, continuous weight, presence of non-Down syndrome comorbidity, bypass, and year of operation 2007 or later (because of decreasing mortality). A risk score was calculated for 95% of cases in the validation set (weight missing in 5%). The model discriminated well; the C-index for validation set was 0.77 (0.81 for post-2007 data). Removal of all but procedural information gave a reduced C-index of 0.72. The model performed well across the spectrum of predicted risk, but there was evidence of underestimation of mortality risk in neonates undergoing operation from 2007. The risk model performs well. Diagnostic information added useful discriminatory power. A future application is risk adjustment during routine monitoring of outcomes in the United Kingdom to assist quality assurance. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Population genomics of the inbred Scandinavian wolf

OpenAIRE

Hagenblad, Jenny; Olsson, Maria; Parker, Heidi G.; Ostrander, Elaine A.; Ellegren, Hans

2009-01-01

The Scandinavian wolf population represents one of the genetically most well characterized examples of a severely bottlenecked natural population (with only two founders), and of how the addition of new genetic material (one immigrant) can at least temporarily provide a “genetic rescue”. However, inbreeding depression has been observed in this population and in the absence of additional immigrants, its long-term viability is questioned. To study the effects of inbreeding and selection on geno...

Acidity of Scandinavian precipitation

Energy Technology Data Exchange (ETDEWEB)

Barrett, E; Bordin, G

1955-01-01

Data on the pH of the total monthly precipitation at stations of a Swedish network for sampling and chemical analysis of precipitation and atmospheric aerosols during the year July 1953 to June 1954 are presented and discussed, together with the pH data from the first two months of operation of a large pan-Scandinavian net. It is found that well-defined regions of acidity and alkalinity relative to the pH of water in equilibrium with atmospheric carbon dioxide exist, and that these regions persist to such an extent that the monthly deviations from the pattern of the annual mean pH at stations unaffected by local pollution show persistently high acidity, while inland northern stations show equally persistent alkalinity. Some possible reasons for the observed distributions are considered.

Resuscitation outcomes of reproductive-age females who experienced out-of-hospital cardiac arrest.

Science.gov (United States)

Hagihara, Akihito; Onozuka, Daisuke; Hasegawa, Manabu; Nagata, Takashi; Abe, Takeru; Nabeshima, Yoshihiro

2017-03-01

Although some studies have shown that women in their reproductive years have better resuscitation outcomes of out-of-hospital cardiac arrest (OHCA), conflicting results and methodological problems have also been noted. Thus, we evaluated the resuscitation outcomes of OHCA of females by age. This was a prospective observational study using registry data from all OHCA cases between 2005 and 2012 in Japan. The subjects were females aged 18-110 years who suffered an out-of-hospital cardiac arrest. Logistic regression analyses were performed using total and propensity-matched patients. There were 381,123 OHCA cases that met the inclusion criteria. Among propensity-matched patients, females aged 18-49 and 50-60 years of age had similar rates of return of spontaneous circulation before hospital arrival and 1-month survival (all p>0.60). In contrast, females aged 18-49 years of age had significantly lower rates of 1-month survival with minimal neurological impairment than did females aged 50-60 years of age (after adjusting for selected variables: Cerebral Performance Category scale 1 or 2 (CPC (1, 2)), OR=0.45, p=0.020; Overall Performance Category scale 1 or 2 (OPC (1, 2)): OR=0.42, p= 0.014; after adjustment for all variables: CPC (1, 2), OR=0.27, p= 0.008; OPC (1, 2), OR=0.29, p=0.009). Women of reproductive age did not show improved resuscitation outcomes in OHCA. Additionally, women in their reproductive years showed worse neurological outcomes one month after the event, which may be explained by the negative effects of estrogen. These findings need to be verified in further studies.

Costs and outcomes after cardiac surgery in patients refusing transfusion compared with those who do not: a case-matched study.

Science.gov (United States)

Guinn, Nicole R; Roberson, Russell S; White, William; Cowper, Patricia A; Broomer, Bob; Milano, Carmelo; Chiricolo, Antonio; Hill, Steven

2015-12-01

Although numerous studies have demonstrated the feasibility of cardiac surgery for blood refusal patients, few studies match to controls, and fewer examine cost. This historical cohort study aims to compare costs and outcomes after cardiac surgery in Jehovah's Witness patients who refuse blood transfusion with a group of matched patients accepting transfusion. A retrospective database review was performed to find all patients having cardiac surgery who refused blood products from January 2005 to July 2012 at Duke University Medical Center. These 45 patients were closely matched 1:2 with controls who accepted transfusion based on characteristics likely to influence transfusion. Cost from day of surgery to hospital discharge and other outcome data (length of stay [LOS], discharge hemoglobin [Hb], acute kidney injury) were analyzed retrospectively. Forty-five Witnesses having cardiac surgery were temporally matched to two controls having the same surgery. Median euroSCORE was the same in both groups (6.0, p = 0.9981). In the matched-pairs comparison of cost, there was no significant difference in total cost for Witnesses and controls. There was no difference in intensive care unit LOS (median, 1 day, both groups) or total LOS (median, 9 days for Witnesses vs. 7 days for controls). Mean Hb at discharge was higher in Witnesses than in controls (11.7 g/dL vs. 9.8 g/dL, p conservation measures, cardiac surgery may be performed with similar outcomes and cost from day of surgery to discharge compared to controls in select patients without blood transfusion. © 2015 AABB.

Development and validation of risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team.

Science.gov (United States)

Harrison, David A; Patel, Krishna; Nixon, Edel; Soar, Jasmeet; Smith, Gary B; Gwinnutt, Carl; Nolan, Jerry P; Rowan, Kathryn M

2014-08-01

The National Cardiac Arrest Audit (NCAA) is the UK national clinical audit for in-hospital cardiac arrest. To make fair comparisons among health care providers, clinical indicators require case mix adjustment using a validated risk model. The aim of this study was to develop and validate risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team in UK hospitals. Risk models for two outcomes-return of spontaneous circulation (ROSC) for greater than 20min and survival to hospital discharge-were developed and validated using data for in-hospital cardiac arrests between April 2011 and March 2013. For each outcome, a full model was fitted and then simplified by testing for non-linearity, combining categories and stepwise reduction. Finally, interactions between predictors were considered. Models were assessed for discrimination, calibration and accuracy. 22,479 in-hospital cardiac arrests in 143 hospitals were included (14,688 development, 7791 validation). The final risk model for ROSC>20min included: age (non-linear), sex, prior length of stay in hospital, reason for attendance, location of arrest, presenting rhythm, and interactions between presenting rhythm and location of arrest. The model for hospital survival included the same predictors, excluding sex. Both models had acceptable performance across the range of measures, although discrimination for hospital mortality exceeded that for ROSC>20min (c index 0.81 versus 0.72). Validated risk models for ROSC>20min and hospital survival following in-hospital cardiac arrest have been developed. These models will strengthen comparative reporting in NCAA and support local quality improvement. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

A longitudinal experimental study comparing the effectiveness of happiness-enhancing strategies in Anglo Americans and Asian Americans.

Science.gov (United States)

Boehm, Julia K; Lyubomirsky, Sonja; Sheldon, Kennon M

2011-11-01

Growing evidence suggests that well-being interventions can be effective. However, it is unclear whether happiness-increasing practices are equally effective for individuals from different cultural backgrounds. To investigate this question, Anglo Americans and predominantly foreign-born Asian Americans were randomly assigned to express optimism, convey gratitude, or list their past experiences (control group). Multilevel analyses indicated that participants in the optimism and gratitude conditions reported enhanced life satisfaction relative to those in the control condition. However, Anglo Americans in the treatment conditions demonstrated larger increases in life satisfaction relative to Asian Americans, while both cultural groups in the control condition showed the least improvement. These results are consistent with the idea that the value individualist cultures place on self-improvement and personal agency bolsters the efforts of Anglo Americans to become more satisfied, whereas collectivist cultures' de-emphasis of self-focus and individual goals interferes with the efforts of Asian Americans to pursue enhanced well-being.

Unstandardized treatment of electroencephalographic status epilepticus does not improve outcome of comatose patients after cardiac arrest

NARCIS (Netherlands)

Hofmeijer, Jeannette; Cloostermans, M.C.; Beishuizen, A.; van Putten, Michel Johannes Antonius Maria

2014-01-01

Objective: Electroencephalographic status epilepticus occurs in 9–35% of comatose patients after cardiac arrest. Mortality is 90–100%. It is unclear whether (some) seizure patterns represent a condition in which anti-epileptic treatment may improve outcome, or severe ischemic damage, in which

The Derivation of Scandinavian Object Shift and Remnant VP-Topicalisation

DEFF Research Database (Denmark)

Engels, Eva; Vikner, Sten

2013-01-01

Based on the examination of remnant VP-topicalization constructions, this chapter argues for an order preservation analysis to Scandinavian Object Shift. Reviewing Fox and Pesetsky’s (2003, 2005) cyclic linearization approach and extending the empirical data base, we show that the phenomena are b...

Factors Promoting Survival After Prolonged Resuscitation Attempts: A Case of Survival With Good Neurological Outcome Following 60 Minutes of Downtime After Out-of-Hospital Cardiac Arrest.

Science.gov (United States)

Bell, Douglas; Gluer, Robert; Murdoch, Dale

2018-03-01

Sudden cardiac arrest is a significant cause of death affecting approximately 25,000 people in Australia annually. We present an out-of-hospital cardiac arrest (OHCA) with prolonged down time and recurrent ventricular arrhythmias treated with extra-corporeal membrane oxygenation. The patient survived to hospital discharge with good neurological outcome. The patient's excellent outcome was a result of immediate good quality CPR, high level premorbid function, reversible cause of arrest and rapid access to an ECMO centre. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Transcript of Audio Narrative Portion of: Scandinavian Heritage. A Set of Five Audio-Visual Film Strip/Cassette Presentations.

Science.gov (United States)

Anderson, Gerald D.; Olson, David B.

The document presents the transcript of the audio narrative portion of approximately 100 interviews with first and second generation Scandinavian immigrants to the United States. The document is intended for use by secondary school classroom teachers as they develop and implement educational programs related to the Scandinavian heritage in…

Komparativ analyse - Scandinavian Airlines & Norwegian Air Shuttle

OpenAIRE

Kallesen, Martin Nystrup; Singh, Ravi Pal; Boesen, Nana Wiaberg

2017-01-01

The project is based around a pondering of how that a company the size of Scandinavian Airlines or Norwegian Air Shuttle use their Finances and how they see their external environment. This has led to us researching the relationship between the companies and their finances as well as their external environment, and how they differ in both.To do this we have utilised a myriad of different methods to analyse the companies, including PESTEL, SWOT, TOWS; DCF, risk analysis, Sensitivity, Porter’s ...

Scandinavian Approaches to Gender Equality in Academia

DEFF Research Database (Denmark)

Nielsen, Mathias Wullum

2017-01-01

This study investigates how Denmark, Norway, and Sweden approach issues of gender equality in research differently. Based on a comparative document analysis of gender equality activities in six Scandinavian universities, together with an examination of the legislative and political frameworks...... surrounding these activities, the article provides new insights into the respective strategies for governing and promoting the advancement of women researchers. In doing so, it exposes some interesting disparities among the cases and shows how Norwegian and Swedish gender equality activities revolve around...

The transnational grip on Scandinavian education reforms

DEFF Research Database (Denmark)

Krejsler, John B.; Olsson, Ulf; Petersson, Kenneth

2014-01-01

This article reveals how templates that emerge from opaque albeit often inclusive policy processes in transnational forums (EU, OECD & the Bologna Process) affect education reform policy in Scandinavian countries, such as Denmark and Sweden. The open method of coordination is the mother template...... of the political technologies (standards, performance indicators, scorecards, best practices) that are instrumental in fashioning reforms. This template commits countries in consensus-making ways to comparison, and normalizes the competitive incentive of mutual peer pressure. The authors draw on post...

The CEO of Anglo American on getting serious about safety.

Science.gov (United States)

Carroll, Cynthia

2012-06-01

When Carroll became the EO of Anglo American, in 2007, the company had suffered 200 worker fatalities over the previous five years. Some company veterans insisted that deaths were inevitable at such a large mining company, given the dangerous nature of the business. Carroll fundamentally rejected that assumption. She undertook a tour of operations in Australia, Chile, Colombia, Venezuela, and South Africa. The platinum business in South Africa had the worst track record in terms of safety, and Carroll was troubled by her conversations with its local managers. Immediately after her visit, another worker died. That was it. She ordered the world's largest platinum mine, which employed 30,000 people, to be shut down immediately. Intensive retraining began, and 3,000 leaders and 12,000 line managers, supervisors, and frontline employees have been through the program since 2008. Carroll also initiated the Tripartite Alliance, a collaboration with the South African Department of Mineral Resources and the National Union of Mineworkers, to study global best practices in safety and make recommendations. By 2011 she had reduced fatalities at Anglo American by 62% and had cut time lost owing to injuries by half.

Strategic management competencies in Scandinavian contractors

DEFF Research Database (Denmark)

Koch, Christian; Buhl, Henrik

2013-01-01

Over the past ten years, a series of contractors operating in Denmark, Norway and Sweden have slowly but surely expanded their markets beyond their previous single-country base towards operating in Scandinavia as a whole, and beyond. This expansion has been accompanied by a restructuring of company...... management and HR concepts and approaches. Methodologically, a sample of the top level leaders of the hundred largest business units at some thirty Scandinavian contractors has been analysed. The focus is on the 400 top level managers in these organisations. On the basis of a desk study, an analysis of 124...

Lost in translation?: Comparing three Scandinavian translations of the Beliefs about Medicines Questionnaire.

Science.gov (United States)

Granas, Anne Gerd; Nørgaard, Lotte Stig; Sporrong, Sofia Kälvemark

2014-08-01

The "Beliefs about Medicines Questionnaire" (BMQ) assess balance of necessity and concern of medicines. The BMQ has been translated from English to many languages. However, the original meaning of statements, such as "My medicine is a mystery to me", may be lost in translation. The aim of this study is to compare three Scandinavian translations of the BMQ. (1) How reliable are the translations? (2) Are they still valid after translation? Translated Norwegian, Swedish and Danish versions of the BMQ were scrutinized by three native Scandinavian researchers. Linguistic differences and ambiguities in the 5-point Likert scale and the BMQ statements were compared. In the Scandinavian translations, the Likert scale expanded beyond the original version at one endpoint (Swedish) or both endpoints (Danish). In the BMQ statements, discrepancies ranged from smaller inaccuracies toward completely different meaning. Some dissimilarities reflect different cultural beliefs about medicines. When translating questionnaires, bilingual researchers should scrutinize translations across similar languages to address content validity across different countries and languages. Our findings are of relevance to other BMQ translations in non-English countries, as direct comparisons between different translations might not be reliable or valid. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Scandinavian Approaches to Gender Equality in Academia: A Comparative Study

Science.gov (United States)

Nielsen, Mathias Wullum

2017-01-01

This study investigates how Denmark, Norway, and Sweden approach issues of gender equality in research differently. Based on a comparative document analysis of gender equality activities in six Scandinavian universities, together with an examination of the legislative and political frameworks surrounding these activities, the article provides new…

Vegetation change in northern KwaZulu-Natal since the Anglo-Zulu ...

African Journals Online (AJOL)

The quality of the landscape is declining in many grassland and savanna areas of Africa as a consequence of woody plant encroachment. We investigated the changes in vegetation at selected sites on the battlefields of the Anglo-Zulu War of 1879 in KwaZulu-Natal. We used fixed-point repeat photographs to compare the ...

Improving outcomes from out-of-hospital cardiac arrest in young children and adolescents.

Science.gov (United States)

Atkins, Dianne L; Berger, Stuart

2012-03-01

Out-of-hospital cardiac arrest (OHCA) is an unusual but devastating occurrence in a young person. Years of life-lost are substantial and long-term health care costs of survivors can be high. However, there have been noteworthy improvements in cardiopulmonary resuscitation (CPR) standards, out-of hospital care, and postcardiac arrest therapies that have resulted in a several-fold improvement in resuscitation outcomes. Recent interest and research in resuscitation of children has the promise of generating improvements in the outcomes of these patients. Integrated and coordinated care in the out-of-hospital and hospital settings are required. This article will review the epidemiology of OHCA, the 2010 CPR guidelines, and developments in public access defibrillation for children.

Prenatally Diagnosis and Outcome of Fetuses with Cardiac Rhabdomyoma – Single Centre Experience

Science.gov (United States)

Bejiqi, Ramush; Retkoceri, Ragip; Bejiqi, Hana

2017-01-01

BACKGROUND Cardiac rhabdomyoma (CRs) are the most common primary tumour of the heart in infants and children. Usually are multiple and, basing on the location can cause a haemodynamic disturbance, dysrhythmias or heart failure during the fetal and early postnatal period. CRs have a natural history of spontaneous regression and are closely associated with tuberous sclerosis complex (TSC). It has an association with tuberous sclerosis (TS), and in those, the tumour may regress and disappear completely, or remain consistent in size. AIM: We aimed to evaluate the prenatal diagnosis, clinical presentation and outcome of CRs and their association with TSC in a single centre. The median follow-up period was three years (range: 6 months - 5 years). MATERIAL AND METHODS: We reviewed medical records of all fetuses diagnosed prenatally with cardiac rhabdomyoma covering the period January 2010 to December 2016 which had undergone detailed ultrasound evaluation at a single centre with limited technical resources. RESULTS: Twelve fetuses were included in the study; mostly had multiple tumours and a total of 53 tumours were identified in all patients - the maximum was one fetus with16 tumours. All patients were diagnosed prenatally by fetal echocardiography. In two patient’s haemodynamic disturbances during the fetal period was noted and pregnancies have been terminated. After long consultation termination of pregnancy was chosen by the parents in totally 8 cases. In four continuing pregnancies during the first year of live tumours regressed. TSC was diagnosed in all patients during the follow-up. CONCLUSIONS: Cardiac rhabdomyoma are benign from the cardiovascular standpoint in most affected fetuses. An early prenatal diagnosis may help for an adequate planning of perinatal monitoring and treatment with the involvement of a multidisciplinary team. Large tumour size, the number of tumours and localisation may cause hydrops, and they are significantly associated with poor

Ambulance cardiopulmonary resuscitation: outcomes and associated factors in out-of-hospital cardiac arrest.

Science.gov (United States)

Rosell Ortiz, Fernando; García Del Águila, Javier; Fernández Del Valle, Patricia; J Mellado-Vergel, Francisco; Vergara-Pérez, Santiago; R Ruiz-Montero, María; Martínez-Lara, Manuela; J Gómez-Jiménez, Francisco; Gonzáez-Lobato, Ismael; García-Escudero, Guillermo; Ruiz-Bailén, Manuel; Caballero-García, Auxiliadora; Vivar-Díaz, Itziar; Olavarría-Govantes, Luis

2018-06-01

To assess factors associated with survival of out-of-hospital cardiac arrest (OHCA) in patients who underwent cardiopulmonary resuscitation (CPR) during ambulance transport. Retrospective analysis of a registry of OHCA cases treated between 2008 and 2014. We included patients who had not recovered circulation at the time it was decided to transport to a hospital and who were rejected as non-heart-beating donors. Multivariate analysis was used to explore factors associated with the use of ambulance CPR, survival, and neurologic outcome. Out of a total of 7241 cases, 259 (3.6%) were given CPR during emergency transport. The mean (SD) age was 51.6 (23.6) years; 27 (10.1%) were aged 16 years or younger. The following variables were associated with the use of CPR during transport: age 16 years or under (odds ratio [OR], 6.48; 95% CI, 3.91-10.76); P<.001)], witnessed OHCA (OR, 1.62; 95% CI, 1.16-2.26; P=.004), cardiac arrest outside the home (OR, 3.17; 95% CI, 2.38-4.21; P<.001), noncardiac cause (OR, 1.47; 95% CI, 1.07-2.02; P=.019], initially shockable rhythm (OR, 1.67; 95% CI, 1.17-2.37; P=.004), no prior basic life support (OR, 3.48; 95% CI, 2.58-4.70; P<.001), and orotracheal intubation (OR, 1.93; 95% CI, 1.24-2.99; P=.003). One patient (0.38%) survived to discharge with good neurologic outcome. Ambulance CPR by a physician on board is applied in few OHCA cases. Young patient age, cardiac arrest outside the home, the presence of a witness, lack of a shockable rhythm on responder arrival, lack of basic life support prior to responder arrival, noncardiac cause, and orotracheal intubation are associated with the use of ambulance CPR, a strategy that can be considered futile.

The Shaping of the Scandinavian Socio-technical IS Research Tradition

DEFF Research Database (Denmark)

Bjørn-Andersen, Niels; Clemmensen, Torkil

2017-01-01

voice of the autoethnographer and the questioning voice of a younger researcher, the second author, who wants to bridge S/T into the future. The main contributions of this paper are to provide: 1) insights into career development in IS in general and in one of the Scandinavian IS pioneers in particular......This paper relates stories instrumental in shaping the career of an individual and which have also contributed to shaping of the IS field in general and the ‘Scandinavian Socio-Technical (S/T) Information Systems Research Tradition’ in particular. The method in this paper is an autoethnography......; 2) a historic account of some of the key events in the early days of S/T IS in Scandinavia; 3) an account of the experiences and the challenges in creating a new research field such as IS; and 4) a summary of Niels’s key learnings hopefully relevant to young and mid-career IS researchers....

Personal investment, culture and learning: insights into school achievement across Anglo, Aboriginal, Asian and Lebanese students in Australia.

Science.gov (United States)

McInerney, Dennis M

2008-10-01

Personal investment theory is a multifaceted theory of motivation, in which three key components: achievement goals (mastery, performance, social, and extrinsic), sense of self (sense of purpose, self-reliance, negative self-concept, positive self-concept), and facilitating conditions (parent support, teacher support, peer support), engage students in the process of learning. Four cultural groups (Anglo Australian, n = 852, Aboriginal Australian, n = 343, Lebanese Australian, n = 372, and Asian Australian, n = 283) of students were compared on these personal investment components and on several outcome measures (engagement, affect, achievement, participation). A series of MANOVAs, followed up by univariate tests, indicated ethnic differences and similarities in the endorsement of the personal investment theory components as well as in the outcome measures. Multiple regression analyses showed that each of the three sets of predictors (achievement goals, sense of self, facilitating conditions) explained a significant amount of the variance in almost all of the outcome measures. Across cultural groups, students' mastery goal and sense of purpose were consistently found to be significant predictors of their intention for further education, positive affect for schooling, and valuing of schooling.

Continuity or colonization in Anglo-Saxon England? Isotope evidence for mobility, subsistence practice, and status at West Heslerton.

Science.gov (United States)

Montgomery, Janet; Evans, Jane A; Powlesland, Dominic; Roberts, Charlotte A

2005-02-01

The adventus Saxonum is a crucial event in English protohistory. Scholars from a range of disciplines dispute the scale and demographic profile of the purported colonizing population. The 5th-7th century burial ground at West Heslerton, North Yorkshire, is one of the few Anglian cemeteries where an associated settlement site has been identified and subjected to extensive multidisciplinary postexcavation study. Skeletal and grave good evidence has been used to indicate the presence of Scandinavian settlers. A small, preliminary study using lead and strontium isotope analysis of tooth enamel, mineralized in early childhood, from Neolithic/Early Bronze Age (n = 8), Iron Age (n = 2), and Early Anglo-Saxon (n = 32) skeletons, was carried out to directly investigate this hypothesis. Results suggest that lead provides dissimilar types of information in different time periods. In post-Roman England, it appears to reflect the level of exposure to circulated anthropogenic rather than natural geological lead, thus being a cultural rather than geographical marker. Consequently, only strontium provides mobility evidence among the Anglian population, whereas both isotope systems do so in pre-Roman periods. Strontium data imply the presence of two groups: one of "local" and one of "nonlocal" origin, but more work is required to define the limits of local variation and identify immigrants with confidence. Correlations with traditional archaeological evidence are inconclusive. While the majority of juveniles and prehistoric individuals fall within the "local" group, both groups contain juveniles, and adults of both sexes. There is thus no clear support for the exclusively male, military-elite invasion model at this site. 2004 Wiley-Liss, Inc.

Have Anglo-Saxon Concepts Really Influenced the Development of European Qualifications Policy?

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Clarke, Linda; Winch, Christopher

2015-01-01

This paper considers how far Anglo Saxon conceptions of vocational education and training have influenced European Union vocational education and training policy, especially given the disparate approaches to vocational education and training across Europe. Two dominant approaches can be identified: the dual system (exemplified by Germany); and…

Cardiac regeneration therapy: connections to cardiac physiology.

Science.gov (United States)

Takehara, Naofumi; Matsubara, Hiroaki

2011-12-01

Without heart transplantation, a large number of patients with failing hearts worldwide face poor outcomes. By means of cardiomyocyte regeneration, cardiac regeneration therapy is emerging with great promise as a means for restoring loss of cardiac function. However, the limited success of clinical trials using bone marrow-derived cells and myoblasts with heterogeneous constituents, transplanted at a wide range of cell doses, has led to disagreement on the efficacy of cell therapy. It is therefore essential to reevaluate the evidence for the efficacy of cell-based cardiac regeneration therapy, focusing on targets, materials, and methodologies. Meanwhile, the revolutionary innovation of cardiac regeneration therapy is sorely needed to help the millions of people who suffer heart failure from acquired loss of cardiomyocytes. Cardiac regeneration has been used only in limited species or as a developing process in the rodent heart; now, the possibility of cardiomyocyte turnover in the human heart is being revisited. In the pursuit of this concept, the use of cardiac stem/progenitor stem cells in the cardiac niche must be focused to usher in a second era of cardiac regeneration therapy for the severely injured heart. In addition, tissue engineering and cellular reprogramming will advance the next era of treatment that will enable current cell-based therapy to progress to "real" cardiac regeneration therapy. Although many barriers remain, the prevention of refractory heart failure through cardiac regeneration is now becoming a realistic possibility.

The eleven observations of comets between 687 AD and 1114 AD recorded in the Anglo Saxon Chronicle

Science.gov (United States)

Mardon, E. G.; Mardon, A. A.; Williams, J.

1992-12-01

This research paper is an examination of the eleven cometary references (679AD, 729AD, 892AD, 950AD, 975AD, 995AD, 1066AD, 1097AD, 1106AD, 1110AD and 1114AD) found in the various manuscripts of The Anglo Saxon Chronicle between 678 AD and 1114 AD. The manuscripts contain more than 35 celestial observations. This is an examination of astronomical phenomena and other climatic or natural events, that are described in The Anglo Saxon Chronicle, which is also referred to as The Old English Annals.

Continuing disparities in cardiovascular risk factors and complications between aboriginal and Anglo-Celt Australians with type 2 diabetes: the Fremantle Diabetes Study.

Science.gov (United States)

Davis, Timothy M E; Hunt, Kerry; McAullay, Daniel; Chubb, Stephen A P; Sillars, Brett A; Bruce, David G; Davis, Wendy A

2012-10-01

To determine whether disparities in the nature and management of type 2 diabetes persist between Aboriginal and the majority Anglo-Celt patients in an urban Australian community. Baseline data from the observational Fremantle Diabetes Study collected from 1993 to 1996 (phase I) and from 2008 to 2011 (phase II) were analyzed. Patients characterized as Aboriginal or Anglo-Celt by self-report and supporting data underwent comprehensive assessment, including questionnaires, examination, and biochemical testing in a single laboratory. Generalized linear modeling with age/sex adjustment was used to examine differences in changes in variables in the two groups between phases I and II. The indigenous participants were younger at entry and at diabetes diagnosis than the Anglo-Celt participants in both phases. They were also less likely to be educated beyond primary level and were more likely to be smokers. HbA(1c) decreased in both groups over time (Aboriginal median 9.6% [interquartile range 7.8-10.7%] to 8.4% [6.6-10.6%] vs. Anglo-Celt median 7.1% [6.2-8.4%] to 6.7% [6.2-7.5%]), but the gap persisted (P = 0.65 for difference between phases I and II by ethnic group). Aboriginal patients were more likely to have microvascular disease in both phases. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.90 or lower-extremity amputation) increased in Aboriginal but decreased in Anglo-Celt participants (15.8-29.7 vs. 30.7-21.5%; P = 0.055). Diabetes management has improved for Aboriginal and Anglo-Celt Australian patients, but disparities in cardiovascular risk factors and complications persist.

Prominente motiewe in ’n seleksie preke voor, tydens en na die Anglo-Boereoorlog

Directory of Open Access Journals (Sweden)

C.J.H. Venter

2000-08-01

Full Text Available Prominent motifs in a selection of sermons delivered before, during and immediately after the Anglo-Boer War This article investigates a selection (160 of sermons delivered before, during and after the Anglo-Boer war and published afterwards. The aim of the investigation is to indicate (possible repetitive motifs used in these sermons. The initial hypothesis taken was that the motif of freedom probably would have functioned prominently within the context of the war. The investigation of the 160 selected sermons, however, proved that although the motif of freedom indeed occurs, it is applied in the broad Biblical sense of being liberated from sin. Freedom in God is stressed and not primarily freedom from British oppression. Several other motifs also function prominently in these sermons – motifs like redemption in Christ, hope, comfort in hardship and peace with God in Jesus Christ. Although these motifs are applied within the context of the Bible, it should be kept in mind that these sermons were delivered in the time of the Anglo-Boer War. These sermons should, therefore, be studied as embedded within a certain time frame: text and context should both be considered in the analysis of these sermons. The analysis, however, indicates that the parts from Scripture selected for these sermons were treated homiletically in a responsible way.

Characteristics and outcome among patients suffering from out-of-hospital cardiac arrest: Factors associated with survival

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Trpković S.

2014-01-01

Full Text Available The aim was to define factors associated with an improved outcome among patients suffering out-of-hospital cardiac arrest (OHCA using the Utstain style data collection. We examined 200 patients suffering from OHCA in a prospective study in a two years period. We determined survival from cardiac arrest (CA to discharge from hospital and the factors associated with survival. 78% of CA patients had a cardiac aetiology, 65% occurred at home, 3.7% received bystander CPR. 36% were found in VF/VT, 64% in asystole/PEA. 52% of patients were intubated in the field, survival to discharge from hospital was significantly higher among patients who were intubated in the field. The mean response time was 6.6 minutes. 66.7% of patients were given the shock after 4 minutes. 131 (65.5% were pronounced dead in the field, 69 patients were transported to the hospital. 53 (76.8% patients of them died during the transport or in the ED, 7 died after hospital admission and 9 survived to hospital discharge. Multivariate logistic regression analysis showed that variables significantly associated with survival to hospital discharge were: age, endotracheal intubation in the field and mean response time. The outcome of CPR was better in patients who were younger, who were intubated in the field and when the response time was shorter.

New Nordic and Scandinavian Retro: reassessment of values and aesthetics in contemporary Nordic design

Directory of Open Access Journals (Sweden)

Niels Peter Skou

2016-11-01

Full Text Available The “New Nordic” label has spread in the design world since 2005, but it is quite difficult to distinguish from the image of “Scandinavian Design” and the heritage of values and aesthetics from the 1950s. Many designer statements and promotional texts are eager to mention both designations. This survey sketches the background and asks, “What is ‘New’?” and “What is ‘Nordic’?” with a focus on the Danish firm Muuto, which has been a central actor in establishing the term “New Nordic Design.” We focus on the interplay between the storytelling around the products and designers on webpages and in marketing, popular literature, etc., and the actual design objects. Reoccurring themes from the 1950s are how it relates to nature and climate, social models of welfare and equality, and pure, minimalist forms. They are, however, more present in the high expectations of an international audience and in promotions than in the objects themselves. The new products of Nordic Design are close to the current international neo-modernism in the form of digitally designed and industrially produced items in often thought-provoking minimalist forms and are directed at an elitist, international audience that wants to engage with these demanding aesthetics and the ideal picture of Nordic cultures—as a nice design and gourmet destination. New Nordic Design shows that the image and ideals of Scandinavian Modern are still living, as a subtle version of Scandinavian Retro, a reimagination of the lifestyle and values of Scandinavian Modern.

EDITORIAL Re-fighting the 2nd Anglo-Boer War: historians in the ...

African Journals Online (AJOL)

economic and political cost to South Africa was greater than the statistics immediately indicate: at least ... battles and foreign wars, the British casualties of the Anglo-Boer War became ... American universities, produced similar works; while S.l. Maphalala and Bill Nasson, ... relations and their participation was not rewarded.

Outcome following postanoxic status epilepticus in patients with targeted temperature management after cardiac arrest.

Science.gov (United States)

Dragancea, Irina; Backman, Sofia; Westhall, Erik; Rundgren, Malin; Friberg, Hans; Cronberg, Tobias

2015-08-01

Postanoxic electrographic status epilepticus (ESE) is considered a predictor of poor outcome in resuscitated patients after cardiac arrest (CA). Observational data suggest that a subgroup of patients may have a good outcome. This study aimed to describe the prevalence of ESE and potential clinical and electrographic prognostic markers. In this retrospective single study, we analyzed consecutive patients who suffered from CA, and who received temperature management and were monitored with simplified continuous EEG (cEEG) during a five-year period. The patients' charts and cEEG data were initially screened to identify patients with clinical seizures or ESE. The cEEG diagnosis of ESE was retrospectively reanalyzed according to strict criteria by a neurophysiologist blinded to patient outcome. The EEG background patterns prior to the onset of ESE, duration of ESE, presence of clinical seizures, and use of antiepileptic drugs were analyzed. The results of somatosensory-evoked potentials (SSEPs) and neuron-specific enolase (NSE) at 48 h after CA were described in all patients with ESE. Antiepileptic treatment strategies were not protocolized. Outcome was evaluated using the Cerebral Performance Category (CPC) scale at 6 months, and good outcome was defined as CPC 1-2. Of 127 patients, 41 (32%) developed ESE. Twenty-five patients had a discontinuous EEG background prior to ESE, and all died without regaining consciousness. Sixteen patients developed a continuous EEG background prior to the start of ESE, four of whom survived, three with CPC 1-2 and one with CPC 3 at 6 months. Among survivors, ESE developed at a median of 46 h after CA. All had preserved N20 peaks on SSEP and NSE values of 18-37 μg/l. Electrographic status epilepticus is common among comatose patients after cardiac arrest, with few survivors. A combination of a continuous EEG background prior to ESE, preserved N20 peaks on SSEPs, and low or moderately elevated NSE levels may indicate a good outcome. This

Conceptions of schizophrenia as a problem of nerves: a cross-cultural comparison of Mexican-Americans and Anglo-Americans.

Science.gov (United States)

Jenkins, J H

1988-01-01

This paper explores indigenous conceptions of psychosis within family settings. The cultural categories nervios and 'nerves', as applied by Mexican-American and Anglo-American relatives to family members diagnosed with schizophrenia, are examined. While Mexican-Americans tended to consider nervios an appropriate interpretation of the problem, Anglo-Americans explicitly dismissed the parallel English term 'nerves'. Anglo-American relatives were likely to consider the problem as 'mental' in nature, often with specific reference to psychiatric diagnostic labels such as 'schizophrenia'. Although variations in conceptions appear related to both ethnicity and socioeconomic status, significant cultural differences were observed independent of socioeconomic status. These results raise questions concerning contemporary anthropological views that psychosis is conceptualized in substantially similar ways cross-culturally, and underscore the need for more contextualized understanding of the meaning and application of indigenous concepts of mental disorder. The paper concludes with a discussion of psychocultural meanings associated with ethnopsychiatric labels for schizophrenia and their importance for the social and moral status of patients and their kin.

Social influences on physical activity in Anglo-Australian and Vietnamese-Australian adolescent females in a single sex school.

Science.gov (United States)

Wilson, Andrew N; Dollman, James

2009-01-01

Social support is a consistent correlate of youth physical activity (PA) but few studies have examined this in cultural sub-groups. Female adolescents (n=113; 13.9+/-0.6years) from a metropolitan single sex private school participated in this study. PA was estimated using the 3 Day Physical Activity Recall (3dPAR), and aspects of social support using a specifically designed questionnaire. Anglo-Australians (n=74), whose parents were both born in Australia, were compared with Vietnamese-Australians (n=39), whose parents were both born in Vietnam. There were non-significant trends towards higher engagement in all measures of PA among Anglo-Australians. Anglo-Australians perceived higher levels of social support to be physically active. In the whole sample and in cultural sub-groups, support by mothers was a consistent predictor of PA. Among Vietnamese-Australians, activities shared with the mother predicted moderate to vigorous PA. Interventions targeting PA among adolescent females should consider interactions of social support and cultural background.

Corporate risk and external sourcing: A study of Scandinavian multinational firms

DEFF Research Database (Denmark)

Aabo, Tom; Pantzalis, Christos; Sørensen, Helle

2016-01-01

data by surveying Scandinavian non-financial firms. We find that highly international firms reduce corporate risk by externally sourcing from foreign suppliers both compared to sourcing from own production facilities abroad (due to superior flexibility) and compared to domestic sourcing (due...

Is it necessary to assume an apartheid-like social structure in Early Anglo-Saxon England?

Science.gov (United States)

Pattison, John E

2008-11-07

It has recently been argued that there was an apartheid-like social structure operating in Early Anglo-Saxon England. This was proposed in order to explain the relatively high degree of similarity between Germanic-speaking areas of northwest Europe and England. Opinions vary as to whether there was a substantial Germanic invasion or only a relatively small number arrived in Britain during this period. Contrary to the assumption of limited intermarriage made in the apartheid simulation, there is evidence that significant mixing of the British and Germanic peoples occurred, and that the early law codes, such as that of King Ine of Wessex, could have deliberately encouraged such mixing. More importantly, the simulation did not take into account any northwest European immigration that arrived both before and after the Early Anglo-Saxon period. In view of the uncertainty of the places of origin of the various Germanic peoples, and their numbers and dates of arrival, the present study adopts an alternative approach to estimate the percentage of indigenous Britons in the current British population. It was found unnecessary to introduce any special social structure among the diverse Anglo-Saxon people in order to account for the estimates of northwest European intrusion into the British population.

Audit of Cardiac Surgery Outcomes for Low Birth Weight and Premature Infants.

Science.gov (United States)

Alarcon Manchego, Peter; Cheung, Michael; Zannino, Diana; Nunn, Russell; D'Udekem, Yves; Brizard, Christian

2018-01-01

The burden of disease associated with cardiac surgery in preterm and low birth weight infants is increasing. This retrospective study aimed to compare the mortality and morbidity of cardiac surgery in low birth weight and preterm infants with that of a case-matched normal population. This was a single-center audit of cardiac surgery interventions at a tertiary pediatric center in Melbourne, Australia. Subjects underwent intervention in the first 3 months of life and were preterm (<37 weeks' gestation) or <2500 g at birth. Subjects were case-matched with 2 controls of term gestation and appropriate birth weight with the same primary diagnosis and intervention. Principal outcomes were mortality and complications in the 6 months following intervention. A total of 513 participants were included for analysis in the 13-year study period. There was an increased risk of mortality (odds ratio 6.26; 95% confidence interval (3.19, 12.3)) and rate of complications (odds ratio 2.29; 95% confidence interval (1.38, 3.78)) in low birth weight and premature infants compared with the control population. Patients who did not survive were more likely to have required extracorporeal membrane oxygenation (relative risk [RR] 6.6, P < 0.001), developed postoperative sepsis (RR 2.6, P = 0.012), and undergone unplanned reintervention (RR 2.3, P < 0.001) compared with survivors. Preterm and low birth weight patients had twice the RR of developing complications and 6 times the risk of mortality in the 6 months following cardiac intervention compared with a matched population. Observed trends suggest delaying surgery in clinically stable infants beyond 35 weeks corrected gestational age and 2500-g weight may result in improved survival. Copyright © 2018 Elsevier Inc. All rights reserved.

Impact of the mother-nurse partnership programme on mother and infant outcomes in paediatric cardiac intensive care unit.

Science.gov (United States)

Uhm, Ju-Yeon; Kim, Hee Soon

2018-04-04

To identify the effects of a mother-nurse partnership programme based on the core components of information sharing, negotiation and participation in care. Specifically, we examined the programme's effects on parental satisfaction, parental self-efficacy, perceived partnership and anxiety, as well as infants' time to reach full oral feeding and length of postoperative hospital stay, following cardiac surgery on infants at a paediatric intensive care unit with a restrictive visiting policy. Quasi-experimental study. An analysis of covariance was used to investigate between-group differences while ensuring homogeneity. A paediatric cardiac ICU. Parental satisfaction, parental self-efficacy, perceived partnership and anxiety. Data from 37 and 36 mothers in the control and experimental groups respectively, were analysed. Compared with controls, experimental group mothers reported significantly higher parental satisfaction (F = 39.29, p partnership (F = 62.30, p < .001) and lower anxiety (F = 12.93, p < .001), upon transfer to the ward. Infant outcomes did not differ between the groups. This programme appears to facilitate collaboration between nurses and mothers and positively influences mothers' emotional and cognitive outcomes following infants' cardiac surgery. Copyright © 2018. Published by Elsevier Ltd.

Impact of on-site cardiac catheterization on resource utilization and fatal and non-fatal outcomes after acute myocardial infarction

Directory of Open Access Journals (Sweden)

Richard Hugues

2006-11-01

Full Text Available Abstract Background Patterns of care for acute myocardial infarction (AMI strongly depend on the availability of on-site cardiac catheterization facilities. Although the management found at hospitals without on-site catheterization does not lead to increased mortality, little it known about its impact on resource utilization and non-fatal outcomes. Methods We identified all patients (n = 35,289 admitted with a first AMI in the province of Quebec between January 1, 1996 and March 31, 1999 using population-based administrative databases. Medical resource utilization and non-fatal and fatal outcomes were compared among patients admitted to hospitals with and without on-site cardiac catheterization facilities. Results Cardiac catheterization and PCI were more frequently performed among patients admitted to hospitals with catheterization facilities. However, non-invasive procedures were not used more frequently at hospitals without catheterization facilities. To the contrary, echocardiography [odds ratio (OR, 2.04; 95% confidence interval (CI, 1.93–2.16] and multi-gated acquisition imaging (OR, 1.24; 95% CI, 1.17–1.32 were used more frequently at hospitals with catheterization, and exercise treadmill testing (OR, 1.02; 95% CI, 0.91–1.15 and Sestamibi/Thallium imaging (OR, 0.93; 95% CI, 0.88–0.98 were used similarly at hospitals with and without catheterization. Use of anti-ischemic medications and frequency of emergency room and physician visits, were similar at both types of institutions. Readmission rates for AMI-related cardiac complications and mortality were also similar [adjusted hazard ratio, recurrent AMI: 1.02, 95% CI, 0.89–1.16; congestive heart failure: 1.02; 95% CI, 0.90–1.15; unstable angina: 0.93; 95% CI, 0.85–1.02; mortality: 0.99; 95% CI, 0.93–1.05]. Conclusion Although on-site availability of cardiac catheterization facilities is associated with greater use of invasive cardiac procedures, non-availability of

Anarchic alchemists : dissident androgyny in Anglo-American gothic fiction from Godwin to Melville

NARCIS (Netherlands)

Leeuwen, Evert Jan van

2006-01-01

The dissertation Anarchic Alchemists: Dissident Androgyny in Anglo-American Gothic Fiction from Godwin to Melville investigates the close generic links between British and American Gothic fictions from the late eighteenth-century up to the middle of the nineteenth century, including studies on

Scandinavian Participatory Design - Beyond Design, Beyond Scandinavia

DEFF Research Database (Denmark)

Zander, Pär-Ola; Georgsen, Marianne; Nyvang, Tom

2011-01-01

This paper presents a stream of research that is relevant for development research generally and also in South Asia, but has hitherto remained outside the discourse of mainstream development research. It goes under the name "Participatory design", referring not only generally to participatory...... approaches, of which there are many in development research, but to a specific body of work that stems from Scandinavia. Within the research fields relating to design of ICT systems the Scandinavian countries have a rich history of incorporating disadvantaged groups in societies. This paper argues...

Pravastatin But Not Simvastatin Improves Survival and Neurofunctional Outcome After Cardiac Arrest and Cardiopulmonary Resuscitation

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Stefan Bergt, MD

2017-04-01

Full Text Available Summary: Cardiac arrest (CA followed by cardiopulmonary resuscitation (CPR is associated with high mortality and poor neurological outcome. We compared the effects of pravastatin and simvastatin on survival and neurofunction in a murine model of CA/CPR. Pravastatin, a hydrophilic statin, increased survival and neurofunction during a 28-day follow-up period. This therapy was associated with improved pulmonary function, reduced pulmonary edema, and increased endothelial cell function in vitro. In contrast, lipophilic simvastatin did not modulate survival but increased pulmonary edema and impaired endothelial cell function. Although pravastatin may display a therapeutic option for post-CA syndrome, the application of simvastatin may require re-evaluation. Key Words: cardiac arrest, endothelial cell function, ischemia and reperfusion injury, pravastatin, resuscitation, simvastatin

Overview of the long distance iron ore slurry pipeline from Anglo Ferrous Brazil

Energy Technology Data Exchange (ETDEWEB)

Silva, Adarlan M.; Passos, Aline C.; Santos, Daniel; Orban, Eduardo M.; Lisboa, Helder D.; Goncalves, Nilton; Guimaraes, Robson C. [Anglo Ferrous Brazil, Rio de Janeiro, RJ (Brazil)

2009-07-01

The objective of this paper is to present an overview of the long distance iron ore slurry pipeline from Anglo Ferrous Brazil. Anglo Ferrous Brazil is a company of Anglo American plc that is one of the world's largest mining and natural resource company. Minas-Rio is a world class iron ore project which has been developed in Brazil aiming to produce 26.6 million tons per year of concentrate. The mine, concentrator and pump station 1 will be located in Conceicao do Mato Dentro, Minas Gerais state, and the terminal station will be located at Acu Port in Sao Joao da Barra, Rio de Janeiro state. The long distance iron ore slurry pipeline will be one of major differentials of Minas-Rio Project and its useful life was initially estimated in 20 years. The slurry pipeline has a total length of 525 kilometers and will be constructed from predominately 26 inches external diameter API 5L X70 pipes. From kilometer 314 to kilometer 480, 24 inches pipe will be installed to prevent slack flow downstream pump station 2. The pump station 1 is designed to provide the hydraulic head necessary to transport the concentrate iron ore slurry with 8 positive displacement pumps to pump station 2. The pump station 2, located 240 kilometers downstream pump station 1, is designed to operate with 10 positive displacement pumps. The valve station will be located at kilometer 347 and will be used to break the static head between pump station 2 and the terminal station during a slurry pipeline shutdown. (author)

La reconstruction du passé anglo-écossais par les premiers historiens whigs de l’Union (1707)

OpenAIRE

Deschamps, Yannick

2018-01-01

À la différence des autres historiens de leur époque, Daniel Defoe (1660-1731), Abel Boyer (1667-1729) et Sir John Clerk of Penicuik (1676-1755) évoquent longuement les relations anglo-écossaises antérieures à l’Union de 1707. Whigs et unionistes, ces auteurs sont enclins à noircir le passé anglo-écossais préunioniste afin de mieux souligner la nécessité d’un rapprochement entre l’Angleterre et l’Écosse. S’ils tombent parfois dans les travers méthodologiques dénoncés par Herbert Butterfield, ...

Outcomes in a Community-Based Intensive Cardiac Rehabilitation Program: Comparison with Hospital-Based and Academic Programs.

Science.gov (United States)

Katzenberg, Charles; Silva, Edna; Young, M Jean; Gilles, Greg

2018-04-13

The purpose of this study was to test the hypothesis that a community-based intensive cardiac rehabilitation program could produce positive changes in risk factor profile and outcomes in an at-risk population. Participants seeking either primary or secondary coronary artery disease prevention voluntarily enrolled in the 12-week intensive cardiac rehabilitation program. Data were obtained at baseline and 6-12 months after completion of the program. A total of 142 individuals, mean age 69 years, completed the Heart Series between 2012 and 2016. Follow-up data were available in 105 participants (74%). Participants showed statistically significant improvements in mean weight (165 to 162 lbs, P = .0005), body mass index (26 to 25 kg/m 2 , P = .001), systolic blood pressure (126 to 122 mm Hg, P = .01), diastolic blood pressure (73 to 70 mm Hg, P = .0005), total cholesterol (175 to 168 mg/dL, P = .03), low-density lipoprotein cholesterol (LDL-C) (100 to 93 mg/dL, P = .005), LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (1.8 to 1.6, P = .005), and cholesterol/HDL-C ratio (3.2 to 3.0, P = .003). Changes in HDL-C, triglycerides, and fasting blood glucose did not reach statistical significance, but all trended in favorable directions. Adverse cardiovascular disease outcomes were rare (one stent placement, no deaths). A total of 105 participants completed our 12-week community-based intensive cardiac rehabilitation program and showed significant positive changes in several measures of cardiac risk, with only 1 adverse event. These results compare favorably with those of hospital-based and academic institutional programs. Copyright © 2018 Elsevier Inc. All rights reserved.

Relationship between cardiac function and resting cerebral blood flow: MRI measurements in healthy elderly subjects.

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Henriksen, Otto M; Jensen, Lars T; Krabbe, Katja; Larsson, Henrik B W; Rostrup, Egill

2014-11-01

Although both impaired cardiac function and reduced cerebral blood flow are associated with ageing, current knowledge of the influence of cardiac function on resting cerebral blood flow (CBF) is limited. The aim of this study was to investigate the potential effects of cardiac function on CBF. CBF and cardiac output were measured in 31 healthy subjects 50-75 years old using magnetic resonance imaging techniques. Mean values of CBF, cardiac output and cardiac index were 43.6 ml per 100 g min(-1), 5.5 l min(-1) and 2.7 l min(-1) m(-2), respectively, in males, and 53.4 ml per 100 g min(-1), 4.3 l min(-1) and 2.4 l min(-1) m(-2), respectively, in females. No effects of cardiac output or cardiac index on CBF or structural signs of brain ageing were observed. However, fractional brain flow defined as the ratio of total brain flow to cardiac output was inversely correlated with cardiac index (r(2) = 0.22, P = 0.008) and furthermore lower in males than in females (8.6% versus 12.5%, P = 0.003). Fractional brain flow was also inversely correlated with cerebral white matter lesion grade, although this effect was not significant when adjusted for age. Frequency analysis of heart rate variability showed a gender-related inverse association of increased low-to-high-frequency power ratio with CBF and fractional brain flow. The findings do not support a direct effect of cardiac function on CBF, but demonstrates gender-related differences in cardiac output distribution. We propose fractional brain flow as a novel index that may be a useful marker of adequate brain perfusion in the context of ageing as well as cardiovascular disease. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Two-year survival and neurodevelopmental outcomes after cardiopulmonary resuscitation in neonatal patients after complex cardiac surgery.

Science.gov (United States)

Hansen, Gregory; Joffe, Ari R; Nettel-Aguirre, Alberto; Robertson, Charlene M T; Biggs, Wayne S G; Ross, David B; Rebeyka, Ivan M

2011-03-01

To examine survival and neurodevelopmental outcomes in neonates having post-operative cardiopulmonary resuscitation (CPR). This inception cohort study included all neonates (6 weeks old or less) who received postoperative CPR (Group 1) after cardiac surgery from 1996 to 2005, matched for heart defect, year of surgery, chromosomal abnormality, and socioeconomic status to two neonates who did not receive postoperative CPR (Group 2). Two-year neurodevelopment was prospectively assessed with Bayley Scales of Infant Development II and Adaptive Behavior Assessment System II. Pre-, intra-, and post-operative variables were collected prospectively. Cardiac arrest variables were collected retrospectively. Predictors of mortality were analyzed by univariate analysis and conditional multiple logistic regression. There were 29 patients in Group 1, and 58 patients in Group 2. In survivors, there were no significant differences between Groups 1 and 2 in outcomes [mean (SD)] of mental developmental index [84.5 (12.2) vs. 81.0 (18.9)], psychomotor developmental index [82.8 (13.8) vs. 80.1 (21.9)], General Adaptive Composite [84.6 (15.3) vs. 84.3 (19.2)], Motor scale [8.4 (3.2) vs. 8.0 (3.8)], or delay on any of these scales. Two-year mortality [58.6% Group 1; 8.6% Group 2], was associated on conditional multiple logistic regression with CPR (OR 26.6; 95% CI, 5.4, 129.5). In Group 1, on multiple logistic regression, 2-year mortality was associated with minutes of chest compressions (OR 1.04, 95% CI, 1.01, 1.08). Among neonates having cardiac surgery, CPR is associated with greater mortality. There is no evidence that CPR survivors have different 2-year neurodevelopmental outcomes than those neonates not having CPR. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Neighborhood characteristics, bystander automated external defibrillator use, and patient outcomes in public out-of-hospital cardiac arrest.

Science.gov (United States)

Andersen, Lars W; Holmberg, Mathias J; Granfeldt, Asger; Løfgren, Bo; Vellano, Kimberly; McNally, Bryan F; Siegerink, Bob; Kurth, Tobias; Donnino, Michael W

2018-05-01

Automated external defibrillators (AEDs) can be used by bystanders to provide rapid defibrillation for patients with out-of-hospital cardiac arrest (OHCA). Whether neighborhood characteristics are associated with AED use is unknown. Furthermore, the association between AED use and outcomes has not been well characterized for all (i.e. shockable and non-shockable) public OHCAs. We included public, non-911-responder witnessed OHCAs registered in the Cardiac Arrest Registry to Enhance Survival (CARES) between 2013 and 2016. The primary patient outcome was survival to hospital discharge with a favorable functional outcome. We first assessed the association between neighborhood characteristics and bystander AED use using logistic regression and then assessed the association between bystander AED use and patient outcomes in a propensity score matched cohort. 25,182 OHCAs were included. Several neighborhood characteristics, including the proportion of people living alone, the proportion of white people, and the proportion with a high-school degree or higher, were associated with bystander AED use. 5132 OHCAs were included in the propensity score-matched cohort. Bystander AED use was associated with an increased risk of a favorable functional outcome (35% vs. 25%, risk difference: 9.7% [95% confidence interval: 7.2%, 12.2%], risk ratio: 1.38 [95% confidence interval: 1.27, 1.50]). This was driven by increased favorable functional outcomes with AED use in patients with shockable rhythms (58% vs. 39%) but not in patients with non-shockable rhythms (10% vs. 10%). Specific neighborhood characteristics were associated with bystander AED use in OHCA. Bystander AED use was associated with an increase in favorable functional outcome. Copyright © 2018 Elsevier B.V. All rights reserved.

Nitrates for the prevention of cardiac morbidity and mortality in patients undergoing non-cardiac surgery.

Science.gov (United States)

Zhao, Na; Xu, Jin; Singh, Balwinder; Yu, Xuerong; Wu, Taixiang; Huang, Yuguang

2016-08-04

Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD. However, their effects on patients' relevant outcomes remain controversial. • To assess effects of nitrates as compared with other interventions or placebo in reducing cardiac risk (such as death caused by cardiac factors, angina pectoris, acute myocardial infarction, acute heart failure and cardiac arrhythmia) in patients undergoing non-cardiac surgery.• To identify the influence of different routes and dosages of nitrates on patient outcomes. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and the Chinese BioMedical Database until June 2014. We also searched relevant conference abstracts of important anaesthesiology or cardiology scientific meetings, the database of ongoing trials and Google Scholar.We reran the search in January 2016. We added three potential new studies of interest to the list of 'Studies awaiting classification' and will incorporate them into our formal review findings for the review update. We included randomized controlled trials (RCTs) comparing nitrates versus no treatment, placebo or other pharmacological interventions in participants (15 years of age and older) undergoing non-cardiac surgery under any type of anaesthesia. We used standard methodological procedures as expected by Cochrane. Two review authors selected trials, extracted data from included studies and assessed risk of bias. We

Introduction of universal prestorage leukodepletion of blood components, and outcomes in transfused cardiac surgery patients.

Science.gov (United States)

McQuilten, Zoe K; Andrianopoulos, Nick; van de Watering, Leo; Aubron, Cecile; Phillips, Louise; Bellomo, Rinaldo; Pilcher, David; Cameron, Peter; Reid, Christopher M; Cole-Sinclair, Merrole F; Newcomb, Andrew; Smith, Julian; McNeil, John J; Wood, Erica M

2015-07-01

To assess whether introduction of universal leukodepletion (ULD) of red blood cells (RBCs) for transfusion was associated with improvements in cardiac surgery patient outcomes. Retrospective study (2005-2010) conducted at 6 institutions. Associations between leukodepletion and outcomes of mortality, infection, and acute kidney injury (AKI) were modeled by logistic regression, and intensive care unit length of stay (LOS) in survivors was explored using linear regression. To examine trends over time, odds ratios (ORs) for outcomes of transfused were compared with nontransfused patients, including a comparison with nontransfused patients who were selected based on propensity score for RBC transfusion. We studied 14,980 patients, of whom 8857 (59%) had surgery pre-ULD. Transfusions of RBCs were made in 3799 (43%) pre-ULD, and 2525 (41%) post-ULD. Administration of exclusively leukodepleted, versus exclusively nonleukodepleted, RBCs was associated with lower incidence of AKI (adjusted OR 0.80, 95% confidence interval [CI] 0.65-0.98, P = .035), but no difference in mortality or infection. For post-ULD patients, no difference was found in mortality (OR 0.96, 95% CI 0.76-1.22, P = .76) or infection (OR 0.91, 95% CI 0.79-1.03, P = .161); however, AKI was reduced (OR 0.79 95% CI 0.68-0.92, P = .003). However, ORs for post-ULD outcomes were not significantly different in nontransfused, versus transfused, patients. Furthermore, those who received exclusively nonleukodepleted RBCs were more likely to have surgery post-ULD. Universal leukodepletion was not associated with reduced mortality or infection in transfused cardiac surgery patients. An association was found between ULD and reduced AKI; however, this reduction was not significantly different from that seen in nontransfused patients, and other changes in care most likely explain such changes in renal outcomes. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Factors influencing the outcome of paediatric cardiac surgical patients during extracorporeal circulatory support

Directory of Open Access Journals (Sweden)

Peek Giles J

2007-01-01

Full Text Available Abstract Background Veno-arterial extracorporeal membrane oxygenation (ECMO is a common modality of circulatory assist device used in children. We assessed the outcome of children who had ECMO following repair of congenital cardiac defects (CCD and identified the risk factors associated with hospital mortality. Methods From April 1990 to December 2003, 53 patients required ECMO following surgical correction of CCD. Retrospectively collected data was analyzed with univariate and multivariate logistic regression analysis. Results Median age and weight of the patients were 150 days and 5.4 kgs respectively. The indications for ECMO were low cardiac output in 16, failure to wean cardiopulmonary bypass in 13, cardiac arrest in 10 and cardio-respiratory failure in 14 patients. The mean duration of ECMO was 143 hours. Weaning off from ECMO was successful in 66% and of these 83% were survival to hospital-discharge. 37.7% of patients were alive for the mean follow-up period of 75 months. On univariate analysis, arrhythmias, ECMO duration >168 hours, bleeding complications, renal replacement therapy on ECMO, arrhythmias and cardiac arrest after ECMO were associated with hospital mortality. On multivariate analysis, abnormal neurology, bleeding complications and arrhythmias after ECMO were associated with hospital mortality. Extra and intra-thoracic cannulations were used in 79% and 21% of patients respectively and extra-thoracic cannulation had significantly less bleeding complications (p = 0.031. Conclusion ECMO provides an effective circulatory support following surgical repair of CCD in children. Extra-thoracic cannulation is associated with less bleeding complications. Abnormal neurology, bleeding complications on ECMO and arrhythmias after ECMO are poor prognostic indicators for hospital survival.

Writing in the literacy era: Scandinavian teachers’ notions of writing in mother tongue education

DEFF Research Database (Denmark)

Krogh, Ellen

2012-01-01

Abstract This study is part of a Scandinavian research project, Nordfag.net, that investigates Scandinavian mother tongue teachers’ didactic profiles and conceptions of the mother tongue education (MTE) subject through an ethnographic approach. The purpose of the present study is to discuss...... the aims of the teach-ing of writing in MTE in the light of contending MTE paradigms and discourses of education tied to the concepts of Bildung and literacy. 26 teachers’ diaries and interviews are examined through two analyti-cal approaches. The first approach is a phenomenological investigation...... are discussed as possible answers to the contemporary educational challenges of MTE. Keywords: MTE, writing, literacy, Bildung, disciplinary didactics....

Association of public health initiatives with outcomes for out-of-hospital cardiac arrest at home and in public locations

DEFF Research Database (Denmark)

Christopher B., Fordyce; Carolina M., Hansen; Kragholm, Kristian

2017-01-01

Importance  Little is known about the influence of comprehensive public health initiatives according to out-of-hospital cardiac arrest (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically been poor.Objective  To describe temporal trends in bystander...... cardiopulmonary resuscitation (CPR) and first-responder defibrillation for OHCAs stratified by home vs public location and their association with survival and neurological outcomes.Design, Setting, and Participants  This observational study reviewed 8269 patients with OHCAs (5602 [67.7%] at home and 2667 [32.......3%] in public) for whom resuscitation was attempted using data from the Cardiac Arrest Registry to Enhance Survival (CARES) from January 1, 2010, through December 31, 2014. The setting was 16 counties in North Carolina.Exposures  Patients were stratified by home vs public OHCA. Public health initiatives...

Sutureless versus Conventional Aortic Valve Replacement: Outcomes in 70 High-Risk Patients Undergoing Concomitant Cardiac Procedures.

Science.gov (United States)

Hanedan, Muhammet Onur; Yuruk, Mehmet Ali; Parlar, Ali Ihsan; Ziyrek, Ugur; Arslan, Ali Kemal; Sayar, Ufuk; Mataraci, Ilker

2018-02-01

In elderly, high-risk surgical patients, sutureless aortic valve replacement (AVR) can often be an alternative to conventional AVR; shorter aortic cross-clamp and cardiopulmonary bypass times are the chief advantages. We compared the outcomes of sutureless AVR with those of conventional AVR in 70 elderly patients who underwent concomitant cardiac surgical procedures. We retrospectively analyzed the cases of 42 men and 28 women (mean age, 70.4 ± 10.3 yr; range, 34-93 yr) who underwent cardiac operations plus AVR with either a sutureless valve (group 1, n=38) or a conventional bioprosthetic or mechanical valve (group 2, n=32). Baseline patient characteristics were similar except for worse New York Heart Association functional status and the prevalence of diabetes mellitus in group 1. In group 1, the operative, cross-clamp, and cardiopulmonary bypass times were shorter (all P =0.001), postoperative drainage amounts were lower ( P =0.009), hospital stays were shorter ( P =0.004), and less red blood cell transfusion was needed ( P =0.037). Echocardiograms before patients' discharge from the hospital showed lower peak and mean aortic gradients in group 1 (mean transvalvular gradient, 8.4 ± 2.8 vs 12.2 ± 5.2 mmHg; P =0.012). We found that elderly, high-risk patients who underwent multiple cardiac surgical procedures and sutureless AVR had better hemodynamic outcomes and shorter ischemic times than did patients who underwent conventional AVR.

Die Anglo-Boereoorlog: ’n vertekende beeld vanuit die vreemde

Directory of Open Access Journals (Sweden)

J. van der Elst

1999-04-01

This article deals with the Dutch author Louwrens Penning (1854-1927 who wrote 18 novels on the Boer War, even though he never visited the country until 1924, long after the Anglo-Boer War had ended One of his books, entitled De held van Spionkop, is discussed as example. Penning s images of the Boer warriors and their endeavors were highly idealised and embedded in a certain view of race relations a n d war. He created idols, like the courageous boy named Blikoortjie, which became widely known among his Dutch readers, especially the Dutch youth. He facilely ignored historic facts and rather idealized a n d fantasized. His works thus became a peculiar mixture off act and fiction. Though he was not a literary master, he succeeded in writing gripping stories which were - up to a point - reprinted time and again. Through his writings he succeeded in creating a positive image of the Afrikaner which persisted in spite of the negative outcome of apartheid. Though one cannot be sure, it may even be true that Dutch immigrants came to South Africa because of a consistently positive image of Afrikaans and Afrikaans heroes as created by Penning in his books.

Overall comparative analysis of management and outcomes of cardiac cases reported on board merchant ships.

Science.gov (United States)

Apostolatos, Charalampos; Andria, Vivian; Licari, Julie

Telemedical assistance has always been the cornerstone of medical care on board. Significant technological progress has provided improved scientific tools and equipment for high-quality communication and prompt management of either minor incidents or major emergencies on board. Med Solutions International is a medical management company, offering services exclusively to the maritime industry. Registered vessels contact the medical team and healthcare professionals provide immediate guidelines for onboard management as well as necessary action thereafter, i.e. examination ashore or urgent medical evacuation. Since cardiac conditions or diseases are potentially the most dangerous when traveling at sea, it is of major importance to analyse and evaluate the overall management and outcomes of cases reporting symptoms of possible heart disease so as to improve telemedical assistance services in future. The study included cases reporting cardiac symptoms from 5 major shipping companies during the year 2016. Data was collected from telecommunication, emails and seafarers' final medical reports. A descriptive analysis of overall management and outcomes was performed. The study showed that the number of confirmed cardiovascular cases on board was very low. Among 551 total cases and 44 cases with reported cardiac symptoms there was only one heart attack, one pulmonary oedema and one suspected myocarditis. In the majority of cases, chest pain was musculoskeletal or due to respiratory infection. Symptoms resulting from issues such as stress or anxiety often present as potential cardiac conditions. Stress may also amplify the severity of symptoms. Language barriers between the seafarer, the master and the doctor often make communication very difficult. According to our findings there are grounds to intensify the prevention process through more efficient pre-employment medical examinations and improve management on board through more intensive training. Communication problems

The association of emergency department administration of sodium bicarbonate after out of hospital cardiac arrest with outcomes.

Science.gov (United States)

Chen, Yi-Chuan; Hung, Ming-Szu; Liu, Chia-Yen; Hsiao, Cheng-Ting; Yang, Yao-Hsu

2018-03-05

Sodium bicarbonate administration is mostly restricted to in-hospital use in Taiwan. This study was conducted to investigate the effect of sodium bicarbonate on outcomes among patients with out-of-hospital cardiac arrest (OHCA). This population-based study used a 16-year database to analyze the association between sodium bicarbonate administration for resuscitation in the emergency department (ED) and outcomes. All adult patients with OHCA were identified through diagnostic and procedure codes. The primary outcome was survival to hospital admission and secondary outcome was the rate of death within the first 30days of incidence of cardiac arrest. Cox proportional-hazards regression, logistic regression, and propensity analyses were conducted. Among 5589 total OHCA patients, 15.1% (844) had survival to hospital admission. For all patients, a positive association was noted between sodium bicarbonate administration during resuscitation in the ED and survival to hospital admission (adjusted odds ratio [OR]: 4.47; 95% confidence interval [CI]: 3.82-5.22, p<0.001). In propensity-matched patients, a positive association was also noted (adjusted OR, 4.61; 95% CI: 3.90-5.46, p<0.001). Among patients with OHCA in Taiwan, administration of sodium bicarbonate during ED resuscitation was significantly associated with an increased rate of survival to hospital admission. Copyright © 2018. Published by Elsevier Inc.

Using MSD prevention for cultural change in mining: Queensland Government/Anglo Coal Industry partnership.

Science.gov (United States)

Tilbury, Trudy; Sanderson, Liz

2012-01-01

Queensland Mining has a strong focus on safety performance, but risk management of health, including Musculoskeletal Disorders (MSDs) continues to have a lower priority. The reliance on individual screening of workers and lower level approaches such as manual handling training is part of the coal mining 'culture'. Initiatives such as the New South Wales and Queensland Mining joint project to develop good practice guidance for mining has allowed for a more consistent message on participatory ergonomics and prevention of MSD. An evidence based practice approach, including the introduction of participatory ergonomics and safe design principles, was proposed to Anglo American Coal operations in Queensland. The project consisted of a skills analysis of current health personnel, design of a facilitated participatory ergonomics training program, site visits to identify good practice and champions, and a graduated mentoring program for health personnel. Early results demonstrate a number of sites are benefiting from site taskforces with a focus on positive performance outcomes.

Proceedings from The 14th Scandinavian Conference on Health Informatics 2016 : Gothenburg, Sweden, April 6-7 2016

OpenAIRE

2016-01-01

The Scandinavian Conference on Health Informtics 2016 is organized together with the national health informatics organisations in Denmark, Norway, and Sweden and this year also the Vitalis conference. The goal of the conference is to stimulate scientific discussion of health informatics issues in the Scandinavian countries. The target audience of the conference are people doing, or having an interest in, health informatics research in a wide sense, including any development, implementation, e...

Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support.

Science.gov (United States)

Sanghavi, Prachi; Jena, Anupam B; Newhouse, Joseph P; Zaslavsky, Alan M

2015-02-01

Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited. To compare the effects of BLS and ALS on outcomes after out-of-hospital cardiac arrest. Observational cohort study of a nationally representative sample of traditional Medicare beneficiaries from nonrural counties who experienced out-of-hospital cardiac arrest between January 1, 2009, and October 2, 2011, and for whom ALS or BLS ambulance services were billed to Medicare (31,292 ALS cases and 1643 BLS cases). Propensity score methods were used to compare the effects of ALS and BLS on patient survival, neurological performance, and medical spending after cardiac arrest. Survival to hospital discharge, to 30 days, and to 90 days; neurological performance; and incremental medical spending per additional survivor to 1 year. Survival to hospital discharge was greater among patients receiving BLS (13.1% vs 9.2% for ALS; 4.0 [95% CI, 2.3-5.7] percentage point difference), as was survival to 90 days (8.0% vs 5.4% for ALS; 2.6 [95% CI, 1.2-4.0] percentage point difference). Basic life support was associated with better neurological functioning among hospitalized patients (21.8% vs 44.8% with poor neurological functioning for ALS; 23.0 [95% CI, 18.6-27.4] percentage point difference). Incremental medical spending per additional survivor to 1 year for BLS relative to ALS was $154,333. Patients with out-of-hospital cardiac arrest who received BLS had higher survival at hospital discharge and at 90 days compared with those who received ALS and were less likely to experience poor neurological functioning.

Differential effects of aprotinin and tranexamic acid on outcomes and cytokine profiles in neonates undergoing cardiac surgery.

Science.gov (United States)

Graham, Eric M; Atz, Andrew M; Gillis, Jenna; Desantis, Stacia M; Haney, A Lauren; Deardorff, Rachael L; Uber, Walter E; Reeves, Scott T; McGowan, Francis X; Bradley, Scott M; Spinale, Francis G

2012-05-01

Factors contributing to postoperative complications include blood loss and a heightened inflammatory response. The objective of this study was to test the hypothesis that aprotinin would decrease perioperative blood product use, reduce biomarkers of inflammation, and result in improved clinical outcome parameters in neonates undergoing cardiac operations. This was a secondary retrospective analysis of a clinical trial whereby neonates undergoing cardiac surgery received either aprotinin (n = 34; before May 2008) or tranexamic acid (n = 42; after May 2008). Perioperative blood product use, clinical course, and measurements of cytokines were compared. Use of perioperative red blood cells, cryoprecipitate, and platelets was reduced in neonates receiving aprotinin compared with tranexamic acid (P factor VII use (2/34 [6%] vs 18/42 [43%]; P Production of tumor necrosis factor and interleukin-2 activation were attenuated in the aprotinin group at 24 hours postoperatively. No differential effects on renal function were seen between agents. Aprotinin, compared with tranexamic acid, was associated with reduced perioperative blood product use, improved early indices of postoperative recovery, and attenuated indices of cytokine activation, without early adverse effects. These findings suggest that aprotinin may have unique effects in the context of neonatal cardiac surgery and challenge contentions that antifibrinolytics are equivalent with respect to early postoperative outcomes. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Ganirelix for luteolysis in poor responder patients undergoing IVF treatment: a Scandinavian multicenter 'extended pilot study'

DEFF Research Database (Denmark)

Nilsson, Lena; Andersen, A.N.; Lindenberg, Svend

2010-01-01

To enhance oocyte yield and pregnancy outcome in poor responder women undergoing IVF treatment, daily low dose GnRH antagonist administration was given during the late luteal phase to induce luteolysis and possibly secure a more synchronous cohort of recruitable follicles. An open extended pilot...... study in four Scandinavian fertility centers was done including 60 patients. Poor response was defined as when 2000 IU FSH. GnRH antagonist (ganirelix) was given, 0.25 mg s.c. daily, from days 3 to 5...... oocyte retrievals resulting in 5 pregnancies (4 delivered). Despite GnRH antagonist administration in the late luteal phase and menstrual bleeding, FSH was not sufficiently reduced to secure a more synchronic cohort of recruitable follicles. Novel GnRH antagonists more specifically targeting FSH release...

Social influences on physical activity in Anglo- and Vietnamese-Australian adolescent males in a single sex school.

Science.gov (United States)

Wilson, Andrew N; Dollman, James

2007-06-01

Understanding factors that influence physical activity levels of adolescents can assist the design of more effective interventions. Social support is a consistent correlate of youth physical activity but few studies have examined this in different cultural settings. Male adolescents (n=180, age=13.58+/-0.97 years) from a metropolitan single sex private school participated in this study. Habitual physical activity was estimated using the 3-day physical activity recall (3dPAR), and aspects of social support to be physically active using a specifically designed questionnaire. Comparisons were made between Anglo-Australians (n=118), whose parents were both born in Australia, and Vietnamese-Australians (n=62), whose parents were both born in Vietnam. There was a trend towards higher physical activity among Anglo-Australians, particularly on weekends. Anglo-Australians reported significantly more parental and peer support across most items pertaining to these constructs. Among the whole sample, social support variables explained 5-12% of the total explained variance in physical activity, with items pertaining to father and best friend support emerging as the strongest and most consistent predictors in multiple regression models. Among Anglo-Australians, the prediction models were relatively weak, explaining 0-9% of the total explained variance in physical activity. Prediction models for physical activity among Vietnamese-Australians were much stronger, explaining 11-32% of the total explained variance, with father's support variables contributing consistently to these models. The strong paternal influence on physical activity among Vietnamese-Australians needs to be confirmed in more diverse population groups, but results from this study suggest that interventions promoting physical activity among adolescent boys need to take into account cultural background as a moderator of widely reported social influences.

Genetic screening of Scandinavian families with febrile seizures and epilepsy or GEFS+

DEFF Research Database (Denmark)

Selmer, K K; Egeland, T; Solaas, M H

2008-01-01

Background - Mutations in the three genes SCN1A, SCN1B and GABRG2, all encoding subunits of ion channels, have been known to cause generalized epilepsy with febrile seizures plus (GEFS+) in families of different origin. Objective - To study the occurrence of mutations in these genes in families...... with GEFS+ or a GEFS+ resembling phenotype of Scandinavian origin. Material and methods - We performed linkage analysis in 19 Scandinavian families with a history of febrile seizures (FS) and epilepsy or GEFS+. Where linkage could not be excluded, the genes of interest were sequenced. Results - We...... identified only one mutation in SCN1A, which seems to be a rare variant with no functional consequence. Conclusion - This suggests that mutations in these three genes are not a prevalent cause of familial cases of FS and epilepsy or GEFS+ in Scandinavia....

Mapping and appraisal of Scandinavian research in early childhood institutions in 2006

DEFF Research Database (Denmark)

Jensen, Bente

a systematically, research based body of knowledge about this field is still missing, even if such an overview is internationally requested. On behalf of the Danish Evaluation Institute the Danish Clearinghouse for Educational Research has conducted a mapping of Scandinavian research in early childhood education...... institutions (Kampman, et al. 2008). The overall aim of the mapping is, on one hand, to give an overview of existing research within Scandinavian early childhood education research, on the other hand lacks of research should be identified. The method applied was the analytical tool provided by The Evidence...... and quantitative approaches. Quantitative research is mainly descriptive and only 7 studies had an intervention design. The majority of the studies are focusing on staff (39) only half of the studies (25) had children as their primary objects of investigation. There is a clear lack of longitudinal, comparative...

Scoring of late gadolinium enhancement in cardiac magnetic resonance imaging can predict cardiac events in patients with hypertrophic cardiomyopathy

International Nuclear Information System (INIS)

Nojiri, Ayumi; Hongo, Kenichi; Kawai, Makoto; Komukai, Kimiaki; Sakuma, Toru; Taniguchi, Ikuo; Yoshimura, Michihiro

2011-01-01

Late gadolinium enhancement (LGE) of cardiac magnetic resonance imaging (MRI) represents myocardial fibrosis and may be related to the clinical outcome of various heart diseases. This study evaluated the relationship between LGE and cardiac events in hypertrophic cardiomyopathy (HCM) using a new scoring method. This study retrospectively followed 46 HCM patients without heart failure symptoms for 3.8±1.8 years. Gadolinium-enhanced cardiac MRI was performed in all patients. Cardiac events including newly developed heart failure or ventricular tachyarrhythmia were evaluated during the follow-up period. We evaluated the predictive factors to identify the patients with cardiac events. None of the risk factors reported to be related to poor outcome or the existence of LGE alone could predict cardiac events, which might be due to the small number of subjects investigated in this study. A new scoring method for LGE-positive areas (LGE score) was applied and higher LGE score can predict cardiac events in this study population. The proposed LGE score for cardiac MRI is considered to be a potentially valid method for assessing cardiac events in HCM patients. (author)

Anglo-Saxon prognostics : a study of the genre with a text edition

NARCIS (Netherlands)

Chardonnens, László Sándor

2006-01-01

The purpose of this study of the Anglo-Saxon prognostics from 900-1200 AD is to present an evaluation of and to add new insight to previous studies in this field by the scholars Thomas Oswald Cockayne, Max Förster and Heinrich Henel in the period 1850-1950 (part I). In addition, part II for the

Slow Shift--Developing Provisions for Talented Students in Scandinavian Higher Education

Science.gov (United States)

Wolfensberger, Marca; Hogenstijn, Maarten

2016-01-01

For decades, Scandinavian culture effectively prohibited the development of special provisions for talented students in higher education. However, in recent years, a cultural shift has gradually made more room for excellence and talent development in the national discourses. This paper analyzes the climate for talent development in Denmark,…

Age × Gender Interaction Effect on Resuscitation Outcomes in Patients With Out-of-Hospital Cardiac Arrest.

Science.gov (United States)

Hagihara, Akihito; Onozuka, Daisuke; Ono, Junko; Nagata, Takashi; Hasegawa, Manabu

2017-08-01

Although an interaction between gender and age has been shown to influence resuscitation outcomes in patients with out-of-hospital cardiac arrest (OHCA), this interaction has not been investigated in Asian populations. In this prospective, observational study, data from all cases of OHCA in Japan between 2005 and 2012 were obtained from the Japanese National Registry. We determined the relative excess risk due to interaction and the ratio of odds ratios (ORs) to assess the interaction effect of gender and age on the incidence of return of spontaneous circulation (ROSC) before hospital arrival, 1-month survival, and neurologically intact survival 1 month after OHCA. Male gender was associated with decreased ROSC and lower 1-month survival rates in patients with OHCA of presumed cardiac origin. Older age was associated with lower 1-month and neurologically intact survival rates in male patients with OHCA of presumed cardiac and noncardiac origin and with increased ROSC in male patients with OHCA of presumed cardiac origin. The relative excess risk due to interaction for ROSC in patients with OHCA of presumed cardiac origin was statistically significant (OR 0.19, 95% confidence interval [CI] 0.06 to 0.32). The ratio of ORs for ROSC was statistically significant in patients with OHCA of presumed cardiac origin (OR 1.25, 95% CI 1.05 to 1.47) and of noncardiac origin (OR 0.40, 95% CI 0.17 to 0.92). In conclusion, the interaction effect between age and gender on ROSC was positive in OHCA cases of presumed cardiac origin and negative in those of noncardiac origin. Copyright © 2017 Elsevier Inc. All rights reserved.

Comorbidity and favorable neurologic outcome after out-of-hospital cardiac arrest in patients of 70 years and older

NARCIS (Netherlands)

Beesems, Stefanie G.; Blom, Marieke T.; van der Pas, Martine H. A.; Hulleman, Michiel; van de Glind, Esther M. M.; van Munster, Barbara C.; Tijssen, Jan G. P.; Tan, Hanno L.; van Delden, Johannes J. M.; Koster, Rudolph W.

2015-01-01

Advanced age is reported to be associated with lower survival after out-of-hospital cardiac arrest (OHCA). We aimed to establish survival rate and neurological outcome at hospital discharge after OHCA in older patients and evaluated whether pre-OHCA comorbidity was associated with favorable

Comorbidity and favorable neurologic outcome after out-of-hospital cardiac arrest in patients of 70 years and older

NARCIS (Netherlands)

Beesems, Stefanie G.; Blom, Marieke T.; van der Pas, Martine H. A.; Hulleman, Michiel; van de Glind, Esther M. M.; van Munster, Barbara C.; Tijssen, Jan G. P.; Tan, Hanno L.; van Delden, Johannes J. M.; Koster, Rudolph W.

Introduction: Advanced age is reported to be associated with lower survival after out-of-hospital cardiac arrest (OHCA). We aimed to establish survival rate and neurological outcome at hospital discharge after OHCA in older patients and evaluated whether pre-OHCA comorbidity was associated with

Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia : Dutch nationwide retrospective cohort study

NARCIS (Netherlands)

Kieboom, J. K.; Verkade, H. J.; Burgerhof, J. G.; Bierens, J. J.; van Rheenen, P. F.; Kneyber, M. C.; Albers, M. J.

2015-01-01

OBJECTIVES To evaluate the outcome of drowned children with cardiac arrest and hypothermia, and to determine distinct criteria for termination of cardiopulmonary resuscitation in drowned children with hypothermia and absence of spontaneous circulation. DESIGN Nationwide retrospective cohort study.

From Binary Features to Elements: The Case of Scandinavian

Directory of Open Access Journals (Sweden)

Ali Tifrit

2015-01-01

Full Text Available In this paper, we show how the Contrastivist Hypothesis (Hall 2007, Dresher 2008 can be amended using Element Theory (KLV 1988; Angoujard 1997; Scheer 1999; Backley 2011 and Government Phonology (KLV 1990; Lowenstamm 1996; Scheer 2004. Given the richness of the phenomenology of Nordic languages, this family constitutes our testing ground. While one might expect five different hierarchies, given that Scandinavian languages are distinct languages, what we actually find is one unique hierarchy where the same features are used in the same order. However, if we want a full understanding of the Nordic phenomenology and if we maintain the hierarchy exactly as it is, two difficulties appear: the first one involves motivation, the second one naturalness. In order to overcome the two kinds of difficulties mentioned above, we aim to develop a representation of the obstruent inventory based on unary primes using Element Theory and Government Phonology. The results we get from this hierarchy cannot be considered independently from the syllabic structure. Therefore, we propose a rereading of the phenomenology of Nordic that connects the new elementary representations that we posit to the syllabic constraints. As a consequence, we explore new hypotheses concerning the phonological activity in Scandinavian languages.

Cultural Differences in Korean- and Anglo-American Preschoolers' Social Interaction and Play Behaviors.

Science.gov (United States)

Farver, Jo Ann M.; And Others

1995-01-01

Compared Korean American and Anglo-American preschoolers' social and play behavior to determine the influence of culture on early development and to understand how culture shapes and organizes the environment in which children's social and play activities take place. Suggests that children's social interaction and pretend play are influenced by…

Temperament and Young Children with Visual Impairments: Perceptions of Anglo and Latino Parents

Science.gov (United States)

Dote-Kwan, Jamie; Chen, Deborah

2010-01-01

This study examined the temperamental characteristics of 18 toddlers with visual impairments as reported by their Anglo and Latino (Mexican American) parents. Differences in the parents' ratings of the children's temperament were related to the children's level of visual functioning and development. No differences were related to the children's…

The Mediatization of Politics in Contemporary Scandinavian Film and Television

DEFF Research Database (Denmark)

Bondebjerg, Ib

2015-01-01

the relation between media, public figures and the citizen. In this article, I will discuss main positions in theories on the mediatization of politics. I will also discuss and analyse three types of film and television genres that reflect this mediatization of politics in Scandinavian film and television...... culture: the political documentary, the political drama and the “nordic noir” crime genre....

Development and validation of risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team☆

Science.gov (United States)

Harrison, David A.; Patel, Krishna; Nixon, Edel; Soar, Jasmeet; Smith, Gary B.; Gwinnutt, Carl; Nolan, Jerry P.; Rowan, Kathryn M.

2014-01-01

Aim The National Cardiac Arrest Audit (NCAA) is the UK national clinical audit for in-hospital cardiac arrest. To make fair comparisons among health care providers, clinical indicators require case mix adjustment using a validated risk model. The aim of this study was to develop and validate risk models to predict outcomes following in-hospital cardiac arrest attended by a hospital-based resuscitation team in UK hospitals. Methods Risk models for two outcomes—return of spontaneous circulation (ROSC) for greater than 20 min and survival to hospital discharge—were developed and validated using data for in-hospital cardiac arrests between April 2011 and March 2013. For each outcome, a full model was fitted and then simplified by testing for non-linearity, combining categories and stepwise reduction. Finally, interactions between predictors were considered. Models were assessed for discrimination, calibration and accuracy. Results 22,479 in-hospital cardiac arrests in 143 hospitals were included (14,688 development, 7791 validation). The final risk model for ROSC > 20 min included: age (non-linear), sex, prior length of stay in hospital, reason for attendance, location of arrest, presenting rhythm, and interactions between presenting rhythm and location of arrest. The model for hospital survival included the same predictors, excluding sex. Both models had acceptable performance across the range of measures, although discrimination for hospital mortality exceeded that for ROSC > 20 min (c index 0.81 versus 0.72). Conclusions Validated risk models for ROSC > 20 min and hospital survival following in-hospital cardiac arrest have been developed. These models will strengthen comparative reporting in NCAA and support local quality improvement. PMID:24830872

Implementing Sustainable Data Collection for a Cardiac Outcomes Registry in an Australian Public Hospital.

Science.gov (United States)

Cox, Nicholas; Brennan, Angela; Dinh, Diem; Brien, Rita; Cowie, Kath; Stub, Dion; Reid, Christopher M; Lefkovits, Jeffrey

2018-04-01

Clinical outcome registries are an increasingly vital component of ensuring quality and safety of patient care. However, Australian hospitals rarely have additional resources or the capacity to fund the additional staff time to complete the task of data collection and entry. At the same time, registry funding models do not support staff for the collection of data at the site but are directed towards the central registry tasks of data reporting, managing and quality monitoring. The sustainability of a registry is contingent on building efficiencies into data management and collection. We describe the methods used in a large Victorian public hospital to develop a sustainable data collection system for the Victorian Cardiac Outcomes Registry (VCOR), using existing staff and resources common to many public hospitals. We describe the features of the registry and the hospital specific strategies that allowed us to do this as part of our routine business of providing good quality cardiac care. All clinical staff involved in patient care were given some data collection task with the entry of these data embedded into the staff's daily workflow. A senior cardiology registrar was empowered to allocate data entry tasks to colleagues when data were found to be incomplete. The task of 30-day follow-up proved the most onerous part of data collection. Cath-lab nursing staff were allocated this role. With hospital accreditation and funding models moving towards performance based quality indicators, collection of accurate and reliable information is crucial. Our experience demonstrates the successful implementation of clinical outcome registry data collection in a financially constrained public hospital environment utilising existing resources. Copyright © 2017. Published by Elsevier B.V.

Networked Intermedia Agenda Setting: The Geography of a Hyperlinked Scandinavian News Ecology

DEFF Research Database (Denmark)

Sjøvaag, Helle; Stavelin, Eirik; Karlsson, Michael

How does agenda setting work within the hyperlinked Scandinavian news ecology? This paper investigates intermedia agenda setting within and between the local, regional, national and supra-national levels in Sweden, Denmark and Norway; analyses the center/periphery dimensions of hyperlink connecti......, social geography and hyperlinked news agendas in Scandinavia, adding to the research on the political implications of the Internet on national public spheres....... March 2016, amounting to approximately 2 million hyperlinks, each geotagged with publication origin. The visualisation of the hyperlink structure is one of the main results of the analysis, illuminating a) the relative disconnect between local and national hyperlinked agendas, b) the relative disconnect...... between news agendas in the three countries, and c) the connectedness enabled by size, resources and central location in the Scandinavian hyperlinked information structure. The network analysis provides new insights into the relationship between centralized political structures, media ownership dispersal...

Ventilation and gas exchange management after cardiac arrest.

Science.gov (United States)

Sutherasan, Yuda; Raimondo, Pasquale; Pelosi, Paolo

2015-12-01

For several decades, physicians had integrated several interventions aiming to improve the outcomes in post-cardiac arrest patients. However, the mortality rate after cardiac arrest is still as high as 50%. Post-cardiac arrest syndrome is associated with high morbidity and mortality due to not only poor neurological outcome and cardiovascular failure but also respiratory dysfunction. To minimize ventilator-associated lung injury, protective mechanical ventilation by using low tidal volume ventilation and driving pressure may decrease pulmonary complications and improve survival. Low level of positive end-expiratory pressure (PEEP) can be initiated and titrated with careful cardiac output and respiratory mechanics monitoring. Furthermore, optimizing gas exchange by avoiding hypoxia and hyperoxia as well as maintaining normocarbia may improve neurological and survival outcome. Early multidisciplinary cardiac rehabilitation intervention is recommended. Minimally invasive monitoring techniques, that is, echocardiography, transpulmonary thermodilution method measuring extravascular lung water, as well as transcranial Doppler ultrasound, might be useful to improve appropriate management of post-cardiac arrest patients. Copyright © 2015 Elsevier Ltd. All rights reserved.

Surface electrocardiogram to predict outcome in candidates for cardiac resynchronization therapy: a sub-analysis of the CARE-HF trial

DEFF Research Database (Denmark)

Gervais, Renaud; Leclercq, Christophe; Shankar, Aparna

2009-01-01

AIMS: In CARE-HF, cardiac resynchronization therapy (CRT) lowered morbidity and mortality in patients with moderate to severe heart failure. We examined whether baseline and follow-up electrocardiographic characteristics might predict long-term outcome. METHODS AND RESULTS: CARE-HF randomly assig...

Termination of Resuscitation Rules to Predict Neurological Outcomes in Out-of-Hospital Cardiac Arrest for an Intermediate Life Support Prehospital System.

Science.gov (United States)

Cheong, Randy Wang Long; Li, Huihua; Doctor, Nausheen Edwin; Ng, Yih Yng; Goh, E Shaun; Leong, Benjamin Sieu-Hon; Gan, Han Nee; Foo, David; Tham, Lai Peng; Charles, Rabind; Ong, Marcus Eng Hock

2016-01-01

Futile resuscitation can lead to unnecessary transports for out-of-hospital cardiac arrest (OHCA). The Basic Life Support (BLS) and Advanced Life Support (ALS) termination of resuscitation (TOR) guidelines have been validated with good results in North America. This study aims to evaluate the performance of these two rules in predicting neurological outcomes of OHCA patients in Singapore, which has an intermediate life support Emergency Medical Services (EMS) system. A retrospective cohort study was carried out on Singapore OHCA data collected from April 2010 to May 2012 for the Pan-Asian Resuscitation Outcomes Study (PAROS). The outcomes of each rule were compared to the actual neurological outcomes of the patients. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and predicted transport rates of each test were evaluated. A total of 2,193 patients had cardiac arrest of presumed cardiac etiology. TOR was recommended for 1,411 patients with the BLS-TOR rule, with a specificity of 100% (91.9, 100.0) for predicting poor neurological outcomes, PPV 100% (99.7, 100.0), sensitivity 65.7% (63.6, 67.7), NPV 5.6% (4.1, 7.5), and transportation rate 35.6%. Using the ALS-TOR rule, TOR was recommended for 587 patients, specificity 100% (91.9, 100.0) for predicting poor neurological outcomes, PPV 100% (99.4, 100.0), sensitivity 27.3% (25.4, 29.3), NPV 2.7% (2.0, 3.7), and transportation rate 73.2%. BLS-TOR predicted survival (any neurological outcome) with specificity 93.4% (95% CI 85.3, 97.8) versus ALS-TOR 98.7% (95% CI 92.9, 99.8). Both the BLS and ALS-TOR rules had high specificities and PPV values in predicting neurological outcomes, the BLS-TOR rule had a lower predicted transport rate while the ALS-TOR rule was more accurate in predicting futility of resuscitation. Further research into unique local cultural issues would be useful to evaluate the feasibility of any system-wide implementation of TOR.

Irish and Scandinavian objection to Sellafield

International Nuclear Information System (INIS)

Haaland, Leif

2001-01-01

The article deals with the objection of Ireland and the Scandinavian countries to the radioactive emissions from the Sellafield reprocessing plant. This contamination follows the sea currents northward and radioactive material from this plant has been found in seaweed and crustaceans along the coast of Norway. The concentration in lobster from the Irish Sea is much higher than in Norwegian crustaceans and above the action limit set by the EU for the radioactive isotope Technetium 99 in the event of a new atomic accident. British authorities have refused to stop the pollution and even plan to start production of MOX fuel at Sellafield. They say new purification techniques will be developed within three or five years. For Norway, the opposition against Sellafield is a priority

[Cardiac myxoma -- the influence of preoperative clinical presentation and surgical technique on late outcome].

Science.gov (United States)

Mikić, Aleksandar; Obrenović-Krcanski, Bilijana; Kocica, Mladen; Vranes, Mile; Lacković, Vesna; Velinović, Milos; Miarković, Miroslav; Kovacević, Natasa; Djukić, Petar

2007-01-01

Cardiac myxomas are the most frequent primary tumours of the heart in adults, and they can be found in each of four cardiac chambers. Although biologically benign, due to their unfavourable localization, myxomas are considered "functionally malignant" tumours. Diagnosis of cardiac myxoma necessitates surgical treatment. To analyse: 1) the influence of localization, size and consistency of cardiac myxomas on preoperative symptomatology; 2) the influence of different surgical techniques (left, right, biatrial approach, tumour basis solving) on early, and late outcomes. From 1982 to 2000, at the Institute for Cardiovascular Diseases, Clinical Centre of Serbia, there were 46 patients with cardiac myxomas operated on, 67.4% of them women, mean age 47.1 +/- 16.3 years. The diagnosis was made according to clinical presentation, electrocardiographic and echocardiographic examinations and cardiac catheterization. Follow-up period was 4-18 (mean 7.8) years. In 41 (89.1%) patients, myxoma was localized in the left, while in 5 (10.9%), it was found in the right atrium. Average size was 5.8 x 3.8 cm (range: 1 x l cm to 9 x 8 cm) and 6 x 4 cm (range: 3 x 2 cm to 9 x 5 cm) for the left and right atrial myxomas, respectively. A racemous form predominated in the left (82.6%) and globous in the right (80%) atrium. Fatigue was the most common general (84.8%) and dyspnoea the most common cardiologic symptom (73.9%). Preoperative embolic events were present in 8 patients (4 pulmonary, 4 systemic). In our series: 1) different localization, size and consistency had no influence on the preoperative symptomatology; 2) surgical treatment applied, regardless of different approaches and basis solving, resulted in excellent functional improvements (63.1% patients in NYHA III and IV class preoperatively vs. 6.7% patients postoperatively) and had no influence on new postoperative rhythm disturbances (8.7% patients preoperatively vs. 24.4% patients postoperatively); 3) early (97.8%), and late

Reduced Right Ventricular Function Predicts Long-Term Cardiac Re-Hospitalization after Cardiac Surgery.

Directory of Open Access Journals (Sweden)

Leela K Lella

Full Text Available The significance of right ventricular ejection fraction (RVEF, independent of left ventricular ejection fraction (LVEF, following isolated coronary artery bypass grafting (CABG and valve procedures remains unknown. The aim of this study is to examine the significance of abnormal RVEF by cardiac magnetic resonance (CMR, independent of LVEF in predicting outcomes of patients undergoing isolated CABG and valve surgery.From 2007 to 2009, 109 consecutive patients (mean age, 66 years; 38% female were referred for pre-operative CMR. Abnormal RVEF and LVEF were considered 30 days outcomes included, cardiac re-hospitalization, worsening congestive heart failure and mortality. Mean clinical follow up was 14 months.Forty-eight patients had reduced RVEF (mean 25% and 61 patients had normal RVEF (mean 50% (p<0.001. Fifty-four patients had reduced LVEF (mean 30% and 55 patients had normal LVEF (mean 59% (p<0.001. Patients with reduced RVEF had a higher incidence of long-term cardiac re-hospitalization vs. patients with normal RVEF (31% vs.13%, p<0.05. Abnormal RVEF was a predictor for long-term cardiac re-hospitalization (HR 3.01 [CI 1.5-7.9], p<0.03. Reduced LVEF did not influence long-term cardiac re-hospitalization.Abnormal RVEF is a stronger predictor for long-term cardiac re-hospitalization than abnormal LVEF in patients undergoing isolated CABG and valve procedures.

42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

Science.gov (United States)

2010-10-01

... of the items and services furnished under the plan. (iii) The goals set for the individual under the... prescribed exercise, cardiac risk factor modification, psychosocial assessment, and outcomes assessment... section. Intensive cardiac rehabilitation site means a hospital outpatient setting or physician's office...

Early Outcomes of Out-of-Hospital Cardiac Arrest after Early Defibrillation: a 24 Months Retrospective Analysis

Directory of Open Access Journals (Sweden)

Paolo Terranova

2006-10-01

Full Text Available Introduction: Cardiovascular disease remains the most common cause of death in the United States and most other Western nations. Among these deaths, sudden, out-of-hospital cardiac arrest claims approximately 1000 lives each day in the United States alone. Most of these cardiac arrests are due to ventricular fibrillation. Though highly reversible with the rapid application of a defibrillator, ventricular fibrillation is otherwise fatal within minutes, even when cardiopulmonary resuscitation is provided immediately. The overall survival rate in the United States is estimated to be less than 5 percent. Recent developments in automated-external-defibrillator technology have provided a means of increasing the rate of prompt defibrillation after out-of-hospital cardiac arrest. After minimal training, nonmedical personnel (e.g., flight attendants and casino workers are also able to use defibrillators in the workplace, with lifesaving effects. Nonetheless, such programs have involved designated personnel whose job description includes assisting persons who have had sudden cardiac arrest. Data are still lacking on the success of programs in which automated external defibrillators have been installed in public places to be used by persons who have no specific training or duty to act. Materials and Methods: All patients who had an out-of-hospital cardiac arrest between January 2003 and December 2004 and who received early defibrillation for ventricular fibrillation were included. We conducted a 24 months retrospective population-based analysis of the outcome in our population. Results: Over a 24 month period, 446 people had non–traumatic cardiac arrest, and in all of them it was observed to be ventricular fibrillation. In a very few cases, the defibrillator operators were good Samaritans, acting voluntarily. Eighty-nine patients (about 19% with ventricular fibrillation were successfully resuscitated, including eighteen who regained consciousness before

Actinic prurigo in Scandinavian adolescent successfully treated with cyclosporine A

Directory of Open Access Journals (Sweden)

Jan C. Sitek

2017-06-01

Full Text Available Actinic prurigo is a pruritic sun-induced dermatosis classified among the immunologically mediated photodermatoses. The disease is a well-known entity among Native Americans and in Central and South America, however rare in Caucasians with only a few reports from Australia, Britain and France. We report the first case of actinic prurigo in a Scandinavian patient, responding favorably to systemic treatment with cyclosporine A.

Actinic Prurigo in Scandinavian Adolescent Successfully Treated with Cyclosporine A.

Science.gov (United States)

Sitek, Jan C

2017-03-13

Actinic prurigo is a pruritic sun-induced dermatosis classified among the immunologically mediated photodermatoses. The disease is a well-known entity among Native Americans and in Central and South America, however rare in Caucasians with only a few reports from Australia, Britain and France. We report the first case of actinic prurigo in a Scandinavian patient, responding favorably to systemic treatment with cyclosporine A.

Bystander Automated External Defibrillator Use and Clinical Outcomes after Out-of-Hospital Cardiac Arrest

DEFF Research Database (Denmark)

Holmberg, Mathias J; Vognsen, Mikael; Andersen, Mikkel S

2017-01-01

Aim: To systematically review studies comparing bystander automated external defibrillator (AED) use to no AED use in regard to clinical outcomes in out-of-hospital cardiac arrest (OHCA), and to provide a descriptive summary of studies on the cost-effectiveness of bystander AED use. Methods: We...... randomized trials, and 13 cost-effectiveness studies were included. Meta-analysis of 6 observational studies without critical risk of bias showed that bystander AED use was associated with survival to hospital discharge (all rhythms OR: 1.73 [95% CI: 1.36, 2.18], shockable rhythms OR: 1.66 [95% CI: 1.54, 1.......79]) and favorable neurological outcome (all rhythms OR: 2.12 [95% CI: 1.36, 3.29], shockable rhythms OR: 2.37 [95% CI: 1.58, 3.57]). There was no association between bystander AED use and neurological outcome for non-shockable rhythms (OR: 0.76 [95% CI: 0.10, 5.87]). The Public-Access Defibrillation trial found...

The interrelationship between preoperative anemia and N-terminal pro-B-type natriuretic peptide: the effect on predicting postoperative cardiac outcome in vascular surgery patients.

Science.gov (United States)

Goei, Dustin; Flu, Willem-Jan; Hoeks, Sanne E; Galal, Wael; Dunkelgrun, Martin; Boersma, Eric; Kuijper, Ruud; van Kuijk, Jan-Peter; Winkel, Tamara A; Schouten, Olaf; Bax, Jeroen J; Poldermans, Don

2009-11-01

N-terminal pro-B-type natriuretic peptide (NT-proBNP) predicts adverse cardiac outcome in patients undergoing vascular surgery. However, several conditions might influence this prognostic value, including anemia. In this study, we evaluated whether anemia confounds the prognostic value of NT-proBNP for predicting cardiac events in patients undergoing vascular surgery. A detailed cardiac history, resting echocardiography, and hemoglobin and NT-proBNP levels were obtained in 666 patients before vascular surgery. Anemia was defined as serum hemoglobin value of NT-proBNP for the prediction of the composite end point. Multivariable regression analysis was used to assess the additional value of NT-proBNP for the prediction of postoperative cardiac events in nonanemic and anemic patients. Anemia was present in 206 patients (31%) before surgery. Hemoglobin level was inversely related with the NT-proBNP levels (beta coefficient = -2.242; P = 0.025). The optimal predictive cutoff value of NT-proBNP for predicting the composite cardiovascular outcome was 350 pg/mL. After adjustment for clinical cardiac risk factors, both anemia (odds ratio [OR] 1.53; 95% confidence interval [CI]: 1.07-2.99) and increased levels of NT-proBNP (OR 4.09; 95% CI: 2.19-7.64) remained independent predictors for postoperative cardiac events. However, increased levels of NT-proBNP were not predictive for the risk of adverse cardiac events in the subgroup of anemic patients (OR 2.16; 95% CI: 0.90-5.21). Both anemia and NT-proBNP are independently associated with an increased risk for postoperative cardiac events in patients undergoing vascular surgery. NT-proBNP has less predictive value in anemic patients.

Elizabeth Bowen, Modernism, and the Spectre of Anglo-Ireland

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James F. Wurtz

2010-03-01

Full Text Available The recent scholarly focus on Elizabeth Bowen’s modernism tends to reinforce a false dichotomy between Bowen as an Ascendancy Big House novelist and Bowen as a literary modernist. In keeping with Jameson’s argument that the colonial experience is at the root of Western modernism, I propose that her representations of Anglo-Irish Big House culture, in The Last September in particular, are in fact focal points for understanding Bowen as a modernist, and I argue that the Gothic, with its unavoidable political and colonial resonances, is fundamental to Bowen’s Irish modernism.

Catálogo de reproductores anglo-árabes, 2016

OpenAIRE

Cervantes Navarro, Isabel; Sánchez Guerrero, María José; Bartolomé Medina, Ester; Negro Rama, Sara; Valera Córdoba, María Mercedes; Molina Alcalá, Antonio; Serradilla Manrique, Juan Manuel; Valera Córdoba, María Mercedes (Coordinador)

2016-01-01

Avanzando en el Programa de Mejora de la raza equina Anglo-árabe (Aá), me es grato presentar el sexto Catálogo de Reproductores de esta raza, en el que se recogen los caballos que han alcanzado alguna de las Categorías Genéticas recogidas en su Programa de Mejora (Jóvenes Reproductores Recomendados y Reproductores Élites), para las disciplinas hípicas de Concurso Completo de Equitación, Salto de Obstáculos y Raid. Como en años anteriores, la información genealógica, fenotípica y genética de l...

Ethnic identity, self-esteem, and occupational aspirations of Indian and Anglo-Saxon British adolescents.

Science.gov (United States)

Hogg, M A; Abrams, D; Patel, Y

1987-11-01

A questionnaire monitoring occupational aspiration, ethnic identification, adolescent experience, and self-esteem was administered to a large sample of Indian and Anglo-Saxon British male and female adolescents attending school in the West Midlands. The relationship between these variables and differences between the four groups were consistent with predictions derived from the social identity approach to intergroup relations and group behaviour (Tajfel & Turner, 1979). Indian males were found to possess a social mobility belief structure that mediates high occupational aspirations and keeness to marry out of their ethnic group. In contrast, Indian females were found to possess a social change belief structure associated with acceptance of the status quo and lower aspirations. Males and Anglo-Saxons reported higher self-esteem than females or Indians. The adolescent experience findings were less clear, but were consistent with the general interpretation of the data that the differences in intersex relations and gender-related experiences are contingent on ethnicity.

The Viking Great Army and its Legacy: plotting settlement shift using metal-detected finds

Directory of Open Access Journals (Sweden)

Dave Haldenby

2016-09-01

Full Text Available Investigation of the Anglian and Anglo-Scandinavian settlement at Burrow House Farm, Cottam, East Yorkshire from 1993-95 was a pioneering collaboration between archaeologists and metal-detectorists, and led to the identification of a new form of Anglo-Scandinavian farmstead. It was also one of the first investigations ever undertaken of a 'productive site', so-called because of the large quantities of early medieval metalwork recovered by metal-detecting. The project provided an important demonstration of the effects of the reorganisation of land ownership following the Scandinavian settlement of Northumbria. Excavation demonstrated that the abandonment of an Anglian 'Butterwick-type' enclosure in the late 9th century was closely followed by the construction of the new Anglo-Scandinavian farmstead some 100m to the north, reinforced by the pattern seen in the horizontal stratigraphy of dated metalwork derived from metal-detecting (Richards 1999a; 2001a. Subsequently, metal-detecting has continued at the site, almost doubling the quantity of artefacts. This has led to further breakthroughs in the interpretation of the chronological and spatial development of the settlement, as well as some substantial revisions to the typology and dating of early medieval artefacts, with important implications for the chronology of the period. It allows some significant new conclusions to be drawn about settlement development at Cottam, identifying the changing function of the settlements, as well as their location: There are two phases of Anglian activity, with a transition from an 8th/9th-century estate centre to a 9th-century market, echoing the similar transitions being recorded in Scandinavia at sites such as Tissø. This is the first time such a configuration has been identified in England, and it throws important new light on the nature of 'productive sites'. There are also two phases of Viking activity, with an initial phase of looting, probably linked to

Impact of recent studies on attitudes and use of hormone therapy among Scandinavian gynaecologists

DEFF Research Database (Denmark)

Pedersen, Anette Tønnes; Iversen, Ole-Erik; Løkkegaard, Ellen

2007-01-01

Climacteric medicine has been in focus during the last 2 decades, and an intensive debate has been ongoing regarding the positive and negative aspects of postmenopausal hormone therapy (HT). Recent randomised controlled studies have been unable to confirm data from observational studies of primary...... or secondary preventive effects of HT on coronary heart disease, and other studies have indicated an increased risk of breast cancer, stroke and venous thromboembolism among HT users. In 2001, we reported on knowledge, attitudes, management strategies and use of HT among Scandinavian gynaecologists. The aim...... of the present study was to re-assess the same parameters concerning HT among Scandinavian gynaecologists in 2002-2003, and compare the results with the data collected in 1995-1997....

FIASCO II failure to achieve a satisfactory cardiac outcome study: the elimination of system errors.

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Farid, Shakil; Page, Aravinda; Jenkins, David; Jones, Mark T; Freed, Darren; Nashef, Samer A M

2013-07-01

Death in low-risk cardiac surgical patients provides a simple and accessible method by which modifiable causes of death can be identified. In the first FIASCO study published in 2009, local potentially modifiable causes of preventable death in low-risk patients with a logistic EuroSCORE of 0-2 undergoing cardiac surgery were inadequate myocardial protection and lack of clarity in the chain of responsibility. As a result, myocardial protection was improved, and a formalized system introduced to ensure clarity of the chain of responsibility in the care of all cardiac surgical patients. The purpose of the current study was to re-audit outcomes in low-risk patients to see if improvements have been achieved. Patients with a logistic EuroSCORE of 0-2 who had cardiac surgery from January 2006 to August 2012 were included. Data were prospectively collected and retrospectively analysed. The case notes of patients who died in hospital were subject to internal and external review and classified according to preventability. Two thousand five hundred and forty-nine patients with a logistic EuroSCORE of 0-2 underwent cardiac surgery during the study period. Seven deaths occurred in truly low-risk patients, giving a mortality of 0.27%. Of the seven, three were considered preventable and four non-preventable. Mortality was marginally lower than in our previous study (0.37%), and no death occurred as a result of inadequate myocardial protection or communication failures. We postulate that the regular study of such events in all institutions may unmask systemic errors that can be remedied to prevent or reduce future occurrences. We encourage all units to use this methodology to detect any similarly modifiable factors in their practice.

The New York State cardiac registries: history, contributions, limitations, and lessons for future efforts to assess and publicly report healthcare outcomes.

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Hannan, Edward L; Cozzens, Kimberly; King, Spencer B; Walford, Gary; Shah, Nirav R

2012-06-19

In 1988, the New York State Health Commissioner was confronted with hospital-level data demonstrating very large, multiple-year, interhospital variations in short-term mortality and complications for cardiac surgery. The concern with the extent to which these differences were due to variations in patients' pre-surgical severity of illness versus hospitals' quality of care led to the development of clinical registries for cardiac surgery in 1989 and for percutaneous coronary interventions in 1992 in New York. In 1990, the Department of Health released hospitals' risk-adjusted cardiac surgery mortality rates for the first time, and shortly thereafter, similar data were released for hospitals and physicians for percutaneous coronary interventions, cardiac valve surgery, and pediatric cardiac surgery (only hospital data). This practice is still ongoing. The purpose of this communication is to relate the history of this initiative, including changes or purported changes that have occurred since the public release of cardiac data. These changes include decreases in risk-adjusted mortality, cessation of cardiac surgery in New York by low-volume and high-mortality surgeons, out-of-state referral or avoidance of cardiac surgery/angioplasty for high-risk patients, alteration of contracting choices by insurance companies, and modifications in market share of cardiac hospitals. Evidence related to these impacts is reviewed and critiqued. This communication also includes a summary of numerous studies that used New York's cardiac registries to examine a variety of policy issues regarding the choice and use of cardiac procedures, the comparative effectiveness of competing treatment options, and the examination of the relationship among processes, structures, and outcomes of cardiac care. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Allocentric and Idiocentric Self-Description and Academic Achievement among Mexican American and Anglo American Adolescents.

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Dabul, Amy J.; And Others

1995-01-01

Posits a distinction between cultures motivated by individualistic value systems (idiocentric) and collectivistic value systems (allocentric). Study reveals that Mexican American adolescents describe themselves in more allocentric terms, while Anglo American adolescents choose idiocentric terms. Suggests a correlation between idiocentric values…

Inclusive and Women-friendly in a time of Diversity? The Scandinavian citizenship regime – the ‘childcare lesson’

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Cecilie Thun

2015-01-01

Full Text Available In this article, I ask: Is the Scandinavian citizenship regime inclusive and women-friendly in a time of diversity? I approach this question by addressing the intersection of gender and ethnicity in relation to social citizenship with the main concern being childcare. I emphasize Norway as a case but also see Norway in comparison with Sweden and Denmark. In comparative studies, the Scandinavian citizenship regime is presented as being the most ‘women-friendly’. However, faced with an increasingly multicultural population, a pertinent question is whether this citizenship model is able to accommodate diversity. I explore two tensions that are basic to the inclusiveness and women-friendliness of the Scandinavian citizenship regime in diverse societies: 1 The tension between principles of gender equality and cultural diversity, and 2 the tension between liberating and controlling aspects of the welfare state. This article discusses the Norwegian family policy ‘hybrid’, which combines dual-earner support with traditional breadwinner elements. One might say that the Norwegian family ‘hybrid’ can be a solution to the tension between, on the one hand, a specific gender-equality family norm, and, on the other hand, the respect for other family norms. However, I argue that there is a double standard with regard to minority women, and it can be understood in light of a discourse about Norwegianness. Parental choice is considered a good thing – as long as the mother in question is considered ‘fully’ Norwegian. However, assumed cultural and ethnic differences – often based on stereotypical collective categories of difference – are used as boundary-markers between the majority and minorities. I conclude that, despite variations, all the Scandinavian countries grapple with the same tensions, and that there is a Scandinavian double standard regarding minority women.

Does pattern-welding make Anglo-Saxon swords stronger?

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Birch, Thomas

2013-01-01

to assess whether the technique affects mechanical properties, this experimental study compared pattern-welded and plain forged blanks in a series of material tests. Specimens were subject to tensile, Charpy and Vickers diamond hardness testing. This was to investigate the relative strength, ductility......The purpose of pattern-welding, used for the construction of some Anglo-Saxon swords, has yet to be fully resolved. One suggestion is that the technique enhanced the mechanical properties of a blade. Another explanation is that pattern-welding created a desired aesthetic appearance. In order...... and toughness of pattern-welding. The results were inconclusive, however the study revealed that the fracture performance of pattern-welding may relate to its use....

[Reliability of nursing outcomes classification label "Knowledge: cardiac disease management (1830)" in outpatients with heart failure].

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Cañón-Montañez, Wilson; Oróstegui-Arenas, Myriam

2015-01-01

To determine the reliability (internal consistency, inter-rater reproducibility and level of agreement) of nursing outcome: "Knowledge: cardiac disease management (1830)" of the version published in Spanish, in outpatients with heart failure. A reliability study was conducted on 116 outpatients with heart failure. Six indicators of nursing outcome were operationalized. All participants were assessed simultaneously by two evaluators. Three evaluation periods were defined: initial (at baseline), final (a month later), and follow-up (two months later). Internal consistency by Cronbach alpha coefficient, inter-rater reproducibility with intraclass correlation coefficient of reproducibility or agreement and level agreement using the 95% limits of Bland and Altman. Cronbach's alpha was 0.83 (95% CI: 0.77 - 0.89) in the final evaluation, and follow-up values of 0.85 (95% CI: 0.82-0.89) and 0.83 (95% CI: 0.78 - 0.88) were found for the first and second evaluator, respectively. The intraclass correlation coefficient showed values greater 0.9 in the three evaluation periods in both the random and mixed model. The Bland-Altman 95% limits of agreement were close to zero in the three evaluations performed. The questionnaire operationalized to assess the nursing outcome: "Knowledge: cardiac disease management (1830)" in its Spanish version, is a reliable method to measure skills and knowledge in outpatients with heart failure in the Colombian context. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Educational Leadership and Culture in China: Dichotomies between Chinese and Anglo-American Leadership Traditions?

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Law, Wing-Wah

2012-01-01

This article explores the extent to which Chinese school leaders espouse dichotomous or integrated Chinese and Anglo-American leadership and management preferences. Data are drawn from questionnaires completed by school leaders and from semi-structured interviews with individual school leaders from different parts of China. The exploratory study…

From Oral Ceremony to Written Document: The Transitional Language of Anglo-Saxon Wills.

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Danet, Brenda; Bogoch, Bryna

1992-01-01

Presents theoretical discussion of the emergence of linguistic features of documents that indicate society is moving toward a view of writing as a form of constitutive social action and of written documents as autonomous material objects having a life of their own. Linguistic features of Anglo-Saxon wills are shown to differ from those of modern…

Blunt Cardiac Injury in the Severely Injured - A Retrospective Multicentre Study.

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Marc Hanschen

Full Text Available Blunt cardiac injury is a rare trauma entity. Here, we sought to evaluate the relevance and prognostic significance of blunt cardiac injury in severely injured patients.In a retrospective multicentre study, using data collected from 47,580 patients enrolled to TraumaRegister DGU (1993-2009, characteristics of trauma, prehospital / hospital trauma management, and outcome analysis were correlated to the severity of blunt cardiac injury. The severity of cardiac injury was assessed according to the abbreviated injury score (AIS score 1-6, the revised injury severity score (RISC allowed comparison of expected outcome with injury severity-dependent outcome. N = 1.090 had blunt cardiac trauma (AIS 1-6 (2.3% of patients.Predictors of blunt cardiac injury could be identified. Sternal fractures indicate a high risk of the presence of blunt cardiac injury (AIS 0 [control]: 3.0%; AIS 1: 19.3%; AIS 2-6: 19.1%. The overall mortality rate was 13.9%, minor cardiac injury (AIS 1 and severe cardiac injury (AIS 2-6 are associated with higher rates. Severe blunt cardiac injury (AIS 4 and AIS 5-6 is associated with a higher mortality (OR 2.79 and 4.89, respectively as compared to the predicted average mortality (OR 2.49 of the study collective.Multiple injured patients with blunt cardiac trauma are at high risk to be underestimated. Careful evaluation of trauma patients is able to predict the presence of blunt cardiac injury. The severity of blunt cardiac injury needs to be stratified according to the AIS score, as the patients' outcome is dependent on the severity of cardiac injury.

DNA polymorphism of Arabian, Thoroughbred and Anglo-Arab horses in Morocco. Application to identification and parentage verification of individual horses

International Nuclear Information System (INIS)

Ouragh, L.

2005-01-01

New techniques of molecular biology used in analysing DNA polymorphism give access to the whole genetic variability of a given individual, while traditional blood typing (red cell typing and biochemical polymorphisms) gives access only to the transcribed Fraction, which is then translated to protein. In addition, this fraction represents only a tiny part (5 to 10%) of the genome's coding fraction. One of the newer testing methods in identifying horses is a DNA-based test using microsatellite marker analysis. The objective of this work was to evaluate the efficacy of this new technology in the identification and parentage verification of Arabian, Thoroughbred and Anglo-Arab horses in Morocco. The Anglo-Arab horse is a crossbreed between Arabian and Thoroughbred. Three samples from the three breeds were analysed for 12 microsatellites (HMS2, HMS3, HMS6, HMS7, HTG4, HTG6, HTG7, AHT4, AHTS, VHL20, HTGlO and ASB2). Blood samples were gathered from a total of 1541 horses: 804 Arabians, 559 Thoroughbreds and 178 Anglo-Arabs. Allelic frequencies of the 12 loci studied were calculated in the three groups. The results allowed the determination of intra-population genetic parameters: heterozygosity ratio (h), probability of identification (P i ) and probability of exclusion (P e ). Based on mean heterozygosity values, variability was relatively lower in Thoroughbred horse (0.7036), while it was almost the same in Arabian and Anglo-Arab horses (respectively 0.7217 and 0.7232). Probabilities of exclusion obtained with the 12 systems were greater than 99.9% for the three populations studied, and probabilities of identification of individual horses were 15.4 x 10 -12 , 3 .5 x 10 -12 and 3.2 x 10 -12 in the Thoroughbred, Arabian and Anglo-Arab breeds, respectively. These results indicate that the test using microsatellite marker analysis constitutes a highly efficient and reliable alternative for the identification and parentage verification of individual horses and so it is a

Contradictory Explorative Assessment. Multimodal Teacher/Student Interaction in Scandinavian Digital Learning Environments

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Kjällander, Susanne

2018-01-01

Assessment in the much-discussed digital divide in Scandinavian technologically advanced schools, is the study object of this article. Interaction is studied to understand assessment; and to see how assessment can be didactically designed to recognise students' learning. With a multimodal, design theoretical perspective on learning teachers' and…

Perspectives on the emblems of the nation in contemporary Estonian and Anglo-Welsh poetry / Ene-Reet Soovik

Index Scriptorium Estoniae

Soovik, Ene-Reet, 1968-

2000-01-01

Kaasaegse eesti luule ja Walesi ingliskeelse luule võrdlemiseks on kasutatud uusi antoloogiaid: Eesti luule antoloogia II (koost. Raivo Kuusk, 1998), Twentieth-century anglo-welsh poetry (ed. Dannie Abse, 1997)

Study of a large Anglo-Saxon family with beta-thalassaemia trait.

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Raik, E; Powell, E; Gordon, S

1976-01-01

Study of a large Anglo-Saxon family with beta-thalassaemia trait revealed evidence of consanguinity, moreover both branches of the family shared a Spanish ancestor. The manifestations of the disorder were varied in severity and yet the degree of severity appeared to breed true within any individual part of the family. Our explanation for the inheritance pattern observed in the family was to postulate the existence of two non-allelic genes influencing the rate of beta-chain synthesis.

Management and outcome of cardiac and endovascular cystic echinococcosis.

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Marta Díaz-Menéndez

2012-01-01

Full Text Available BACKGROUND: Cystic echinococcosis (CE can affect the heart and the vena cava but few cases are reported. METHODS: A retrospective case series of 11 patients with cardiac and/or endovascular CE, followed-up over a period of 15 years (1995-2009 is reported. RESULTS: Main clinical manifestations included thoracic pain or dyspnea, although 2 patients were asymptomatic. Cysts were located mostly in the right atrium and inferior vena cava. Nine patients were previously diagnosed with disseminated CE. Echocardiography was the diagnostic method of choice, although serology, electrocardiogram, chest X-ray, computed tomography/magnetic resonance imaging and histology aided with diagnosis and follow-up. Nine patients underwent cardiac surgery and nine received long-term antiparasitic treatment for a median duration of 25 months (range 4-93 months. One patient died intra-operatively due to cyst rupture and endovascular dissemination. Two patients died 10 and 14 years after diagnosis, due to pulmonary embolism (PE and cardiac failure, respectively. One patient was lost to follow-up. Patients who had cardiac involvement exclusively did not have complications after surgery and were considered cured. There was only one recurrence requiring a second operation. Patients with vena cava involvement developed PEs and presented multiple complications. CONCLUSIONS: Cardiovascular CE is associated with a high risk of potentially lethal complications. Clinical manifestations and complications vary according to cyst location. Isolated cardiac CE may be cured after surgery, while endovascular extracardiac involvement is associated with severe chronic complications. CE should be included in the differential diagnosis of cardiovascular disease in patients from endemic areas.

Impact of Bystander Automated External Defibrillator Use on Survival and Functional Outcomes in Shockable Observed Public Cardiac Arrests.

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Pollack, Ross A; Brown, Siobhan P; Rea, Thomas; Aufderheide, Tom; Barbic, David; Buick, Jason E; Christenson, James; Idris, Ahamed H; Jasti, Jamie; Kampp, Michael; Kudenchuk, Peter; May, Susanne; Muhr, Marc; Nichol, Graham; Ornato, Joseph P; Sopko, George; Vaillancourt, Christian; Morrison, Laurie; Weisfeldt, Myron

2018-02-26

Background - Survival following out-of-hospital cardiac arrest (OHCA) with shockable rhythms can be improved with early defibrillation. Although shockable OHCA accounts for only ≈25% of overall arrests, ≈60% of public OHCAs are shockable, offering the possibility of restoring thousands of individuals to full recovery with early defibrillation by bystanders. We sought to determine the association of bystander automated external defibrillator use with survival and functional outcomes in shockable observed public OHCA. Methods - From 2011 to 2015, the Resuscitation Outcomes Consortium prospectively collected detailed information on all cardiac arrests at 9 regional centers. The exposures were shock administration by a bystander-applied automated external defibrillator in comparison with initial defibrillation by emergency medical services. The primary outcome measure was discharge with normal or near-normal (favorable) functional status defined as a modified Rankin Score ≤2. Survival to hospital discharge was the secondary outcome measure. Results -Among 49 555 OHCAs, 4115 (8.3%) observed public OHCAs were analyzed, of which 2500 (60.8%) were shockable. A bystander shock was applied in 18.8% of the shockable arrests. Patients shocked by a bystander were significantly more likely to survive to discharge (66.5% versus 43.0%) and be discharged with favorable functional outcome (57.1% versus 32.7%) than patients initially shocked by emergency medical services. After adjusting for known predictors of outcome, the odds ratio associated with a bystander shock was 2.62 (95% confidence interval, 2.07-3.31) for survival to hospital discharge and 2.73 (95% confidence interval, 2.17-3.44) for discharge with favorable functional outcome. The benefit of bystander shock increased progressively as emergency medical services response time became longer. Conclusions - Bystander automated external defibrillator use before emergency medical services arrival in shockable observed

Effect of battery longevity on costs and health outcomes associated with cardiac implantable electronic devices: a Markov model-based Monte Carlo simulation.

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Schmier, Jordana K; Lau, Edmund C; Patel, Jasmine D; Klenk, Juergen A; Greenspon, Arnold J

2017-11-01

The effects of device and patient characteristics on health and economic outcomes in patients with cardiac implantable electronic devices (CIEDs) are unclear. Modeling can estimate costs and outcomes for patients with CIEDs under a variety of scenarios, varying battery longevity, comorbidities, and care settings. The objective of this analysis was to compare changes in patient outcomes and payer costs attributable to increases in battery life of implantable cardiac defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-D). We developed a Monte Carlo Markov model simulation to follow patients through primary implant, postoperative maintenance, generator replacement, and revision states. Patients were simulated in 3-month increments for 15 years or until death. Key variables included Charlson Comorbidity Index, CIED type, legacy versus extended battery longevity, mortality rates (procedure and all-cause), infection and non-infectious complication rates, and care settings. Costs included procedure-related (facility and professional), maintenance, and infections and non-infectious complications, all derived from Medicare data (2004-2014, 5% sample). Outcomes included counts of battery replacements, revisions, infections and non-infectious complications, and discounted (3%) costs and life years. An increase in battery longevity in ICDs yielded reductions in numbers of revisions (by 23%), battery changes (by 44%), infections (by 23%), non-infectious complications (by 10%), and total costs per patient (by 9%). Analogous reductions for CRT-Ds were 23% (revisions), 32% (battery changes), 22% (infections), 8% (complications), and 10% (costs). Based on modeling results, as battery longevity increases, patients experience fewer adverse outcomes and healthcare costs are reduced. Understanding the magnitude of the cost benefit of extended battery life can inform budgeting and planning decisions by healthcare providers and insurers.

Serum cardiac troponin I and cardiac troponin T concentrations in dogs with gastric dilatation-volvulus.

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Schober, Karsten E; Cornand, Corinna; Kirbach, Babett; Aupperle, Heike; Oechtering, Gerhard

2002-08-01

To determine whether serum concentrations of cardiac troponin I (cTnI) and cardiac troponin T (cTnT) are increased in dogs with gastric dilatationvolvulus (GDV) and whether concentrations correlate with severity of ECG abnormalities or outcome. Prospective case series. 85 dogs with GDV. Serum cTnl and cTnT concentrations were measured 12 to 24, 48, 72, and 96 hours after surgery. Dogs were grouped on the basis of severity of ECG abnormalities and outcome. cTnl and cTnT were detected in serum from 74 (87%) and 43 (51%) dogs, respectively. Concentrations were significantly different among groups when dogs were grouped on the basis of severity of ECG abnormalities (none or mild vs moderate vs severe). Dogs that died (n = 16) had significantly higher serum cTnI (24.9 ng/ml) and cTnT (0.18 ng/ml) concentrations than did dogs that survived (2.05 and dogs with high serum cardiac troponin concentrations. Results indicate that concentrations of cTnI and cTnT suggestive of myocardial cell injury can commonly be found in serum from dogs with GDV and that serum cardiac troponin concentrations are associated with severity of ECG abnormalities and outcome.

Immigration and integration policy and labour market attainment among Scandinavian immigrants

DEFF Research Database (Denmark)

Jakobsen, Vibeke; Korpi, Tomas; Lorentzen, Thomas

Comparing immigrant labour market integration, the OECD ranked the Scandinavian countries Denmark, Norway and Sweden at the bottom. Integration depends on immigration and integration policy, and the countries’ policies have traditionally here been very similar. However, in the early 2000s Denmark......, employment trends in Norway and Sweden were almost as positive without similar earnings penalties, questioning the aptness of the Danish reforms....

Enhanced pyruvate dehydrogenase activity improves cardiac outcomes in a murine model of cardiac arrest.

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Lin Piao

Full Text Available Post-ischemic changes in cellular metabolism alter myocardial and neurological function. Pyruvate dehydrogenase (PDH, the limiting step in mitochondrial glucose oxidation, is inhibited by increased expression of PDH kinase (PDK during ischemia/reperfusion injury. This results in decreased utilization of glucose to generate cellular ATP. Post-cardiac arrest (CA hypothermia improves outcomes and alters metabolism, but its influence on PDH and PDK activity following CA are unknown. We hypothesized that therapeutic hypothermia (TH following CA is associated with the inhibition of PDK activity and increased PDH activity. We further hypothesized that an inhibitor of PDK activity, dichloroacetate (DCA, would improve PDH activity and post-CA outcomes.Anesthetized and ventilated adult female C57BL/6 wild-type mice underwent a 12-minute KCl-induced CA followed by cardiopulmonary resuscitation. Compared to normothermic (37°C CA controls, administering TH (30°C improved overall survival (72-hour survival rate: 62.5% vs. 28.6%, P<0.001, post-resuscitation myocardial function (ejection fraction: 50.9±3.1% vs. 27.2±2.0%, P<0.001; aorta systolic pressure: 132.7±7.3 vs. 72.3±3.0 mmHg, P<0.001, and neurological scores at 72-hour post CA (9.5±1.3 vs. 5.4±1.3, P<0.05. In both heart and brain, CA increased lactate concentrations (1.9-fold and 3.1-fold increase, respectively, P<0.01, decreased PDH enzyme activity (24% and 50% reduction, respectively, P<0.01, and increased PDK protein expressions (1.2-fold and 1.9-fold, respectively, P<0.01. In contrast, post-CA treatment with TH normalized lactate concentrations (P<0.01 and P<0.05 and PDK expressions (P<0.001 and P<0.05, while increasing PDH activity (P<0.01 and P<0.01 in both the heart and brain. Additionally, treatment with DCA (0.2 mg/g body weight 30 min prior to CA improved both myocardial hemodynamics 2 hours post-CA (aortic systolic pressure: 123±3 vs. 96±4 mmHg, P<0.001 and 72-hour survival rates

[Cardiac surgery in octogenarian patients: evaluation of predictive factors of mortality, long-term outcome and quality of life].

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Viana-Tejedor, Ana; Domínguez, Francisco J; Moreno Yangüela, Mar; Moreno, Raúl; López de Sá, Esteban; Mesa, José M; López-Sendón, José

2008-10-04

Increasing life expectancy in Western countries in the last decades has resulted in a significant gradual increasing number of octogenarians referred for cardiac surgery. There is a need for a critical evaluation of the long-term surgical outcome and quality of life in the elderly. The aim of this study is to identify risk factors of mortality in octogenarians undergoing cardiac surgery and to assess the long term survival and quality of life. Data were reviewed on 150 patients aged over 80 years--mean age (standard deviation): 82.7 (2.5) years--who underwent cardiac surgery at our institution in the last 26 years. We analyzed clinical and epidemiological variables included in the European System for Cardiac Operative Risk Evaluation (euroSCORE), in-hospital morbidity and mortality, long term survival and quality of life after cardiac surgery. The 30-day mortality rate was 30.1%, with a mean hospital stay of 16.5 days (13-27). Emergent procedure, reparation of postinfarction ventricular ruptures, New York Heart Association functional class IV, chronic renal failure and previous myocardial infarction were independent predictors of in-hospital mortality. Mean follow up was 72.2 (9.9) months with survival rates of 87.3% and 57% at 1 and 5 years, respectively. Late postoperative quality of life in our 53 long-term survivors was significantly better than prior to surgery. New York Heart Association functional class improved from 2.52 to 1.48. Most survivors (97.7%) were satisfied with present quality of life Cardiac surgery in octogenarians is associated with increased in-hospital mortality rate and longer hospital stay. Our findings support that cardiac surgery can be performed in a selected elderly population with good long-term survival and quality of life.

Associations between blood glucose level and outcomes of adult in-hospital cardiac arrest: a retrospective cohort study.

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Wang, Chih-Hung; Huang, Chien-Hua; Chang, Wei-Tien; Tsai, Min-Shan; Yu, Ping-Hsun; Wu, Yen-Wen; Chen, Wen-Jone

2016-08-24

We intended to analyse the associations between blood glucose (BG) level and clinical outcomes of in-hospital cardiac arrest (IHCA). We conducted a retrospective observational study in a single medical centre and evaluated patients who experienced IHCA between 2006 and 2014. We used multivariable logistic regression analysis to study associations between independent variables and outcomes. We calculated the mean BG level for each patient by averaging the maximum and minimum BG levels in the first 24 h after arrest, and we used mean BG level for our final analysis. We included a total of 402 patients. Of these, 157 patients (39.1 %) had diabetes mellitus (DM). The average mean BG level was 209.9 mg/dL (11.7 mmol/L). For DM patients, a mean BG level between 183 and 307 mg/dL (10.2-17.1 mmol/L) was significantly associated with favourable neurological outcome (odds ratio [OR] 2.71, 95 % confidence interval [CI] 1.18-6.20; p value = 0.02); a mean BG level between 147 and 317 mg/dL (8.2-17.6 mmol/L) was significantly associated with survival to hospital discharge (OR 2.38, 95 % CI 1.26-4.53; p value = 0.008). For non-DM patients, a mean BG level between 143 and 268 mg/dL (7.9-14.9 mmol/L) was significantly associated with survival to hospital discharge (OR 2.93, 95 % CI 1.62-5.40; p value level in the first 24 h after cardiac arrest was associated with neurological outcome for IHCA patients with DM. For neurological and survival outcomes, the optimal BG range may be higher for patients with DM than for patients without DM.

Initial Efficacy of a Cardiac Rehabilitation Transition Program: Cardiac TRUST

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Zullo, Melissa; Boxer, Rebecca; Moore, Shirley M.

2012-01-01

Patients recovering from cardiac events are increasingly using postacute care, such as home health care and skilled nursing facility services. The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self- Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity walking and education in self-management skills to facilitate recovery following a cardiac event. Using a randomized two-group design, exercise self-efficacy, steps walked, and participation in an outpatient cardiac rehabilitation program were compared in a sample of 38 older adults; 17 who received the Cardiac TRUST program and 21 who received usual care only. At discharge from postacute care, the intervention group had a trend for higher levels of self-efficacy for exercise outcomes (X=39.1, SD=7.4) than the usual care group (X=34.5; SD=7.0) (t-test 1.9, p=.06). During the 6 weeks following discharge, compared with the usual care group, the intervention group had more attendance in out-patient cardiac rehabilitation (33% compared to 11.8%, F=7.1, p=.03) and a trend toward more steps walked during the first week (X=1,307, SD=652 compared to X=782, SD=544, t-test 1.8, p=.07). The feasibility of the intervention was better for the home health participants than for those in the skilled nursing facility and there were no safety concerns. The provision of cardiac-focused rehabilitation during postacute care has the potential to bridge the gap in transitional services from hospitalization to outpatient cardiac rehabilitation for these patients at high risk for future cardiac events. Further evidence of the efficacy of Cardiac TRUST is warranted. PMID:22084960

The borderline conditions--an introduction from a Scandinavian perspective

DEFF Research Database (Denmark)

Simonsen, E

1994-01-01

disorder--impulsive or borderline subcategory. This closer demarcation of prototypes in the classification system may facilitate less confusion in future. All Scandinavian countries have contributed a great deal to the research in the field of borderline conditions, especially with regard to genetic...... and nosological issues. A brief summary of these contributions is presented. Some important notions in the phenomenologic and prototypically oriented European tradition of classifying personality disorders are explained in order to understand the rather ambiguous reaction to the borderline concept in European...

Priority setting in health care: trends and models from Scandinavian experiences.

Science.gov (United States)

Hofmann, Bjørn

2013-08-01

The Scandinavian welfare states have public health care systems which have universal coverage and traditionally low influence of private insurance and private provision. Due to raises in costs, elaborate public control of health care, and a significant technological development in health care, priority setting came on the public agenda comparatively early in the Scandinavian countries. The development of health care priority setting has been partly homogeneous and appears to follow certain phases. This can be of broader interest as it may shed light on alternative models and strategies in health care priority setting. Some general trends have been identified: from principles to procedures, from closed to open processes, and from experts to participation. Five general approaches have been recognized: The moral principles and values based approach, the moral principles and economic assessment approach, the procedural approach, the expert based practice defining approach, and the participatory practice defining approach. There are pros and cons with all of these approaches. For the time being the fifth approach appears attractive, but its lack of true participation and the lack of clear success criteria may pose significant challenges in the future.

O poder das letras: cristianismo e magia no Pater Noster anglo-saxão

Directory of Open Access Journals (Sweden)

Elton Oliveira Souza de Medeiros

2013-05-01

Full Text Available Uma área que vem crescendo nas últimas décadas no campo historiográfico é o estudo sobre as práticas mágicas medievais. Dentro do cenário a ser abordado neste artigo – a Inglaterra anglo-saxônica – há uma documentação substancial de natureza literária, escrita entre os séculos IX e XI, que se revela como uma fonte essencial para o tema em questão. Neste artigo então pretendemos realizar uma análise sobre o uso e a importância das letras e palavras para as práticas mágicas dentro do contexto da cristandade e focando como um exemplo disso o poder do Pater Noster contido no poema em inglês antigo Salomão & Satuno I, que se revela como uma mescla de elementos da tradição cristã greco-romana e das práticas mágicas populares anglo-saxônicas.

Why Should We Prevent a Global Anglo-American Life-World? A Democratic-Deliberative Answer

Directory of Open Access Journals (Sweden)

Morales-Gálvez Sergi

2016-10-01

Full Text Available Should English be promoted as a worldwide lingua franca for justice-related reasons? Philippe Van Parijs answers affirmatively in order to promote global distributive justice. In contrast, I argue that a rapid expansion of English could lead to one undesirable consequence that ought to be prevented: the globalization of an Anglo-American life-world that impoverishes democratic-deliberative debates. Inspired by John Stuart Mill, I will defend the idea that the more dominant the Anglo-American life-world is, the less diversity of life-worlds and, therefore, the less diversity of substantial voices in the global democratic-deliberative process there will be. It might be that more voices could be heard (because of the lingua franca, but with less substantial diversity of opinions. In that sense, the life-worlds (and language as an access key to them have an instrumental value that enables plurality and better deliberative discussion. For that reason, I contend that there is a pro tanto reason to prevent the expansion of English as a lingua franca.

Cardiac biomarkers in neonatal hypoxic ischaemia.

LENUS (Irish Health Repository)

Sweetman, D

2012-04-01

Following a perinatal hypoxic-ischaemic insult, term infants commonly develop cardiovascular dysfunction. Troponin-T, troponin-I and brain natriuretic peptide are sensitive indicators of myocardial compromise. The long-term effects of cardiovascular dysfunction on neurodevelopmental outcome following perinatal hypoxic ischaemia remain controversial. Follow-up studies are warranted to ensure optimal cardiac function in adulthood. CONCLUSION: Cardiac biomarkers may improve the diagnosis of myocardial injury, help guide management, estimate mortality risk and may also aid in longterm neurodevelopmental outcome prediction following neonatal hypoxic-ischaemia.

Direct Cardiac Reprogramming: Advances in Cardiac Regeneration

Directory of Open Access Journals (Sweden)

Olivia Chen

2015-01-01

Full Text Available Heart disease is one of the lead causes of death worldwide. Many forms of heart disease, including myocardial infarction and pressure-loading cardiomyopathies, result in irreversible cardiomyocyte death. Activated fibroblasts respond to cardiac injury by forming scar tissue, but ultimately this response fails to restore cardiac function. Unfortunately, the human heart has little regenerative ability and long-term outcomes following acute coronary events often include chronic and end-stage heart failure. Building upon years of research aimed at restoring functional cardiomyocytes, recent advances have been made in the direct reprogramming of fibroblasts toward a cardiomyocyte cell fate both in vitro and in vivo. Several experiments show functional improvements in mouse models of myocardial infarction following in situ generation of cardiomyocyte-like cells from endogenous fibroblasts. Though many of these studies are in an early stage, this nascent technology holds promise for future applications in regenerative medicine. In this review, we discuss the history, progress, methods, challenges, and future directions of direct cardiac reprogramming.

The Image of War Correspondents in Anglo-American Fiction. Journalism Monographs Number Ninety-Seven.

Science.gov (United States)

Good, Howard

The work of war correspondents involves violence, danger, and drama; and what they endure to get a story is often as interesting as the actual news itself. Anglo-American fiction tends toward an ironic, even cynical, view of combat reporting that serves as a corrective to the notion, fostered in journalists' autobiographies, that war is fun. It…

Scandinavian Dialect Syntax (before and after 2005

Directory of Open Access Journals (Sweden)

Øystein Alexander Vangsnes

2007-04-01

Full Text Available This paper gives an outline of the goals of the pan-Nordic project umbrella Scandinavian Dialect Syntax and of how the research collaboration is organized and financed, and of how the collaboration has advanced during the last 4-5 years. Special attention is devoted to the NORMS Nordic Center of Excellence project which in effect constitutes a highly focused branch of the larger network. There are clear scientific advantages of initiating large scale cooperation of the sort represented by the ScanDiaSyn umbrella, but there are also several challenges and obstacles, especially when it comes to funding. The experiences from the ScanDiaSyn collaboration may therefore be useful from the perspective of the organization of research more generally.

Verkkokauppa PCI DSS - standardin mukaiseksi : case Scandinavian Outdoor

OpenAIRE

Kiiski, Tomi

2015-01-01

Tämän opinnäytetyön tavoitteena on selvittää, mitä toimia verkkokaupalta vaaditaan PCI DSS - standardin mukaisuuteen sekä mikä PCI DSS -standardi on ja mitä se sisältää. Työn toimeksiantaja on Scandinavian Outdoor Oy. Toimeksiantajan edellinen PCI DSS -auditointi on suoritettu standardin vanhalla versiolla ja standardista on nyt uusi versio. Työn teoriaosa käsittelee yleisesti PCI DSS -standardia, sen sisältöä sekä vaatimuksia. Työn tärkeimpänä lähteenä on käytetty PCI SSC:n ju...

Right Atrial Dual-loop Reentry Tachycardia after Cardiac Surgery: Prevalence, Electrophysiologic Characteristics and Ablation Outcomes.

Science.gov (United States)

Yang, Jian-du; Sun, Qi; Guo, Xiao-Gang; Zhou, Gong-Bu; Liu, Xu; Luo, Bin; Wei, Hui-Qiang; Santangeli, Pasquale; Liang, Jackson J; Ma, Jian

2018-04-03

Right atrial dual-loop reentry tachycardia has been described in patients with open-heart surgery. However, the prevalence, electrophysiologic substrate and ablation outcomes have been poorly characterized. We aimed to investigate the prevalence, electrophysiologic substrate and ablation outcomes for RA dual-loop reentry tachycardia following cardiac surgery. We identified all patients with atrial tachycardia after cardiac surgery. We compared electrophysiologic findings and outcomes of those with RA dual-loop reentry tachycardia versus a control group of patients with RA macro-reentrant arrhythmias in the setting of linear RA free wall (FW) scar. Out of 127 patients with 152 post-surgical atrial tachycardias (ATs), 28 (18.4%) had diagnosis of RA dual-loop reentry and 24/28 (85.7%) had tricuspid annular (TA) reentry combined with FW incisional reentry. An incision length > 51.5mm along the FW predicted the substrate for a second loop. In 22/23 patients (95.7%) with initial ablation in the cavo-tricuspid isthmus, a change in the interval between Halo d to CS p could be recorded, while 15/23 patients (65.2%) had CS activation pattern change. Complete success was achieved in 25/28 (89.3%) and 64/69 (92.8%) in the dual-loop reentry and control groups, respectively. After mean follow-up of 33.9±24.2 months, 24/28 (85.7%) and 60/69 (86.95%) were free of arrhythmias after initial procedure in two groups. The prevalence of RA dual-loop reentry is 18.4% among ATs with prior atriotomy scar. A long incision should alert physician the possibility of the second loop at the FW. Halo and CS activation pattern are important clues for circuit transformation. Copyright © 2018. Published by Elsevier Inc.

Organized medicine and Scandinavian professional unionism: hospital policies and exit options in Denmark and Sweden.

Science.gov (United States)

Heidenheimer, A J; Johansen, L N

1985-01-01

Strikes by junior hospital doctors over the issue of on-call remuneration in Denmark and Sweden in 1981 are analyzed to clarify the impact of public-sector cost-control policies on intra- and interprofessional solidarity within the Scandinavian professional peak associations. The junior doctors' grievances could find expression either through increased "voice" within the medical negotiating machinery, or by pursuing the exit option in having the medical associations quit the peak associations. The article explains why the "exit" option was selected in Denmark, while in Sweden the granting of additional voice helped persuade the medical association to withdraw its exit threat and to remain within the peak association. The two cases are interpreted as presaging a divergence in the paths being taken by the various Scandinavian welfare states.

Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study.

NARCIS (Netherlands)

Amant, F.; Calsteren, K. van; Halaska, M.J.; Gziri, M.M.; Hui, W.; Lagae, L.; Willemsen, M.A.A.P.; Kapusta, L.; Calster, B. van; Wouters, H; Heyns, L.; Han, S.N.; Tomek, V.; Mertens, L.; Ottevanger, P.B.

2012-01-01

BACKGROUND: Chemotherapy for the treatment of maternal cancers during pregnancy has become more acceptable in the past decade; however, the effect of prenatal exposure to chemotherapy on cardiac and neurodevelopmental outcomes of the offspring is still uncertain. We aimed to record the general

Stress cardiac magnetic resonance imaging provides effective cardiac risk reclassification in patients with known or suspected stable coronary artery disease.

Science.gov (United States)

Shah, Ravi; Heydari, Bobak; Coelho-Filho, Otavio; Murthy, Venkatesh L; Abbasi, Siddique; Feng, Jiazhuo H; Pencina, Michael; Neilan, Tomas G; Meadows, Judith L; Francis, Sanjeev; Blankstein, Ron; Steigner, Michael; di Carli, Marcelo; Jerosch-Herold, Michael; Kwong, Raymond Y

2013-08-06

A recent large-scale clinical trial found that an initial invasive strategy does not improve cardiac outcomes beyond optimized medical therapy in patients with stable coronary artery disease. Novel methods to stratify at-risk patients may refine therapeutic decisions to improve outcomes. In a cohort of 815 consecutive patients referred for evaluation of myocardial ischemia, we determined the net reclassification improvement of the risk of cardiac death or nonfatal myocardial infarction (major adverse cardiac events) incremental to clinical risk models, using guideline-based low (3%) annual risk categories. In the whole cohort, inducible ischemia demonstrated a strong association with major adverse cardiac events (hazard ratio=14.66; Pstatistic, 0.81-0.86; P=0.04; adjusted hazard ratio=7.37; PStress cardiac magnetic resonance imaging effectively reclassifies patient risk beyond standard clinical variables, specifically in patients at moderate to high pretest clinical risk and in patients with previous coronary artery disease. http://www.clinicaltrials.gov. Unique identifier: NCT01821924.

Practice Variation in Single-Ventricle Patients Undergoing Elective Cardiac Catheterization: A Report from the Congenital Cardiac Catheterization Project on Outcomes (C3PO).

Science.gov (United States)

Goldstein, Bryan H; Holzer, Ralf J; Trucco, Sara M; Porras, Diego; Murphy, Joshua; Foerster, Susan R; El-Said, Howaida G; Beekman, Robert H; Bergersen, Lisa

2016-01-01

The objective of this study was to investigate variation in practice surrounding elective cardiac catheterization in patients with single-ventricle (SV) congenital heart disease. Patient and procedural characteristics and outcomes during SV catheterization were collected prospectively from eight centers using a web-based registry (Congenital Cardiac Catheterization Project on Outcomes). We attempted to identify a population of elective procedures by limiting the cohort in case type and timing. Cases were then stratified by stage of SV palliation (pre-bidirectional cavopulmonary anastomosis [pre-BCPA], pre-Fontan and post-Fontan) and limited by age. Subcohort analysis was performed by mode of airway management (assisted vs. spontaneous ventilation). Institutional variation was assessed. Between 2/2007 and 6/2010, 1459 (10.1%) of 14 467 cases in the registry met the inclusion and exclusion criteria, including 326 pre-BCPA, 571 pre-Fontan and 562 post-Fontan procedures. Median patient age was 0.4 (interquartile range 0.3, 0.5), 2.6 (1.0, 3.4) and 9.6 (5.2, 15.4) years and weight was 5.6 (4.8, 6.4), 12.2 (10.5, 14), and 26.3 (16.6, 51.8) kg in the pre-BCPA, pre-Fontan and post-Fontan cohorts, respectively. Cases were more commonly diagnostic in the pre-BCPA cohort (57%) whereas they were more commonly interventional in the pre-Fontan (69%) and post-Fontan (77%) cohorts. At least one adverse event (AE) occurred in 210 cases (14.4%) overall, including 20% of pre-BCPA, 11% of pre-Fontan and 14% of post-Fontan catheterizations. Mode of airway management was associated with statistically significant, but clinically small differences in hemodynamic measures in the pre- and post-Fontan cohorts, but not in the pre-BCPA group. Considerable practice variation exists across centers with variability in airway management, AE rate, case type, interventions performed and fluoroscopy time, in all SV cohorts. Elective catheterization in SV patients, frequently performed with

Experiences and Perceptions of Physical Activity Among South Asian and Anglo-Australians With Type 2 Diabetes or Cardiovascular Disease: Implications for Clinical Practice.

Science.gov (United States)

Gupta, Sabrina S; Aroni, Rosalie; Teede, Helena

2017-02-01

Research indicates that there are worryingly low levels of physical activity among South Asians compared with Anglo-Australians with type 2 diabetes and/or cardiovascular disease (CVD). We compared perceptions, barriers, and enablers of physical activity in these groups. We used a qualitative design, conducting in-depth, semistructured iterative interviews in Victoria with 57 South Asian and Anglo-Australian participants with either type 2 diabetes or CVD. While both groups exhibited knowledge of the value of physical activity in health maintenance and disease management, they wished for more specific and culturally tailored advice from clinicians about the type, duration, and intensity of physical activity required. Physical activity identities were tied to ethnic identities, with members of each group aspiring to meet the norms of their culture regarding engagement with physical activity as specific exercise or as incidental exercise. Individual personal exercise was deemed important by Anglo-Australians whereas South Asians preferred family-based physical activity.

Spaces for the Social Shaping of Information Technology and Work. A reassessment of Scandinavian action research and its implications for action

DEFF Research Database (Denmark)

Clausen, Christian

2004-01-01

This contribution explores a range of social spaces where unions and workers have played or potential can play a role in the local social shaping of IT and work. It will mainly be based on the authors own research and experiences within Scandinavian research on technology and working from the past...... 30 years. The paper provides an overview of Scandinavian research within technology and working life form a Danish perspective. A major contribution is con-cerned with a variety of strategies employed by social actors involved in action research pro-jects and their role in the social shaping...... of technology. The point is made that no single strat-egy have proved to provide an uncontested route for union or workers influence. Instead the Scandinavian experiences indicate, that a range of spaces, players and positions have been developed, providing opportunities for addressing questions related...

Ecological Predictors of Disciplinary Style and Child Abuse Potential in a Hispanic and Anglo-American Sample

Science.gov (United States)

Rodriguez, Christina M.

2008-01-01

Recent attention to multicultural issues has sparked recognition that parenting is also a culturally construed phenomenon. The present study involved a diverse sample of 90 Anglo-American and Hispanic parents examining predictors based on distal/proximal levels as conceptualized in the ecological model. The study examined background…

An Audit Of Perioperative Cardiac Arrest At Lagos University ...

African Journals Online (AJOL)

Objective: Intraoperative cardiac arrests are not uncommon and are related to both surgical and anaesthetic factors. This study aimed to examine the factors which predispose to a periopeartive cardiac arrest, to assess the appropriateness of therapy and the outcome. Materials and Methods: All perioperative cardiac arrests ...

Spectral pulsed-wave tissue Doppler imaging lateral-to-septal delay fails to predict clinical or echocardiographic outcome after cardiac resynchronization therapy

NARCIS (Netherlands)

O.I.I. Soliman (Osama Ibrahim Ibrahim); D.A.M.J. Theuns (Dominic); M.L. Geleijnse (Marcel); A. Nemes (Attila); K. Caliskan (Kadir); W.B. Vletter (Wim); L.J.L.M. Jordaens (Luc); F.J. ten Cate (Folkert)

2007-01-01

textabstractAims: The current study sought to assess if pre-implantation lateral-to-septal delay (LSD) ≥60 ms assessed by spectral pulsed-wave myocardial tissue Doppler imaging (PW-TDI) could predict successful long-term outcome after cardiac resynchronization therapy (CRT). Methods and results

The Economy of Scandinavian-American Exchange: Donations and Scholarships in the American-Scandinavian Foundation, 1912–1995

Directory of Open Access Journals (Sweden)

Christin Mays

2015-05-01

Full Text Available The importance of philanthropy for academic exchange cannot be overestimated. Especially in the first half of the twentieth century, scholarships for academic exchange originated from the private sector instead of the state. But what is the relationship between academic exchange and the donations which finance scholarships? How can specific donations and the restrictions placed on them change the flow of exchange? This article investigates donation and scholarship praxis within the American-Scandinavian Foundation (ASF from 1912–1995, a philanthropic organisation devoted to academic exchange between Scandinavia and the United States. The period, 1912–1944, is characterised by various small donations and few scholarships to mostly American fellows. The second period, 1945–1995, represents an era of economic growth created from a surge in large, restricted donations invested in scholarship funds. This led to an increased number of scholarships to a more geographically diverse population.

Social inequalities in "sickness"

DEFF Research Database (Denmark)

van der Wel, Kjetil A; Dahl, Espen; Thielen, Karsten

2012-01-01

In comparative studies of health inequalities, public health researchers have usually studied only disease and illness. Recent studies have also examined the sickness dimension of health, that is, the extent to which ill health is accompanied by joblessness, and how this association varies...... consistent results. They analyze data from the European Union Statistics on Income and Living Conditions (EU-SILC); health was measured by limiting longstanding illness (LLSI). Results show that for both men and women reporting LLSI in combination with low educational level, the probabilities of non......-employment were particularly high in the Anglo-Saxon and Eastern welfare regimes, and lowest in the Scandinavian regime. For men, absolute and relative social inequalities in sickness were lowest in the Southern regime; for women, inequalities were lowest in the Scandinavian regime. The authors conclude...

Identification of cardiac repercussions after intense and prolonged concentric isokinetic exercise in young sedentary people.

Science.gov (United States)

Le Goff, Caroline; Kaux, Jean-François; Couffignal, Vincent; Coubard, Romain; Mélon, Pierre; Cavalier, Etienne; Croisier, Jean-Louis

2015-09-01

Cardiopathies are the world's leading cause of mortality and morbidity. Although rare, cardiovascular accidents can occur during intense and infrequent sporting activity, particularly among those who are unaware of their heart condition. The development of cardiospecific biochemical markers has led to a reconsideration of the role of biology in the diagnosis of cardiovascular illnesses. The aim of this study therefore was, through the use of cardiac biomarker assays, to highlight the impact of sustained physical effort in the form of intense and prolonged concentric isokinetic exercise and to research potential cardiovascular risks. Eighteen subjects participated in a maximal concentric isokinetic exercise involving 30 knee flexion-extensions for each leg. Five blood tests were taken to study the kinetics of the cardiac biomarkers. Haemodynamic parameters were measured continuously using a Portapres, and respiratory parameters were measured using a Sensormedics Vmax 29C. The results showed significant increases in the creatine kinase, myoglobin, homocysteine and haemoglobin cardiac markers. Evolutionary trends were also observed for the following biomarkers: NT-proBNP, myeloperoxydase and C-reactive protein. All the physiological parameters measured presented statistically significant changes. Isokinetic effort leads to the release of cardiac markers in the blood, but these do not exceed the reference values in healthy subjects. Maximal concentric isokinetic exercise does not, therefore, lead to an increased risk of cardiovascular pathologies. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Neurologic outcome in comatose patients resuscitated from out-of-hospital cardiac arrest with prolonged downtime and treated with therapeutic hypothermia

Science.gov (United States)

Kim, Won Young; Giberson, Tyler A.; Uber, Amy; Berg, Katherine; Cocchi, Michael N.; Donnino, Michael W.

2014-01-01

Background Previous reports have shown that prolonged duration of resuscitation efforts in out-of-hospital cardiac arrest (OHCA) is associated with poor neurologic outcome. This concept has recently been questioned with advancements in post-cardiac arrest care including the use of therapeutic hypothermia (TH). The aim of this study was to determine the rate of good neurologic outcome based on the duration of resuscitation efforts in OHCA patients treated with TH. Methods This prospective, observational, study was conducted between January 2008 and September 2012. Inclusion criteria consisted of adult non-traumatic OHCA patients who were comatose after return of spontaneous circulation (ROSC) and received TH. The primary endpoint was good neurologic outcome defined as a cerebral performance category score of 1 or 2. Downtime was calculated as the length of time between the patient being recognized as pulseless and ROSC. Results 105 patients were treated with TH and 19 were excluded due to unknown downtime, leaving 86 patients for analysis. The median downtime was 18.5 (10.0–32.3) minutes and 33 patients (38.0%) had a good neurologic outcome. When downtime was divided into four groups (≤10 min, 11-20 min, 21-30 min, > 30 min), good neurologic outcomes were 62.5%, 37%, 25%, and 21.7%, respectively (p=0.02). However, even with downtime >20 minutes, 22.9% had a good neurologic outcome, and this percentage increased to 37.5% in patients with an initial shockable rhythm. Conclusions Although longer downtime is associated with worse outcome in OHCA patients, we found that comatose patients who have been successfully resuscitated and treated with TH have neurologically intact survival rates of 23% even with downtime > 20 minutes. PMID:24746783

Neurologic outcome in comatose patients resuscitated from out-of-hospital cardiac arrest with prolonged downtime and treated with therapeutic hypothermia.

Science.gov (United States)

Kim, Won Young; Giberson, Tyler A; Uber, Amy; Berg, Katherine; Cocchi, Michael N; Donnino, Michael W

2014-08-01

Previous reports have shown that prolonged duration of resuscitation efforts in out-of-hospital cardiac arrest (OHCA) is associated with poor neurologic outcome. This concept has recently been questioned with advancements in post-cardiac arrest care including the use of therapeutic hypothermia (TH). The aim of this study was to determine the rate of good neurologic outcome based on the duration of resuscitation efforts in OHCA patients treated with TH. This prospective, observational, study was conducted between January 2008 and September 2012. Inclusion criteria consisted of adult non-traumatic OHCA patients who were comatose after return of spontaneous circulation (ROSC) and received TH. The primary endpoint was good neurologic outcome defined as a cerebral performance category score of 1 or 2. Downtime was calculated as the length of time between the patient being recognized as pulseless and ROSC. 105 patients were treated with TH and 19 were excluded due to unknown downtime, leaving 86 patients for analysis. The median downtime was 18.5 (10.0-32.3)min and 33 patients (38.0%) had a good neurologic outcome. When downtime was divided into four groups (≤10min, 11-20min, 21-30min, >30min), good neurologic outcomes were 62.5%, 37%, 25%, and 21.7%, respectively (p=0.02). However, even with downtime >20min, 22.9% had a good neurologic outcome, and this percentage increased to 37.5% in patients with an initial shockable rhythm. Although longer downtime is associated with worse outcome in OHCA patients, we found that comatose patients who have been successfully resuscitated and treated with TH have neurologically intact survival rates of 23% even with downtime >20min. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Learning Style Preferences of Korean-, Mexican-, Armenian-American, and Anglo Students in Secondary Schools. Research Brief.

Science.gov (United States)

Park, Clara C.

1997-01-01

Investigated the four basic learning style preferences (visual, auditory, kinesthetic, and tactile) of Korean-, Armenian-, and Mexican-American students attending 10 Los Angeles schools and compared them with those of Anglo students. All four ethnic groups, regardless of sex and academic achievement level, indicate a major preference for…

Home Environments and Perceived Needs of Anglo and Latino Families of Young Children with Visual Impairments

Science.gov (United States)

Dote-Kwan, Jamie; Chen, Deborah; Hughes, Margaret

2009-01-01

This study examined the influence of home environment, socioeconomic status, and visual functioning on mothers' perceptions of the family needs and development of 19 toddlers with visual impairments from Latino and Anglo backgrounds. Differences were found between the mothers' perceived needs based on ethnicity and their children's degree of…

The influence of body mass index on outcomes in patients undergoing cardiac surgery: does the obesity paradox really exist?

Directory of Open Access Journals (Sweden)

Juan Carlos Lopez-Delgado

Full Text Available Obesity influences risk stratification in cardiac surgery in everyday practice. However, some studies have reported better outcomes in patients with a high body mass index (BMI: this is known as the obesity paradox. The aim of this study was to quantify the effect of diverse degrees of high BMI on clinical outcomes after cardiac surgery, and to assess the existence of an obesity paradox in our patients.A total of 2,499 consecutive patients requiring all types of cardiac surgery with cardiopulmonary bypass between January 2004 and February 2009 were prospectively studied at our institution. Patients were divided into four groups based on BMI: normal weight (18.5-24.9 kg∙m-2; n = 523; 21.4%, overweight (25-29.9 kg∙m-2; n = 1150; 47%, obese (≥ 30-≤ 34.9 kg∙m-2; n = 624; 25.5% and morbidly obese (≥ 35kg∙m-2; n = 152; 6.2%. Follow-up was performed in 2,379 patients during the first year.After adjusting for confounding factors, patients with higher BMI presented worse oxygenation and better nutritional status, reflected by lower PaO2/FiO2 at 24h and higher albumin levels 48 h after admission respectively. Obese patients showed a higher risk for Perioperative Myocardial Infarction (OR: 1.768; 95% CI: 1.035-3.022; p = 0.037 and septicaemia (OR: 1.489; 95% CI: 1.282-1.997; p = 0.005. In-hospital mortality was 4.8% (n = 118 and 1-year mortality was 10.1% (n = 252. No differences were found regarding in-hospital mortality between BMI groups. The overweight group showed better 1-year survival than normal weight patients (91.2% vs. 87.6%; Log Rank: p = 0.029. HR: 1.496; 95% CI: 1.062-2.108; p = 0.021.In our population, obesity increases Perioperative Myocardial Infarction and septicaemia after cardiac surgery, but does not influence in-hospital mortality. Although we found better 1-year survival in overweight patients, our results do not support any protective effect of obesity in patients undergoing cardiac surgery.

Experience of digital control systems in Scandinavian BWRs

International Nuclear Information System (INIS)

Rydahl, I.

1989-01-01

Since 1984 digital control systems have been in operation in various Scandinavian BWRs. Examples of such digital control systems are: dual microprocessor based system for complete control of radwaste plant, three channel recirculation control system, and three channel feedwater control system. This paper describes Swedish development from one channel through three channel analog control systems to digital systems. The author describes experience of digital control systems during design, testing, commissioning and operation. The main benefits of digital compared with analog technology are discussed. Especially the outstanding facility of using a built-in process simulator for commissioning and tuning. The use of digital technology in nuclear safety system and future plans are dealt with

Impact of recent studies on attitudes and use of hormone therapy among Scandinavian gynaecologists

DEFF Research Database (Denmark)

Pedersen, Anette Tønnes; Iversen, Ole-Erik; Løkkegaard, Ellen

2007-01-01

or secondary preventive effects of HT on coronary heart disease, and other studies have indicated an increased risk of breast cancer, stroke and venous thromboembolism among HT users. In 2001, we reported on knowledge, attitudes, management strategies and use of HT among Scandinavian gynaecologists. The aim...

Contemporary Anglo-Jewish community leadership: coping with multiculturalism.

Science.gov (United States)

Gidley, Ben; Kahn-Harris, Keith

2012-03-01

In this article, drawing on qualitative interviews and documentary analysis, we argue that the Jewish community in Britain has undergone a fundamental shift since 1990 from a 'strategy of security', a strategy of communal leadership based on emphasizing the secure British citizenship and belonging of the UK's Jews, to a 'strategy of insecurity', where the communal leadership instead stresses an excess of security among Anglo-Jewry. We demonstrate this based on two case studies: of the Jewish renewal movement in the 1990s and the 'new antisemitism' phenomenon of the 2000s. We conclude that this shift is tied to the shift from a monocultural Britain to an officially multicultural one, and that therefore there are lessons that can be taken from it for the study of British and other multiculturalisms. © London School of Economics and Political Science 2012.

Perioperative Rosuvastatin in Cardiac Surgery.

Science.gov (United States)

Zheng, Zhe; Jayaram, Raja; Jiang, Lixin; Emberson, Jonathan; Zhao, Yan; Li, Qi; Du, Juan; Guarguagli, Silvia; Hill, Michael; Chen, Zhengming; Collins, Rory; Casadei, Barbara

2016-05-05

Complications after cardiac surgery are common and lead to substantial increases in morbidity and mortality. Meta-analyses of small randomized trials have suggested that perioperative statin therapy can prevent some of these complications. We randomly assigned 1922 patients in sinus rhythm who were scheduled for elective cardiac surgery to receive perioperative rosuvastatin (at a dose of 20 mg daily) or placebo. The primary outcomes were postoperative atrial fibrillation within 5 days after surgery, as assessed by Holter electrocardiographic monitoring, and myocardial injury within 120 hours after surgery, as assessed by serial measurements of the cardiac troponin I concentration. Secondary outcomes included major in-hospital adverse events, duration of stay in the hospital and intensive care unit, left ventricular and renal function, and blood biomarkers. The concentrations of low-density lipoprotein cholesterol and C-reactive protein after surgery were lower in patients assigned to rosuvastatin than in those assigned to placebo (PSTICS ClinicalTrials.gov number, NCT01573143.).

Causes and consequences of past and projected Scandinavian summer temperatures, 500-2100 AD.

Directory of Open Access Journals (Sweden)

Ulf Büntgen

Full Text Available Tree rings dominate millennium-long temperature reconstructions and many records originate from Scandinavia, an area for which the relative roles of external forcing and internal variation on climatic changes are, however, not yet fully understood. Here we compile 1,179 series of maximum latewood density measurements from 25 conifer sites in northern Scandinavia, establish a suite of 36 subset chronologies, and analyse their climate signal. A new reconstruction for the 1483-2006 period correlates at 0.80 with June-August temperatures back to 1860. Summer cooling during the early 17th century and peak warming in the 1930s translate into a decadal amplitude of 2.9°C, which agrees with existing Scandinavian tree-ring proxies. Climate model simulations reveal similar amounts of mid to low frequency variability, suggesting that internal ocean-atmosphere feedbacks likely influenced Scandinavian temperatures more than external forcing. Projected 21st century warming under the SRES A2 scenario would, however, exceed the reconstructed temperature envelope of the past 1,500 years.

The Innovation Clusters in the Developments by the Scandinavian School of Cluster Theory

Directory of Open Access Journals (Sweden)

Onipko Tetiana A.

2017-08-01

Full Text Available The article generalizes and analyzes the developments by the Scandinavian School of cluster theory (scientists from Sweden, Norway and Denmark on innovative clusters. It has been found that the Scandinavian scientists considered innovative clusters as an integral component of both the regional and the national innovation systems. It has been clarified that the efficiency of an innovative cluster depends largely on the «knowledge base». It was emphasized that innovative clusters, by facilitating interactive training and generating new ideas, stimulate the development of the «economy of training». It has been determined that the coordinating structures of innovative clusters are the institutions of cooperation that facilitate interaction between enterprises, scientific centres, and authorities. It has been specified that innovative clusters contribute to the emerging of benefits for participants, including the growing opportunities for innovation, improved conditions for establishing a business, and increased productivity. It has been concluded that the development of the inner environment of an innovative cluster depends largely on its relationships to the external environment.

Tax Performance Assessment in Scandinavian Countries

Directory of Open Access Journals (Sweden)

Bunescu Liliana

2015-04-01

Full Text Available The aim of this paper is to evaluate fiscal policy performance level in Nordic countries of Europe by quantifying the gap between their performance and an optimum benchmark value. In this study it was selected Denmark, Finland, Sweden and Norway. These countries occupy the first places in the ranking of countries with the highest rate of tax burden in Europe. The first part of paper contains general aspects of fiscal performance in international research and an overview of the Nordic tax systems model. The second part of paper focuses on evaluation of tax policy performance in these countries by using OptimTax scoring analysis. The research is based on a multivariate analysis instrument that uses quantitative data on various aspects of tax policy. OptimTax achieves a score for assessing the degree of optimization of fiscal policy. The results reveal high levels of tax performance in Scandinavian countries and a trend that seems to be more constant than ascending, except Norway.

Scandinavian neuroscience during the Nazi era.

Science.gov (United States)

Kondziella, Daniel; Hansen, Klaus; Zeidman, Lawrence A

2013-07-01

Although Scandinavian neuroscience has a proud history, its status during the Nazi era has been overlooked. In fact, prominent neuroscientists in German-occupied Denmark and Norway, as well as in neutral Sweden, were directly affected. Mogens Fog, Poul Thygesen (Denmark) and Haakon Sæthre (Norway) were resistance fighters, tortured by the Gestapo: Thygesen was imprisoned in concentration camps and Sæthre executed. Jan Jansen (Norway), another neuroscientist resistor, escaped to Sweden, returning under disguise to continue fighting. Fritz Buchthal (Denmark) was one of almost 8000 Jews escaping deportation by fleeing from Copenhagen to Sweden. In contrast, Carl Værnet (Denmark) became a collaborator, conducting inhuman experiments in Buchenwald concentration camp, and Herman Lundborg (Sweden) and Thorleif Østrem (Norway) advanced racial hygiene in order to maintain the "superior genetic pool of the Nordic race." Compared to other Nazi-occupied countries, there was a high ratio of resistance fighters to collaborators and victims among the neuroscientists in Scandinavia.

Pattern of perioperative cardiac arrests at University of Maiduguri Teaching Hospital.

Science.gov (United States)

Kwari, Y D; Bello, M R; Eni, U E

2010-01-01

Perioperative cardiac arrests and death on the table represent the most serious complications of surgery and anaesthesia. This paper was designed to study their pattern, causes and outcomes following cardiopulmonary resuscitation (CPR) and intensive care unit (ICU) management in our institution. Three year retrospective review of perioperative cardiac arrests and death on operating table following surgical procedure under anaesthesia. For each cardiac arrest or death on the table the sequence of events leading to the arrest was evaluated using case notes, anaesthetic chart and ICU records. Study variables which include demographic data, ASA score, anaesthetic technique, causes and outcome were analysed and discussed. Fourteen perioperative cardiac arrests were encountered following 4051 anaesthetics administered over the three year study period. Twelve out of the fourteen cardiac arrests occurred following general anaesthesia, while the remaining two occurred following spinal anaesthesia. There was no cardiac arrest following local anaesthesia. Children suffered more cardiac arrest than adults. ASA class III and IV risk status suffered more arrests than ASA I and II. Hypoxia from airway problems was the commonest cause of cardiac arrest followed by septic shock. Monitoring with pulse oximeter was done in only 4 out of the 14 cardiac arrests. Only 2 (14%) out of 14 cardiac arrests recovered to home discharge, one of them with significant neurological deficit. Majority of arrests were due to hypoxia from airway problems that were not detected early There is need to improve on patient monitoring, knowledge of CPR and intensive care so as to improve the outcome of perioperative cardiac arrest.

Comparison of Childrearing Practices of Anglos, Cuban-Americans, and Latin Americans. Occasional Papers Series, Dialogues #5.

Science.gov (United States)

Escovar, Luis; Escovar, Peggy L.

In this report perceived childrearing practices among three cultural groups (American Anglos, Cuban Americans, and Latin Americans) were compared. Subjects were 445 college students (168 males and females from universities in Colombia and Venezuela, and 154 from a university in South Florida). A multivariate analysis of covariance was used to…

Clinical Outcomes and Quality of Life in Recipients of Livers Donated after Cardiac Death

Directory of Open Access Journals (Sweden)

Neehar D. Parikh

2015-01-01

Full Text Available Donation after cardiac death (DCD has expanded in the last decade in the US; however, DCD liver utilization has flattened in recent years due to poor outcomes. We examined clinical and quality of life (QOL outcomes of DCD recipients by conducting a retrospective and cross-sectional review of patients from 2003 to 2010. We compared clinical outcomes of DCD recipients (n=60 to those of donation after brain death (DBD liver recipients (n=669 during the same time period. DCD recipients had significantly lower rates of 5-year graft survival (P<0.001 and a trend toward lower rates of 5-year patient survival (P=0.064 when compared to the DBD cohort. In order to examine QOL outcomes in our cohorts, we administered the Short Form Liver Disease Quality of Life questionnaire to 30 DCD and 60 DBD recipients. The DCD recipients reported lower generic and liver-specific QOL. We further stratified the DCD cohort by the presence of ischemic cholangiopathy (IC. Patients with IC reported lower QOL when compared to DBD recipients and those DCD recipients without IC (P<0.05. While the results are consistent with clinical experience, this is the first report of QOL in DCD recipients using standardized measures. These data can be used to guide future comparative effectiveness studies.

The outcomes of simultaneous liver and kidney transplantation using donation after cardiac death organs.

Science.gov (United States)

Alhamad, Tarek; Spatz, Christin; Uemura, Tadahiro; Lehman, Eric; Farooq, Umar

2014-12-15

There has been a remarkable increase in simultaneous liver and kidney transplantations (SLK). As organ demand has increased, so has the use of donation after cardiac death (DCD). However, little is known about the outcomes of DCD in SLK. We performed a retrospective analysis using the United Network for Organ Sharing database to compare the outcomes of DCD SLK to donation after brain death (DBD) and determine the impact of donor and recipient factors on allograft and patient survival. Between 2002 and 2011, a total of 3,026 subjects received SLK from DBD and 98 from DCD. Kidney, liver, and patient survival from DCD donors were inferior to DBD at 1, 3, and 5 years (P=0.0056, P=0.0035, and P=0.0205, respectively). With the use of the Cox model, DCD was a significant risk factor for kidney and liver allograft failure and patient mortality. Recipient factors that were associated with worse allograft and patient outcomes included black race, diabetes, being on a ventilator, hospitalization, delayed graft function, hepatocellular carcinoma, and intensive care unit stay. Older age of the donor was also associated with worse outcomes. Despite the decreased allograft and patient survival compared with DBD, DCD SLK provides an acceptable option for SLK, with a survival probability of more than 50% at 5 years.

Successful cardiac transplantation outcomes in patients with adult congenital heart disease.

Science.gov (United States)

Menachem, Jonathan N; Golbus, Jessica R; Molina, Maria; Mazurek, Jeremy A; Hornsby, Nicole; Atluri, Pavan; Fuller, Stephanie; Birati, Edo Y; Kim, Yuli Y; Goldberg, Lee R; Wald, Joyce W

2017-09-01

The purpose of our study is (1) to characterise patients with congenital heart disease undergoing heart transplantation by adult cardiac surgeons in a large academic medical centre and (2) to describe successful outcomes associated with our multidisciplinary approach to the evaluation and treatment of adults with congenital heart disease (ACHD) undergoing orthotopic heart transplantation (OHT). Heart failure is the leading cause of death in patients with ACHD leading to increasing referrals for OHT. The Penn Congenital Transplant Database comprises a cohort of patients with ACHD who underwent OHT between March 2010 and April 2016. We performed a retrospective cohort study of the 20 consecutive patients. Original cardiac diagnoses include single ventricle palliated with Fontan (n=8), dextro-transposition of the great arteries after atrial switch (n=4), tetralogy of Fallot (n=4), pulmonary atresia (n=1), Ebstein anomaly (n=1), unrepaired ventricular septal defect (n=1) and Noonan syndrome with coarctation of the aorta (n=1). Eight patients required pretransplant inotropes and two required pretransplant mechanical support. Nine patients underwent heart-liver transplant and three underwent heart-lung transplant. Three patients required postoperative mechanical circulatory support. Patients were followed for an average of 38 months as of April 2016, with 100% survival at 30 days and 1 year and 94% overall survival (19/20 patients). ACHD-OHT patients require highly specialised, complex and multidisciplinary healthcare. The success of our programme is attributed to using team-based, patient-centred care including our multidisciplinary staff and specialists across programmes and departments. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Chronically elevated bilirubin protects from cardiac reperfusion injury in the male Gunn rat.

Science.gov (United States)

Bakrania, B; Du Toit, E F; Ashton, K J; Wagner, K-H; Headrick, J P; Bulmer, A C

2017-08-01

Bilirubin is associated with reduced risk of cardiovascular disease, as evidenced in conditions of mild hyperbilirubinaemia (Gilbert's Syndrome). Little is known regarding myocardial stress resistance in hyperbilirubinaemic conditions or whether life-long exposure modifies cardiac function, which might contribute to protection from cardiovascular disease. Hyperbilirubinaemic rats and littermate controls underwent echocardiography at 3, 6 and 12 months of age, with hearts subsequently assessed for resistance to 30 min of ischaemia. Heart tissue was then collected for assessment of bilirubin content. No difference in baseline cardiac function was evident until 6 months onwards, where Gunn rats demonstrated aortic dilatation and reduced peak ejection velocities. Additionally, duration of ventricular ejection increased progressively, indicating a negative inotropic effect of bilirubin in vivo. Ex vivo analysis of baseline function revealed reduced left ventricular pressure development (LVDP) and contractility in hyperbilirubinaemic rats. Furthermore, stress resistance was improved in Gunn hearts: post-ischaemic recoveries of LVDP (76 ± 22% vs. 29 ± 17% Control, P bilirubin exerts sex-independent effects on vascular structure, myocardial function and ischaemic tolerance, the latter likely mediated via bilirubin's antioxidant properties. © 2017 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

The Clinical Presentation, Survival Outcomes, and Management of Patients With Renal Cell Carcinoma and Cardiac Metastasis Without Inferior Vena Cava Involvement: Results From a Pooled Clinical Trial Database and Systematic Review of Reported Cases.

Science.gov (United States)

Viteri Malone, Mariuxi A; Ares, Gustavo Ruiz; De Velasco, Guillermo; Brandão, Raphael; Lin, Xun; Norton, Craig; Simantov, Ronit; Moslehi, Javid; Krajewski, Katherine M; Choueiri, Toni K; McKay, Rana R

2018-04-01

Cardiac metastases from renal cell carcinoma (RCC) are uncommon and there are limited data regarding the presentation and outcomes of this population. The objective of this study was to evaluate the characteristics and outcomes of patients with RCC with cardiac metastasis without inferior vena cava (IVC) involvement. We conducted a pooled retrospective analysis of metastatic RCC patients treated in 4 clinical trials. Additionally, we conducted a systematic review of cases reported in the literature from 1973 to 2015. Patients with cardiac metastases from RCC without IVC involvement were included. Patient and disease characteristics were described. Additionally, treatments, response to therapy, and survival outcomes were summarized. Of 1765 metastatic RCC patients in the clinical trials database, 10 had cardiac metastases without IVC involvement. All patients received treatment with targeted therapy. There was 1 observed partial response (10%) and 6 patients showed stable disease (60%). The median progression-free survival was 6.9 months. The systematic review of reported clinical cases included 39 patients. In these patients, the most common cardiac site of involvement was the right ventricle (51%; n = 20). Patients were treated with medical (28%; n = 11) and/or surgical treatment (49%; n = 19) depending on whether disease was isolated (n = 13) or multifocal (n = 26). To our knowledge, this is the first series to report on the presentation and outcomes of patients with cardiac metastasis without IVC involvement in RCC. We highlight that although the frequency of patients with cardiac metastases without IVC involvement is low, these patients have a unique clinical presentation and warrant special multidisciplinary management. Copyright © 2017 Elsevier Inc. All rights reserved.

Cardiac changes in anorexia nervosa.

Science.gov (United States)

Spaulding-Barclay, Michael A; Stern, Jessica; Mehler, Philip S

2016-04-01

Introduction Anorexia nervosa is an eating disorder, which is associated with many different medical complications as a result of the weight loss and malnutrition that characterise this illness. It has the highest mortality rate of any psychiatric disorder. A large portion of deaths are attributable to the cardiac abnormalities that ensue as a result of the malnutrition associated with anorexia nervosa. In this review, the cardiac complications of anorexia nervosa will be discussed. A comprehensive literature review on cardiac changes in anorexia nervosa was carried out. There are structural, functional, and rhythm-type changes that occur in patients with anorexia nervosa. These become progressively significant as ongoing weight loss occurs. Cardiac changes are inherent to anorexia nervosa and they become more life-threatening and serious as the anorexia nervosa becomes increasingly severe. Weight restoration and attention to these cardiac changes are crucial for a successful treatment outcome.

Scandinavian object shift, remnant VP-topicalisation, verb particles and causatives

DEFF Research Database (Denmark)

Engels, Eva; Vikner, Sten

2013-01-01

constructions in Danish and Swedish, namely particle verb constructions and causative constructions with Danish "lade" and Swedish "låta" ‘let’. It is shown how differences in the VP-internal object position give rise to mirror image sequences concerning Object Shift in connection with verb second (Vº......On the basis of an examination of remnant VP-topicalisation constructions, this paper argues for an order preservation analysis of Scandinavian Object Shift. Extending the empirical database, we account for the phenomena in an Optimality Theoretic framework. The paper focusses on two particular...

Adaptive Traffic Control Systems in a medium-sized Scandinavian city

DEFF Research Database (Denmark)

Agerholm, Niels; Olesen, Anne Vingaard

2018-01-01

Adaptive Traffic Control Systems (ATCS) are aimed at reducing congestion. ATCS adapt to approaching traffic to continuously optimise the traffic flows in question. ATCS have been implemented in many locations, including the Scandinavian countries, with various effects. Due to congestion problems......, and GPS data from a range of cars driving on the ring road formed the basis for the study. The result of ATCS implementation was a significant 17% reduction in transportation time on the ring road in the most congested period, the afternoon peak. Less significant effects were found regarding the morning...

[Scandinavian guidelines for prehospital management of severe traumatic brain injury

DEFF Research Database (Denmark)

Sollid, S.; Sundstrom, T.; Kock-Jensen, C.

2008-01-01

. Evidence-based guidelines already exist that focus on all steps in the process. In the present article members of the Scandinavian Neurotrauma Committee present recommendations on prehospital management of traumatic brain injury adapted to the infrastructure of the Nordic region Udgivelsesdato: 2008/6/26......Head trauma is the cause the death for many young persons. The number of fatalities can be reduced through systematic management. Prevention of secondary brain injury combined with the fastest possible transport to a neurosurgical unit, have been shown to effectively reduce mortality and morbidity...

Applying Critical Scandinavian ISD research principles in an African Context

DEFF Research Database (Denmark)

Mengiste, Shegaw Anagaw; Tjørnehøj, Gitte

2013-01-01

these countries have a vast need for the technology to develop their economies and living standards. We investigate opportunities of applying Scandinavian principles for ISD&I in the context of Africa, through analyzing and comparing two action research projects that have applied two classic approaches; The Trade...... Unionist (TU) and the Activity Theory approach. We focus specifically on the principles of participation, empowerment, and evolutionary design and discuss how they can help mitigate the challenges, create opportunities and exploit possibilities of ISD&I in this context. Based on this we argue how and why...

Highly discrepant proportions of female and male Scandinavian and British Isles ancestry within the isolated population of the Faroe Islands

DEFF Research Database (Denmark)

Als, Thomas Damm; TH, Jørgensen; Børglum, Anders

2006-01-01

The Faroe Islands in the North Atlantic Ocean are inhabited by a small population, whose origin is thought to date back to the Viking Age. Historical, archaeological and linguistic evidence indicates that the present population of the Faroe Islands may have a mixture of Scandinavian and British...... a frequency-based admixture approach taking private haplotypes into account by the use of phylogenetic information. While previous studies have suggested an excess of Scandinavian ancestry among the male settlers of the Faroe Islands, the current study indicates an excess of British Isles ancestry among...

The epidermal melanocyte system in individuals of Scandinavian origin, determined by DOPA-staining and TEM

DEFF Research Database (Denmark)

Drzewiecki, K T; Piltz-Drzewiecka, J

1979-01-01

The quantitative evaluation of DOPA-positive epidermal melanocytes in 16 patients of Scandinavian origin showed both individual and regional differences in the melanocyte count. Our data is in agreement with other published studies. The distribution in the number of melanocytes varies significant...

Outcomes Following Three-Factor Inactive Prothrombin Complex Concentrate Versus Recombinant Activated Factor VII Administration During Cardiac Surgery.

Science.gov (United States)

Harper, Patrick C; Smith, Mark M; Brinkman, Nathan J; Passe, Melissa A; Schroeder, Darrell R; Said, Sameh M; Nuttall, Gregory A; Oliver, William C; Barbara, David W

2018-02-01

To compare outcomes following inactive prothrombin complex concentrate (PCC) or recombinant activated factor VII (rFVIIa) administration during cardiac surgery. Retrospective propensity-matched analysis. Academic tertiary-care center. Patients undergoing cardiac surgery requiring cardiopulmonary bypass who received either rFVIIa or the inactive 3-factor PCC. Outcomes following intraoperative administration of rFVIIa (263) or factor IX complex (72) as rescue therapy to treat bleeding. In the 24 hours after surgery, propensity-matched patients receiving PCC versus rFVIIa had significantly less chest tube outputs (median difference -464 mL, 95% confidence interval [CI] -819 mL to -110 mL), fresh frozen plasma transfusion rates (17% v 38%, p = 0.028), and platelet transfusion rates (26% v 49%, p = 0.027). There were no significant differences between propensity-matched groups in postoperative stroke, deep venous thrombosis, pulmonary embolism, myocardial infarction, or intracardiac thrombus. Postoperative dialysis was significantly less likely in patients administered PCC versus rFVIIa following propensity matching (odds ratio = 0.3, 95% CI 0.1-0.7). No significant difference in 30-day mortality in patients receiving PCC versus rFVIIa was present following propensity matching. Use of rFVIIa versus inactive PCCs was significantly associated with renal failure requiring dialysis and increased postoperative bleeding and transfusions. Copyright © 2018 Elsevier Inc. All rights reserved.

Work-related outcome after acute coronary syndrome: Implications of complex cardiac rehabilitation in occupational medicine.

Science.gov (United States)

Lamberti, Monica; Ratti, Gennaro; Gerardi, Donato; Capogrosso, Cristina; Ricciardi, Gianfranco; Fulgione, Cosimo; Latte, Salvatore; Tammaro, Paolo; Covino, Gregorio; Nienhaus, Albert; Grazillo, Elpidio Maria; Mallardo, Mario; Capogrosso, Paolo

2016-01-01

Coronary heart disease is frequent in the working-age population. Traditional outcomes, such as mortality and hospital readmission, are useful for evaluating prognosis. Fit-for-work is an emerging outcome with clinical as well as socioeconomic significance. We describe the possible benefit of a cardiac rehabilitation (CR) program for return to work (RTW) after acute coronary syndrome (ACS). We evaluated 204 patients with recent ACS. They were divided into 4 groups on the basis of their occupational work load: very light (VL), light (L), moderate (M), and heavy (H). Work-related outcomes were assessed with the Work Performance Scale (WPS) of the Functional Status Questionnaire and as "days missed from work" (DMW) in the previous 4 weeks. The variables considered for outcomes were percent ejection fraction, functional capacity expressed in metabolic equivalents (METs), and participation or non-participation in the CR program (CR+ and CR-). One hundred thirty (66%) patients took part in the CR program. Total WPS scores for CR+ and CR- subgroups were VL group: 18±4 vs. 14±4 (p workplace, in particular among clerical workers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Milrinone for cardiac dysfunction in critically ill adult patients

DEFF Research Database (Denmark)

Koster, Geert; Bekema, Hanneke J; Wetterslev, Jørn

2016-01-01

INTRODUCTION: Milrinone is an inotrope widely used for treatment of cardiac failure. Because previous meta-analyses had methodological flaws, we decided to conduct a systematic review of the effect of milrinone in critically ill adult patients with cardiac dysfunction. METHODS: This systematic...... trials were at high risk of bias, and none reported the primary composite outcome SAE. Fourteen trials with 1611 randomised patients reported mortality data at maximum follow-up (RR 0.96; 95% confidence interval 0.76-1.21). Milrinone did not significantly affect other patient-centred outcomes. All...... analyses displayed statistical and/or clinical heterogeneity of patients, interventions, comparators, outcomes, and/or settings and all featured missing data. DISCUSSION: The current evidence on the use of milrinone in critically ill adult patients with cardiac dysfunction suffers from considerable risks...

Significance of change in serum bilirubin in predicting left ventricular reverse remodeling and outcomes in heart failure patients with cardiac resynchronization therapy.

Science.gov (United States)

Hosoda, Junya; Ishikawa, Toshiyuki; Matsumoto, Katsumi; Iguchi, Kohei; Matsushita, Hirooki; Ogino, Yutaka; Taguchi, Yuka; Sugano, Teruyasu; Ishigami, Tomoaki; Kimura, Kazuo; Tamura, Kouichi

2017-11-01

Research on the correlation of serum bilirubin level with cardiac function as well as outcomes in heart failure patients with cardiac resynchronization therapy (CRT) has not yet been reported. The aim of this study was to analyze the relationship between change in serum bilirubin level and left ventricular reverse remodeling, and also to clarify the impact of bilirubin change on clinical outcomes in CRT patients. We evaluated 105 consecutive patients who underwent CRT. Patients who had no serum total-bilirubin data at both baseline and 3-9 months' follow-up or had died less than 3 months after CRT implantation were excluded. Accordingly, a total of 69 patients were included in the present analysis. The patients were divided into two groups: decreased bilirubin group (serum total-bilirubin level at follow-up≤that at baseline; n=48) and increased bilirubin group (serum total-bilirubin level at follow-up>that at baseline; n=21). Mean follow-up period was 39.3 months. In the decreased bilirubin group, mean left ventricular end-systolic diameter decreased from 54.5mm to 50.2mm (p=0.001) and mean left ventricular ejection fraction increased significantly from 29.8% to 37.0% (p=0.001). In the increased bilirubin group, there was no significant change in echocardiographic parameters from baseline to follow-up. In Kaplan-Meyer analysis, cardiac mortality combined with heart failure hospitalization in the increased bilirubin group was significantly higher than that in the decreased bilirubin group (log-rank p=0.018). Multivariate Cox regression analysis revealed that increased bilirubin was an independent predictor of cardiac mortality combined with heart failure hospitalization (OR=2.66, p=0.023). The change in serum bilirubin is useful for assessment of left ventricular reverse remodeling and prediction of outcomes in heart failure patients with CRT. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Irish and Scandinavian objection to Sellafield; Norden protesterer

Energy Technology Data Exchange (ETDEWEB)

Haaland, Leif

2001-07-01

The article deals with the objection of Ireland and the Scandinavian countries to the radioactive emissions from the Sellafield reprocessing plant. This contamination follows the sea currents northward and radioactive material from this plant has been found in seaweed and crustaceans along the coast of Norway. The concentration in lobster from the Irish Sea is much higher than in Norwegian crustaceans and above the action limit set by the EU for the radioactive isotope Technetium 99 in the event of a new atomic accident. British authorities have refused to stop the pollution and even plan to start production of MOX fuel at Sellafield. They say new purification techniques will be developed within three or five years. For Norway, the opposition against Sellafield is a priority.

Marshal of the Royal Air Force Sir John Cotesworth Slessor and the Anglo-American Air Power Alliance, 1940-1945

National Research Council Canada - National Science Library

Connolly, Corvin

2001-01-01

.... He played a remarkable and extensive role in building the Anglo-American air power partnership as an air planner on the Royal Air Force Staff, the British Chiefs of Staff, and the Combined Chiefs of Staff...

Jüri Okas’ ‘specific objects’: diverging discourses in Estonian Art in the 1970s.

OpenAIRE

Kurg, Andres.

2003-01-01

Previously in the University eprints HAIRST pilot service at http://eprints.st-andrews.ac.uk/archive/00000367/ Article 3 of 6 in issue devoted to the visual culture of the Scandinavian and Baltic region. This article will look at the early works of Estonian architect and artist Jüri Okas and will try to work between diverging languages and interpretations, reading works by Okas against the background of Anglo-american conceptualism and minimalism of the same period. The first part of th...

Between Apathy and Antipathy: The Vikings in Irish and Scandinavian History

OpenAIRE

HOLM, POUL

1995-01-01

PUBLISHED "Neither apathy nor antipathy can ever bring out the truth of history" (Eoin MacNeill, Phases of Irish History, Dublin, 1919, vi). Around 1970 the subject of "the Vikings in Ireland" was seen, historiographically, as a non-problem. Scandinavian historians did not deal with Irish history, and except for the casual asides of four or five specialists, there was no particular interest in Ireland as an area in Viking studies. However, during the seventies there was a veritable boom...

British Icons and Catholic perfidy--Anglo-Saxon historiography and the battle for Crimean War nursing.

Science.gov (United States)

Wells, John S G; Bergin, Michael

2016-03-01

Taking as its starting point Carr's view that historical narrative reflects the preoccupations of the time in which it is written and Foucault's concept of consensual historical discourse as the outcome of a social struggle in which the victor suppresses or at least diminishes contrary versions of historical events in favour of their own, this paper traces and discusses the historical narrative of British nursing in the Crimean war and, in particular, three competing narratives that have arisen in the latter half of the 20th century and the first decade of the 21st. These are the established narrative surrounding Florence Nightingale, the new narrative surrounding Mary Seacole and an Irish narrative surrounding the role of the Sisters of Mercy. It is argued that the increased vehemence of the debate surrounding these narratives is representative of the changes that have taken place in British society. However, we also argue that the Irish narrative and its critique are reflective of deep-rooted Anglo-Protestant attitudes articulated by Nightingale and uncritically accepted by subsequent historians even in modern British historiography. © 2015 John Wiley & Sons Ltd.

Multimodal Outcome Prognostication After Cardiac Arrest and Targeted Temperature Management: Analysis at 36 °C.

Science.gov (United States)

Tsetsou, Spyridoula; Novy, Jan; Pfeiffer, Christian; Oddo, Mauro; Rossetti, Andrea O

2018-02-01

Targeted temperature management (TTM) represents the standard of care in comatose survivors after cardiac arrest (CA) and may be applied targeting 33° or 36 °C. While multimodal prognostication has been extensively tested for 33 °C, scarce information exists for 36 °C. In this cohort study, consecutive comatose adults after CA treated with TTM at 36 °C between July 2014 and October 2016 were included. A combination of neurological examination, electrophysiological features, and serum neuron-specific enolase (NSE) was evaluated for outcome prediction at 3 months (mortality; good outcome defined as cerebral performance categories (CPC) score of 1-2, poor outcome defined as CPC 3-5). We analyzed 61 patients. The presence of two or more predictors out of, unreactive electroencephalogram (EEG) background, epileptiform EEG, absent pupillary and/or corneal reflex, early myoclonus, bilaterally absent cortical somatosensory evoked potentials, and serum NSE >75 μg/l, had a high specificity for predicting mortality (positive predictive value [PPV] = 1.00, 95% CI 0.87-1.00) and poor outcome (PPV = 1.00, 95% CI 0.80-1.00). Reactive EEG background was highly sensitive for predicting good outcome (0.95, 95% CI 0.74-0.99). Prediction of outcome after CA and TTM targeting 36 °C seems valid in adults using the same features tested at 33 °C. A reactive EEG under TTM appears highly sensitive for good outcome.

Dagboeke as oorlogsdokumentasie: Johanna van Warmelo se dagboek en haar belewing van die Anglo-Boereoorlog

Directory of Open Access Journals (Sweden)

R. van der Merwe

1999-04-01

Johanna van Warmelo resided in Sunnyside, Pretoria, with her mother virtually throughout the Anglo-Boer War. She was 23 years old when the war broke out. Her fiancé, whom she later married, lived in Holland. Johanna started a diary immediately after the outbreak of the war In this she not only wrote down factual reports, but also her perceptions of the war and the belligerents. The diary grew into seven volumes of more than a thousand pages. After serving as a nurse in the Irene Concentration Camp, Johanna in 1901 became involved in the spying activities of the Secret Service Commission of the Boers in Pretoria. Through assisting the famous scout J.J. Naude, she and her mother formed a crucial link between the Boer commanders in the field and President Kruger in Europe. She later related those experiences in The Petticoat Commando. It was published in both English and Dutch and eventually also in Afrikaans and became one of the classic factual tales of adventure of the Anglo- Boer War. In this article her diary is analysed as a source on the war

Prognostic value of depression, anxiety, and anger in hospitalized cardiovascular disease patients for predicting adverse cardiac outcomes.

Science.gov (United States)

Nakamura, Shunichi; Kato, Koji; Yoshida, Asuka; Fukuma, Nagaharu; Okumura, Yasuyuki; Ito, Hiroto; Mizuno, Kyoichi

2013-05-15

Although attention has recently been focused on the role of psychosocial factors in patients with cardiovascular disease (CVD), the factors that have the greatest influence on prognosis have not yet been elucidated. The aim of this study was to evaluate the effects of depression, anxiety, and anger on the prognosis of patients with CVD. Four hundred fourteen consecutive patients hospitalized with CVD were prospectively enrolled. Depression was evaluated using the Patient Health Questionnaire, anxiety using the Generalized Anxiety Disorder Questionnaire, and anger using the Spielberger Trait Anger Scale. Cox proportional-hazards regression was used to examine the individual effects of depression, anxiety, and anger on a combined primary end point of cardiac death or cardiac hospitalization and on a combined secondary end point of all-cause death or hospitalization during follow-up (median 14.2 months). Multivariate analysis showed that depression was a significant risk factor for cardiovascular hospitalization or death after adjusting for cardiac risk factors and other psychosocial factors (hazard ratio 2.62, p = 0.02), whereas anxiety was not significantly associated with cardiovascular hospitalization or death after adjustment (hazard ratio 2.35, p = 0.10). Anger was associated with a low rate of cardiovascular hospitalization or death (hazard ratio 0.34, p depression in hospitalized patients with CVD is a stronger independent risk factor for adverse cardiac events than either anxiety or anger. Anger may help prevent adverse outcomes. Routine screening for depression should therefore be performed in patients with CVD, and the potential effects of anger in clinical practice should be reconsidered. Copyright © 2013 Elsevier Inc. All rights reserved.

Oligoclonal band status in Scandinavian multiple sclerosis patients is associated with specific genetic risk alleles

DEFF Research Database (Denmark)

Mero, Inger-Lise; Gustavsen, Marte W; Sæther, Hanne S

2013-01-01

The presence of oligoclonal bands (OCB) in cerebrospinal fluid (CSF) is a typical finding in multiple sclerosis (MS). We applied data from Norwegian, Swedish and Danish (i.e. Scandinavian) MS patients from a genome-wide association study (GWAS) to search for genetic differences in MS relating...

Outcome of community-acquired pneumonia with cardiac complications

Directory of Open Access Journals (Sweden)

R. Eman Shebl

2015-07-01

Conclusions: Cardiac complications are common in the admitted patients with pneumonia and they are associated with increased pneumonia severity and increased cardiovascular risk, these complications adds to the risk of mortality, so optimal management of these events may reduce the burden of death associated with this infection.

Siblings, Birth Order, and Cooperative-Competitive Social Behavior: A Comparison of Anglo-American and Mexican-American Children.

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Knight, George P.; Kagan, Spencer

1982-01-01

Tested the hypothesis that differences in cooperative-competitive social behavior between Anglo-Americans and Mexican Americans is a result of larger family size among the latter group. Found that, even after controlling for number of siblings and birth order, statistically significant differences in such behavior remained between the two groups.…

The outcome of critical illness in decompensated alcoholic liver cirrhosis

DEFF Research Database (Denmark)

Kavli, M; Strøm, T; Carlsson, M

2012-01-01

physiology and chronic health evaluation II (APACHE II) and simplified organ failure assessment (SOFA) in predicting outcome. We hypothesized that in a Scandinavian cohort of ICU patients, APACHE II, SOFA, and simplified acute physiology score (SAPS II) were superior to predict outcome compared...... with the Child-Pugh score. METHODS: A single-centre retrospective cohort analysis was conducted in a university-affiliated ICU. Eighty-seven adult patients with decompensated liver alcoholic cirrhosis were admitted from January 2007 to January 2010. RESULTS: The patients were severely ill with median scores...... alcoholic liver disease should be revised....

[Acute kidney injury after pediatric cardiac surgery: risk factors and outcomes. Proposal for a predictive model].

Science.gov (United States)

Cardoso, Bárbara; Laranjo, Sérgio; Gomes, Inês; Freitas, Isabel; Trigo, Conceição; Fragata, Isabel; Fragata, José; Pinto, Fátima

2016-02-01

To characterize the epidemiology and risk factors for acute kidney injury (AKI) after pediatric cardiac surgery in our center, to determine its association with poor short-term outcomes, and to develop a logistic regression model that will predict the risk of AKI for the study population. This single-center, retrospective study included consecutive pediatric patients with congenital heart disease who underwent cardiac surgery between January 2010 and December 2012. Exclusion criteria were a history of renal disease, dialysis or renal transplantation. Of the 325 patients included, median age three years (1 day-18 years), AKI occurred in 40 (12.3%) on the first postoperative day. Overall mortality was 13 (4%), nine of whom were in the AKI group. AKI was significantly associated with length of intensive care unit stay, length of mechanical ventilation and in-hospital death (p<0.01). Patients' age and postoperative serum creatinine, blood urea nitrogen and lactate levels were included in the logistic regression model as predictor variables. The model accurately predicted AKI in this population, with a maximum combined sensitivity of 82.1% and specificity of 75.4%. AKI is common and is associated with poor short-term outcomes in this setting. Younger age and higher postoperative serum creatinine, blood urea nitrogen and lactate levels were powerful predictors of renal injury in this population. The proposed model could be a useful tool for risk stratification of these patients. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

[Scandinavian guidelines on the pre-hospital management of traumatic brain injury

DEFF Research Database (Denmark)

Juul, N.; Sollid, S.; Sundstrom, T.

2008-01-01

. Evidence-based guidelines already exist that focus on all steps in the management. This article, which was written by members of the Scandinavian Neurotrauma Committee, presents recommendations on the pre-hospital management of traumatic brain injury adapted to the infrastructure of Scandinavia......Head trauma causes the death of many young persons. The number of fatalities can be reduced through systematic management. Preventing secondary brain injury together with the fastest possible transport to a neurosurgical unit has been shown to be effective in reducing mortality and morbidity...

Enacting Green Consumers: The Case of the Scandinavian Preppies

Directory of Open Access Journals (Sweden)

Christian Fuentes

2014-10-01

Full Text Available The aim of this paper is to develop and illustrate an analytic approach that brings the active making and makings of green consumer images to the fore. Efforts to "know" the green consumers have generated multiple representations. Enactments of the green consumer are not innocent but also play a role in shaping how we understand and approach sustainable consumption. Because of this it is important to examine and critically discuss how green consumers are enacted today. This paper develops an approach that allows us to examine how green consumers are enacted and discuss the consequences these constructions might have for sustainability. Theoretically, a performativity approach drawing on theories from Science and Technology Studies (STS and economic sociology is used to discuss the enactment of green consumers. Empirically, focus is on Boomerang � a Swedish fashion retailer, brand, and producer � and its marketing practices. The analysis shows how the marketing work of the Boomerang Company leads to the enactment of the Green Scandinavian Preppy. This specific version of the green consumer is a combination of the knowledgeable green connoisseur - a consumer that knows quality when he/she sees it - and the green hedonist in search of the good life. The Green Scandinavian Preppy wants to enjoy nature, go sailing, and do so wearing fashionable quality clothes. This is a consumer that knows quality, appreciates design, and has the means to pay for both. While this is a version of the green consumer that might be appealing and thus have the potential to pro-mote a version of green consumption, it is also a green consumer image that has lost much of its political power as green consumption is framed as simply another source of pleasure and identity-making.

Cooling the crisis: Therapeutic hypothermia after sickle cardiac arrest

NARCIS (Netherlands)

Metske, Hennie A.; Postema, Pieter G.; Biemond, Bart J.; Bouman, Catherine S. C.

2012-01-01

Objective: The management of patients with sickle-cell disease and cardiac arrest presents special challenges. Mild therapeutic hypothermia may improve survival and neurologic outcome after cardiac arrest, however, it may also precipitate sickling in patients with sickle-cell disease. Rigorous

Anglo-Saxon Ideologies in the 1920s-1930s: Their Impact on the Segregation of Mexican Students in California.

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Menchaca, Martha; Valencia, Richard R.

1990-01-01

Traces the development of Anglo-Saxon superiority theories from the nineteenth century onward and demonstrates their impact on social conditions in the southwest, specifically on school segregation in Santa Paula School District (California) from the 1920s to the present. (DM)

Cardiopulmonary resuscitation by trained responders versus lay persons and outcomes of out-of-hospital cardiac arrest: A community observational study.

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Park, Yoo Mi; Shin, Sang Do; Lee, Yu Jin; Song, Kyoung Jun; Ro, Young Sun; Ahn, Ki Ok

2017-09-01

The study aims to compare bystander processes of care (cardiopulmonary resuscitation (CPR) and defibrillation) and outcomes for witnessed presumed cardiac etiology in OHCA patients in whom initial resuscitation was provided by dedicated trained responder (TR) versus lay person (LP) bystanders. Data on witnessed and presumed cardiac OHCA in adults (15 years or older) from 2011 to 2015 in a metropolitan city with 10 million persons were collected, excluding cases in which the information on TRs, bystander CPR, defibrillation, and clinical outcomes was unknown. Exposure variables were TRs who were legally designated with CPR education and response and LPs who were bystanders who witnessed the OHCA by chance. The primary/secondary/tertiary outcomes were a good cerebral performance category (CPC) of 1 or 2, survival to discharge, and bystander defibrillation. A multivariable logistic regression analysis was used to calculate the adjusted odds ratio (AOR) with 95% confidence intervals (CIs), adjusting for potential confounders. Of 20,984 OHCA events, 6475 cases were ultimately analyzed. The TR group constituted 6.4% of the cases, and the patients showed significantly better survival and a good CPC. From the multivariable logistic regression analysis of the outcomes, by comparing the TR group with the LP group, the AOR (95% CIs) was 1.49 (1.04-2.15) for a good CPC, 1.59 (1.20-2.11) for survival to discharge, and 10.02 (7.04-14.26) for bystander defibrillation. The TR group witnessed a relatively low proportion of OHCA but was associated with better survival outcomes and good neurological recovery through higher CPR rates and defibrillation of adults older than 15 years with witnessed OHCA in a metropolitan city. Copyright © 2017 Elsevier B.V. All rights reserved.

Cross-Cultural Validation of the Inventory of School Motivation (ISM): Motivation Orientations of Navajo and Anglo Students.

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McInerney, Dennis M.; Yeung, Alexander Seeshing; McInerney, Valentina

2001-01-01

Validated the Motivation Orientation scales of the Inventory of School Motivation (ISM) (M. Maher, 1984) across Navajo (n=760) and Anglo (n=1,012) students. Findings show that even though the ISM motivation orientation scales are applicable to students of different cultural backgrounds, meaningful cross-cultural comparisons should use the 30 items…

Jewish history as a history of immigration: an overview of current historiography in the Scandinavian countries

Directory of Open Access Journals (Sweden)

Christhard Hoffmann

2016-01-01

Full Text Available This article provides a first critical overview of the historiography of Jewish immigration and integration in Sweden, Denmark and Norway. While the experience of immigration has been crucial for Scandinavian Jewry, scholarly interest in Jewish migration history only emerged during the 1980s in connection with the focus on migration and ethnicity in Swedish research and the adaptation of sociological concepts of migration in general historiography. By analysing key historio-graphical works, focusing on their approaches and main narratives, this article aims at a critical methodological self-reflection. It identifies two major approaches to Jewish immigration history in current Scandinavian historiography: the demographic and social history approach, focusing in particular on the role of Jewish immigrants in the labour market, their settlement and housing conditions and their social mobility; and the cultural history approach, reconstructing and preserving the vanished world of Yiddish immigrant culture.

Cardiac surgeons and the quality movement: the Michigan experience.

Science.gov (United States)

Prager, Richard L; Armenti, Frederick R; Bassett, Joseph S; Bell, Gail F; Drake, Daniel; Hanson, Eric C; Heiser, John C; Johnson, Scott H; Plasman, F B; Shannon, Francis L; Share, David; Theurer, Patty; Williams, Jaelene

2009-01-01

The Michigan Society of Thoracic and Cardiovascular Surgeons created a voluntary quality collaborative with all the cardiac surgeons in the state and all hospitals doing adult cardiac surgery. Utilizing this collaborative over the last 3 years and creating a unique relationship with a payor, an approach to processes and outcomes has produced improvements in the quality of care for cardiac patients in the state of Michigan.

'Him bid sona sel': psychiatry in the Anglo-Saxon Leechbooks.

Science.gov (United States)

Pell, Christopher

2011-12-01

Classical Greek and Roman writers documented the diagnosis and treatment of psychiatric illness in ancient times. Following the fall of the Western Roman Empire however, we find little writing on the topic in early Medieval Europe. Yet in Britain, medical texts survived and were complemented by local traditions and treatments. This article explores the best-known Anglo-Saxon medical texts, the Leechbooks and Lacnunga, for evidence of psychiatric illness and the treatments employed by physicians in the tenth century. The difficulties encountered when working with sources translated from Old English and speculations about the supernatural aetiology ascribed to these illnesses are detailed. The efficacy of the leechdoms (treatments) described are also investigated for both their placebo and potential pharmacological effects.

Surgeon length of service and risk-adjusted outcomes: linked observational analysis of the UK National Adult Cardiac Surgery Audit Registry and General Medical Council Register.

Science.gov (United States)

Hickey, Graeme L; Grant, Stuart W; Freemantle, Nick; Cunningham, David; Munsch, Christopher M; Livesey, Steven A; Roxburgh, James; Buchan, Iain; Bridgewater, Ben

2014-09-01

To explore the relationship between in-hospital mortality following adult cardiac surgery and the time since primary clinical qualification for the responsible consultant cardiac surgeon (a proxy for experience). Retrospective analysis of prospectively collected national registry data over a 10-year period using mixed-effects multiple logistic regression modelling. Surgeon experience was defined as the time between the date of surgery and award of primary clinical qualification. UK National Health Service hospitals performing cardiac surgery between January 2003 and December 2012. All patients undergoing coronary artery bypass grafts and/or valve surgery under the care of a consultant cardiac surgeon. All-cause in-hospital mortality. A total of 292,973 operations performed by 273 consultant surgeons (with lengths of service from 11.2 to 42.0 years) were included. Crude mortality increased approximately linearly until 33 years service, before decreasing. After adjusting for case-mix and year of surgery, there remained a statistically significant (p=0.002) association between length of service and in-hospital mortality (odds ratio 1.013; 95% CI 1.005-1.021 for each year of 'experience'). Consultant cardiac surgeons take on increasingly complex surgery as they gain experience. With this progression, the incidence of adverse outcomes is expected to increase, as is demonstrated in this study. After adjusting for case-mix using the EuroSCORE, we observed an increased risk of mortality in patients operated on by longer serving surgeons. This finding may reflect under-adjustment for risk, unmeasured confounding or a real association. Further research into outcomes over the time course of surgeon's careers is required. © The Royal Society of Medicine.

Apples to apples or apples to oranges? International variation in reporting of process and outcome of care for out-of-hospital cardiac arrest

NARCIS (Netherlands)

Nishiyama, Chika; Brown, Siobhan P.; May, Susanne; Iwami, Taku; Koster, Rudolph W.; Beesems, Stefanie G.; Kuisma, Markku; Salo, Ari; Jacobs, Ian; Finn, Judith; Sterz, Fritz; Nürnberger, Alexander; Smith, Karen; Morrison, Laurie; Olasveengen, Theresa M.; Callaway, Clifton W.; Shin, Sang Do; Gräsner, Jan-Thorsten; Daya, Mohamud; Ma, Matthew Huei-Ming; Herlitz, Johan; Strömsöe, Anneli; Aufderheide, Tom P.; Masterson, Siobhán; Wang, Henry; Christenson, Jim; Stiell, Ian; Davis, Dan; Huszti, Ella; Nichol, Graham

2014-01-01

Survival after out-of-hospital cardiac arrest (OHCA) varies between communities, due in part to variation in the methods of measurement. The Utstein template was disseminated to standardize comparisons of risk factors, quality of care, and outcomes in patients with OHCA. We sought to assess whether

Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery

DEFF Research Database (Denmark)

Mazer, C David; Whitlock, Richard P; Fergusson, Dean A

2017-01-01

BACKGROUND: The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear. METHODS: In this multicenter, open-label, noninferiority trial, we randomly assigned 5243 adults undergoing cardiac surgery who had a E...

Improved Outcome of Cardiac Extracorporeal Membrane Oxygenation in Infants and Children Using Magnetic Levitation Centrifugal Pumps.

Science.gov (United States)

Luciani, Giovanni Battista; Hoxha, Stiljan; Torre, Salvatore; Rungatscher, Alessio; Menon, Tiziano; Barozzi, Luca; Faggian, Giuseppe

2016-01-01

Extracorporeal membrane oxygenation (ECMO) has traditionally been and, for the most part, still is being performed using roller pumps. Use of first-generation centrifugal pumps has yielded controversial outcomes, perhaps due to mechanical properties of the same and the ensuing risk of hemolysis and renal morbidity. Latest-generation centrifugal pumps, using magnetic levitation (ML), exhibit mechanical properties which may have overcome limitations of first-generation devices. This retrospective study aimed to assess the safety and efficacy of veno-arterial (V-A) ECMO for cardiac indications in neonates, infants, and children, using standard (SP) and latest-generation ML centrifugal pumps. Between 2002 and 2014, 33 consecutive neonates, infants, and young children were supported using V-A ECMO for cardiac indications. There were 21 males and 12 females, with median age of 29 days (4 days-5 years) and a median body weight of 3.2 kg (1.9-18 kg). Indication for V-A ECMO were acute circulatory collapse in ICU or ward after cardiac repair in 16 (49%) patients, failure to wean after repair of complex congenital heart disease in 9 (27%), fulminant myocarditis in 4 (12%), preoperative sepsis in 2 (6%), and refractory tachy-arrhythmias in 2 (6%). Central cannulation was used in 27 (81%) patients and peripheral in 6. Seven (21%) patients were supported with SP and 26 (79%) with ML centrifugal pumps. Median duration of support was 82 h (range 24-672 h), with 26 (79%) patients weaned from support. Three patients required a second ECMO run but died on support. Seventeen (51%) patients required peritoneal dialysis for acute renal failure. Overall survival to discharge was 39% (13/33 patients). All patients with fulminant myocarditis and with refractory arrhythmias were weaned, and five (83%) survived, whereas no patient supported for sepsis survived. Risk factors for hospital mortality included lower (pumps in infants and children yields outcomes absolutely comparable to

Differences in the Relationship between Family Environments and Self-Determination among Anglo, Latino, and Female Students with Disabilities

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Rodriguez, Raymond J.; Cavendish, Wendy

2013-01-01

The role of gender and ethnicity as moderators of the relationship between perceived family environments and levels of self-determination was examined in a sample of students with disabilities. A sample of 157 Latino and Anglo students with disabilities completed the "Family Environment Scale" and the "Arc Self-Determination…

Prognostic value of serum phosphate level in adult patients resuscitated from cardiac arrest.

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Jung, Yong Hun; Lee, Byung Kook; Jeung, Kyung Woon; Youn, Chun Song; Lee, Dong Hun; Lee, Sung Min; Heo, Tag; Min, Yong Il

2018-07-01

Several studies have reported increased levels of phosphate after cardiac arrest. Given the relationship between phosphate level and the severity of ischaemic injury reported in previous studies, higher phosphate levels may be associated with worse outcomes. We investigated the prognostic value of phosphate level after the restoration of spontaneous circulation (ROSC) in adult cardiac arrest patients. This study was a retrospective observational study including adult cardiac arrest survivors treated at the Chonnam National University Hospital between January 2014 and June 2017. From medical records, data regarding clinical characteristics, outcome at hospital discharge, and laboratory parameters including phosphate levels after ROSC were collected. The primary outcome was poor outcome at hospital discharge, defined as Cerebral Performance Categories 3-5. Of the 674 included patients, 465 had poor outcome at hospital discharge. Serum phosphate level was significantly higher in patients with poor outcome than in those with good outcome (p level was correlated with time to ROSC (r = 0.350, p level. In multivariate analysis, a higher phosphate level was independently associated with poor outcome at hospital discharge (odds ratio, 1.432; 95% CI, 1.245-1.626; p level after ROSC was independently associated with poor outcome at hospital discharge in adult cardiac arrest patients. However, given its modest prognostic performance, phosphate level should be used in combination with other prognostic indicators. Copyright © 2018 Elsevier B.V. All rights reserved.

Review of Novum Inventorium Sepulchrale: Kentish Anglo-Saxon Graves and Grave Goods in the Sonia Chadwick Hawkes Archive (Online Digital Corpus

Directory of Open Access Journals (Sweden)

Tara-Jane Sutcliffe

2008-02-01

Full Text Available In 2007, the year in which the Society of Antiquaries of London celebrated its tercentenary, what more fitting tribute to those industrious individuals than that their work be made accessible to a new generation of students. One means was by a celebratory exhibition hosted by the Royal Academy, Making History: Antiquaries in Britain, 1707-2007, which showcased a treasure-trove of art, antiquities and manuscripts (for review, see Mount 2007. Structured display is one thing: scholarly use or re-use of antiquarian data is, however, quite another matter. Indeed, therein arguably lays one of the more pressing challenges facing the practice of 'modern' archaeology (see Jones et al. 2001. A timely response was the online publication in October 2007 of the Novum Inventorium Sepulchrale (NIS, a digital corpus of Kentish Anglo-Saxon graves and grave goods. Through this project a wealth of primary data has been made accessible as never before. This resource will be of interest to all those researching Anglo-Saxon Archaeology, particularly material culture and mortuary practices. Whilst the editors express the hope that the NIS will 'enable future generations of researchers to gain a better understanding of the origins of the Anglo-Saxon kingdoms', users will find themselves both delighted and frustrated by the quantity and format of the data presented in it.

Thermoregulation and performance of British Anglo-Nubian and Saanen goats reared in an intensive system in Trinidad.

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Lallo, Cicero H O; Paul, Ian; Bourne, Gregory

2012-03-01

Anglo-Nubian and Saanen goats were imported into Trinidad and Tobago to form the nucleus of the goat expansion and improvement programme. Thermoregulation and performance of the parent stock and the F1 were evaluated under intensive housing and management. Rectal temperature in the A.M.: irrespective of breed or season ranged from 38.5°C to 38.7°C and P.M.: ranged from 38.8°C to 39.0°C. After 2 h of exposure outdoors without shade, Saanen parent stock (SAPS) respiration rate (105 br/min) was significantly higher (p  0.05) between breeds or between the parent stock and the F1 generations, ranging from 638 to 686 days. The ANPS were the most prolific of all groups (p  0.05) difference between the groups, ranging from 319 to 521 days. It was concluded that the Anglo-Nubian appears to be more suitable than the Saanen for the tropical humid environment in Trinidad as indicated by their thermoregulation, prolificacy and kidding interval.

Maternal obesity, gestational weight gain and childhood cardiac outcomes: role of childhood body mass index.

Science.gov (United States)

Toemen, L; Gishti, O; van Osch-Gevers, L; Steegers, E A P; Helbing, W A; Felix, J F; Reiss, I K M; Duijts, L; Gaillard, R; Jaddoe, V W V

2016-07-01

Maternal obesity may affect cardiovascular outcomes in the offspring. We examined the associations of maternal prepregnancy body mass index and gestational weight gain with childhood cardiac outcomes and explored whether these associations were explained by parental characteristics, infant characteristics or childhood body mass index. In a population-based prospective cohort study among 4852 parents and their children, we obtained maternal weight before pregnancy and in early, mid- and late pregnancy. At age 6 years, we measured aortic root diameter (cm) and left ventricular dimensions. We calculated left ventricular mass (g), left ventricular mass index (g m(-2.7)), relative wall thickness ((2 × left ventricular posterior wall thickness)/left ventricular diameter), fractional shorting (%), eccentric left ventricular hypertrophy and concentric remodeling. A one standard deviation score (SDS) higher maternal prepregnancy body mass index was associated with higher left ventricular mass (0.10 SDS (95% confidence interval (CI) 0.08, 0.13)), left ventricular mass index (0.06 SDS (95% CI 0.03, 0.09)) and aortic root diameter (0.09 SDS (95% CI 0.06, 0.12)), but not with relative wall thickness or fractional shortening. A one SDS higher maternal prepregnancy body mass index was associated with an increased risk of eccentric left ventricular hypertrophy (odds ratio 1.21 (95% CI 1.03, 1.41)), but not of concentric remodeling. When analyzing the effects of maternal weight in different periods simultaneously, only maternal prepregnancy weight and early pregnancy weight were associated with left ventricular mass, left ventricular mass index and aortic root diameter (P-valuesMaternal prepregnancy body mass index and weight gain in early pregnancy are both associated with offspring cardiac structure in childhood, but these associations seem to be fully explained by childhood body mass index.

Effect of exercise-based cardiac rehabilitation on mobility and self-esteem of persons after cardiac surgery.

Science.gov (United States)

Ng, J Y; Tam, S F

2000-08-01

This study adopted an experimental design with using a nonequivalent, posttest only control group to study the rehabilitation outcomes of 152 persons who received cardiac surgery. 37 subjects in a rehabilitation group participated in a 2-mo. exercise-based cardiac rehabilitation programme, and another 115 subjects who did not attend the programme formed the control group. The subjects' self-esteem was measured on the Adult Source of Self-esteem Inventory by Elvoson and Fleming, and their mobility skill was measured by a simple mobility test based on New York Heart Association Classification. Analysis of covariance (with covariance analysis of the subjects' age, years of education, occupational skill, and mobility skill) indicated that the experimental group scored higher on positive self esteem and showed significantly better improvement in mobility skill. The exercise-based cardiac rehabilitation programme positively affected physical and psychological outcomes. Also, subjects' self-esteem was significantly correlated with their mobility skills (r=.21, p<.05) among those aged under 60 years (n=96) but not among those aged 60 or above (n=53).

What is at stake? Exploring the moral experience of stigma with Indian-Australians and Anglo-Australians living with depression.

Science.gov (United States)

Brijnath, Bianca; Antoniades, Josefine

2018-04-01

This article applies the framework of moral experience to examine the cultural experience of stigma with Indian-Australians and Anglo-Australians living with depression in Melbourne, Australia. To date few studies have examined this dynamic in relation to mental illness and culture, and no studies have applied this framework in a culturally comparative way. Based on 58 in-depth interviews with people with depression recruited from the community, we explicate how stigma modulates what is at stake upon disclosure of depression, participants' lived experience following that disclosure, and how practices of health-seeking become stigmatised. Findings show that the social acceptance of depression jars against participants' experience of living with it. Denialism and fear of disclosure were overwhelming themes to emerge from our analysis with significant cultural differences; the Anglo-Australians disclosed their depression to family and friends and encountered significant resistance about the legitimacy of their illness. In contrast, many Indian-Australians, especially men, did not disclose their illness for fear of a damaged reputation and damaged social relations. For Indian-Australians, social relations in the community were at stake, whereas for Anglo-Australians workplace relations (but not community relations) were at stake. Participants' experiences in these settings also influenced their patterns of health-seeking behaviors and age and inter-generational relationships were important mediators of stigma and social support. These findings illuminate how stigma, culture, and setting are linked and they provide critical information necessary to identify and develop customised strategies to mitigate the harmful effects of stigma in particular cultural groups.

Scandinavian exceptionalism? Civic integration and labour market activation for newly arrived immigrants.

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Breidahl, Karen N

2017-01-01

Since the late 1990s, a wide range of so-called new civic integration policies aimed at civilizing or disciplining newcomers have been introduced. Consequently, migration scholars have discussed whether a converging restrictive 'civic turn' has taken place in Western Europe or whether national models have been resilient: Based on an in-depth historical and comparative analysis of labour market activation policies targeting newly arrived immigrants in Sweden, Norway, and Denmark since the early 1990s, the article contributes to the overall question: To what extent do the institutional pathways of the Scandinavian welfare states prevail when confronted with newcomers? Activation policies targeting newly arrived immigrants exemplifies how the ambition of states to promote functional, individual autonomy is also an important, ongoing process in diverse policy areas of the welfare state and not restricted to early integration instruments. While the Scandinavian welfare states differ on a number of counts with respect to immigration control, national integration philosophies and citizenship policies, the article outlines how activation policies aimed at newly arrived immigrants share several features. One of the key factors in this turn involves path dependency from, among others, a lengthy tradition for strong state involvement and norms about employment. Another factor in this turn involves transnational policy learning. On some points, national versions of these policies are also found due to country-specific citizenship traditions, integration philosophies and party political constellations.

Combined androgen blockade in the treatment of advanced prostate cancer--an overview. The Scandinavian Prostatic Cancer Group

DEFF Research Database (Denmark)

Iversen, P

1997-01-01

The value of combined androgen blockade in the treatment of patients with advanced prostate cancer is still controversial. In this review by the Scandinavian Prostatic Cancer Group, the literature addressing the concept and its clinical use is critically reviewed....

Mutual brokerage and women’s participation in nineteenth-century Anglo-American abolitionist movements

DEFF Research Database (Denmark)

Walsh-Russo, Cecelia Catherine

2017-01-01

an international network of abolitionist actors tied to one another through previous fora for discussion and debate. Mutual brokerage is perhaps most clearly seen within the example of female abolitionists during the nineteenth-century abolition campaigns. Women brought to the Anglo-American abolitionism the co...... of the movement were channels through which ideas flowed. Instead of a one-directional flow with brokers as translators bringing new tactics from one locale to another, the channels were characterized by the absence of earlier ‘originators’ and later ‘adopters’ – traditional categories assigned to actors within...

Resuscitation Outcomes Consortium (ROC) PRIMED cardiac arrest trial methods part 1: rationale and methodology for the impedance threshold device (ITD) protocol.

Science.gov (United States)

Aufderheide, Tom P; Kudenchuk, Peter J; Hedges, Jerris R; Nichol, Graham; Kerber, Richard E; Dorian, Paul; Davis, Daniel P; Idris, Ahamed H; Callaway, Clifton W; Emerson, Scott; Stiell, Ian G; Terndrup, Thomas E

2008-08-01

The primary aim of this study is to compare survival to hospital discharge with a modified Rankin score (MRS)CPR) plus an active impedance threshold device (ITD) versus standard CPR plus a sham ITD in patients with out-of-hospital cardiac arrest. Secondary aims are to compare functional status and depression at discharge and at 3 and 6 months post-discharge in survivors. Prospective, double-blind, randomized, controlled, clinical trial. Patients with non-traumatic out-of-hospital cardiac arrest treated by emergency medical services (EMS) providers. EMS systems participating in the Resuscitation Outcomes Consortium. Based on a one-sided significance level of 0.025, power=0.90, a survival with MRSCPR and sham ITD, and two interim analyses, a maximum of 14,742 evaluable patients are needed to detect a 6.69% survival with MRSCPR and active ITD (1.36% absolute survival difference). If the ITD demonstrates the hypothesized improvement in survival, it is estimated that 2700 deaths from cardiac arrest per year would be averted in North America alone.

Weaning at Anglo-Saxon Raunds: Implications for changing breastfeeding practice in Britain over two millennia.

Science.gov (United States)

Haydock, Hannah; Clarke, Leon; Craig-Atkins, Elizabeth; Howcroft, Rachel; Buckberry, Jo

2013-08-01

This study investigated stable-isotope ratio evidence of weaning for the late Anglo-Saxon population of Raunds Furnells, Northamptonshire, UK. δ(15)N and δ(13)C values in rib collagen were obtained for individuals of different ages to assess the weaning age of infants within the population. A peak in δ(15) N values at about 2-year-old, followed by a decline in δ(15) N values until age three, indicates a change in diet at that age. This change in nitrogen isotope ratios corresponds with the mortality profile from the site, as well as with archaeological and documentary evidence on attitudes towards juveniles in the Anglo-Saxon period. The pattern of δ(13) C values was less clear. Comparison of the predicted age of weaning to published data from sites dating from the Iron Age to the 19th century in Britain reveals a pattern of changing weaning practices over time, with increasingly earlier commencement and shorter periods of complementary feeding in more recent periods. Such a change has implications for the interpretation of socioeconomic changes during this period of British history, since earlier weaning is associated with decreased birth spacing, and could thus have contributed to population growth. Copyright © 2013 Wiley Periodicals, Inc.

Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a survey on forces, conditions and jurisdictional control.

NARCIS (Netherlands)

Kroezen, M.; Francke, A.L.; Groenewegen, P.P.; Dijk, L. van

2012-01-01

Background: The number of Western European and Anglo-Saxon countries where nurses are legally allowed to prescribe medicines is growing. As the prescribing of medicines has traditionally been the task of the medical profession, nurse prescribing is changing the relationship between the medical and

The muscle contraction mode determines lymphangiogenesis differentially in rat skeletal and cardiac muscles by modifying local lymphatic extracellular matrix microenvironments.

Science.gov (United States)

Greiwe, L; Vinck, M; Suhr, F

2016-05-01

Lymphatic vessels are of special importance for tissue homeostasis, and increases of their density may foster tissue regeneration. Exercise could be a relevant tool to increase lymphatic vessel density (LVD); however, a significant lack of knowledge remains to understand lymphangiogenesis in skeletal muscles upon training. Interestingly, training-induced lymphangiogenesis has never been studied in the heart. We studied lymphangiogenesis and LVD upon chronic concentric and chronic eccentric muscle contractions in both rat skeletal (Mm. Edl and Sol) and cardiac muscles. We found that LVD decreased in both skeletal muscles specifically upon eccentric training, while this contraction increased LVD in cardiac tissue. These observations were supported by opposing local remodelling of lymphatic vessel-specific extracellular matrix components in skeletal and cardiac muscles and protein levels of lymphatic markers (Lyve-1, Pdpn, Vegf-C/D). Confocal microscopy further revealed transformations of lymphatic vessels into vessels expressing both blood (Cav-1) and lymphatic (Vegfr-3) markers upon eccentric training specifically in skeletal muscles. In addition and phenotype supportive, we found increased inflammation (NF-κB/p65, Il-1β, Ifn-γ, Tnf-α and MPO(+) cells) in eccentrically stressed skeletal, but decreased levels in cardiac muscles. Our data provide novel mechanistic insights into lymphangiogenic processes in skeletal and cardiac muscles upon chronic muscle contraction modes and demonstrate that both tissues adapt in opposing manners specifically to eccentric training. These data are highly relevant for clinical applications, because eccentric training serves as a sufficient strategy to increase LVD and to decrease inflammation in cardiac tissue, for example in order to reduce tissue abortion in transplantation settings. © 2015 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

Evaluating the Feasibility and Intercorrelation of Measurements on the Functioning of Residents Living in Scandinavian Nursing Homes

DEFF Research Database (Denmark)

Andresen, Mette; Frändin, Kerstin; Grönstedt, Helena

2010-01-01

Background. The purpose of this study is to investigate the feasibility of measurements of muscle strength, balance, cognitive function, mobility, activities of daily living (ADL), and physical activity for use in a Scandinavian nursing home population and to examine intercorrelations between...

The civic turn of immigrant integration policies in the Scandinavian welfare states

DEFF Research Database (Denmark)

Borevi, Karin; Jensen, Kristian Kriegbaum; Mouritsen, Per

2017-01-01

This special issue addresses the question of how to understand the civic turn within immigrant integration in the West towards programs and instruments, public discourses and political intentions, which aim to condition, incentivize, and shape through socialization immigrants into ‘citizens’. Emp...... thesis and its descriptive and explanatory claims, and explain why studying the Scandinavian welfare states can further our understanding of the nature of the civic turn and its driving forces. Before concluding, we discuss whether civic integration policies actually work....

PARTICIPATORY GOVERNANCE IN THE PUBLIC HEALTHCARE SYSTEMS OF THE SCANDINAVIAN AND BALTIC COUNTRIES

Directory of Open Access Journals (Sweden)

Stefanescu Aurelia

2011-12-01

Full Text Available The diminished trust of citizens in the public sector, the increased complexity of policy issues and the reforms in accordance with the new public management principles generate the need of focusing more extensively on participatory governance. Participatory governance can be defined as the genuine engagement of citizens and other organizations in the formulation of policies and strategies, in the decision-making process from the public sector and in the implementation of the decisions. The present paper's objectives are to define the concept of participatory governance, to argue in favor of implementing it in the public sector and to find to what extent public healthcare institutions from Scandinavian and Baltic countries publish information on participatory governance and how they perceive community engagement. The research findings are that the information on participatory governance disclosed on the websites of relevant institutions from within the Scandinavian and Baltic public healthcare systems is scarce. The countries with the greatest concern for community engagement are Denmark and Sweden. It is argued that there should be a shift in focus within the public sector in general and within the healthcare system in particular, so that citizens are genuinely involved in the relevant processes and their satisfaction is indeed at an adequate level.

Pioglitazone improves cardiac function and alters myocardial substrate metabolism without affecting cardiac triglyceride accumulation and high-energy phosphate metabolism in patients with well-controlled type 2 diabetes mellitus

NARCIS (Netherlands)

van der Meer, Rutger W.; Rijzewijk, Luuk J.; de Jong, Hugo W. A. M.; Lamb, Hildo J.; Lubberink, Mark; Romijn, Johannes A.; Bax, Jeroen J.; de Roos, Albert; Kamp, Otto; Paulus, Walter J.; Heine, Robert J.; Lammertsma, Adriaan A.; Smit, Johannes W. A.; Diamant, Michaela

2009-01-01

Cardiac disease is the leading cause of mortality in type 2 diabetes mellitus (T2DM). Pioglitazone has been associated with improved cardiac outcome but also with an elevated risk of heart failure. We determined the effects of pioglitazone on myocardial function in relation to cardiac high-energy

How an Anglo-American methodology took root in France.

Science.gov (United States)

Laszlo, Pierre

2011-01-01

French organic chemistry had a strong nationalistic bent in the immediate aftermath to World War II. It continued to bask in the glow of the pre-World War I Nobel prize awarded jointly in 1912 to Victor Grignard and Paul Sabatier. In addition, the influence of the two mandarins then in power, Charles Prévost at the Sorbonne and Albert Kirrmann, a Dean in Strasbourg who would be called upon as vice-director at the École normale supérieure in Paris, saw to it that the only theory of organic reactions, admissible in the classroom and in the laboratory, was Prévost's. As Mary Jo Nye has shown, a wall was erected against penetration of the ideas of the British school of Ingold and Hughes. Mechanistic chemistry, as was being vigorously studied by the contemporary Anglo-American physical organic chemists, was 'persona non grata' in France. Publication by Bianca Tchoubar, in 1960, of "Les mécanismes réactionnels en chimie organique" opened a breach. The irony was for Dr. Tchoubar, a militant member of the Communist Party and a lady of fierce opinions, to have become a propagandist for the Anglo-American school of mechanistic studies. Truth for her overruled political propaganda. Her little book was revolutionary in the French context of the times. Together with the GECO (Groupe d'étude de chimie organique) summer conferences pioneered by Guy Ourisson after his return from Harvard, it ushered in the new ideas. This historical essay, based on an in-depth study of Tchoubar's book, will include a portrait of this remarkable woman scientist. It will delve at some length into the renewal of French science initiated by De Gaulle's government after his return to power in 1958. The tension in the French scientific establishment of the sixties reflected two opposed versions of nationalism, the one conservative, Malthusian, inner-directed, the other forward-looking, eager for the recovery of national status, seeing a strong French science as a means for asserting national

Scandinavian Fellowship for Oral Pathology and Oral Medicine

DEFF Research Database (Denmark)

Kragelund, Camilla; Reibel, J; Hietanen, J

2012-01-01

as new approaches, treatments and diagnostic possibilities develop. Likewise, the role of the dentist in the community changes and may vary in different countries. As members of the Scandinavian Fellowship for Oral Pathology and Oral Medicine and subject representatives of oral pathology and oral......In Scandinavia, as in many European countries, most patients consult their general dentist once a year or more. This gives the dentist a unique opportunity and an obligation to make an early diagnosis of oral diseases, which is beneficial for both the patient and the society. Thus, the dentist must...... medicine, we feel obliged to contribute to the discussion of how the guidelines of the dental curriculum support the highest possible standards of dental education. This article is meant to delineate a reasonable standard of oral pathology and oral medicine in the European dental curriculum and to guide...

The outcome of anaesthesia related cardiac arrest in a

Directory of Open Access Journals (Sweden)

O.O. Adekola

2016-07-01

Conclusion: Anaesthesia related cardiac arrest and mortality were linked to cardiovascular depression from halothane overdose in our institution. The burden can be reduced by improving on establishing standard monitoring in the perioperative period, and a team approach to patients care.

Paramedic versus emergency physician emergency medical service: role of the anaesthesiologist and the European versus the Anglo-American concept

NARCIS (Netherlands)

Timmermann, Arnd; Russo, Sebastian G.; Hollmann, Markus W.

2008-01-01

Purpose of review Much controversy exists about who can provide the best medical care for critically ill patients in the prehospital setting. The Anglo-American concept is on the whole to provide well trained paramedics to fulfil this task, whereas in some European countries emergency medical

Ancient DNA reveals lack of continuity between neolithic hunter-gatherers and contemporary Scandinavians

DEFF Research Database (Denmark)

Malmström, Helena; Gilbert, M Thomas P; Thomas, Mark G

2009-01-01

of the two cultures in Scandinavia has been cited as an argument against population replacement between the Mesolithic and the present [7, 8]. Through analysis of DNA extracted from ancient Scandinavian human remains, we show that people of the Pitted Ware culture were not the direct ancestors of modern......]. Furthermore, our data are consistent with the view that the eastern Baltic represents a genetic refugia for some of the European hunter-gatherer populations....

Consequences of a demographic bottleneck on genetic structure and variation in the Scandinavian brown bear.

Science.gov (United States)

Xenikoudakis, G; Ersmark, E; Tison, J-L; Waits, L; Kindberg, J; Swenson, J E; Dalén, L

2015-07-01

The Scandinavian brown bear went through a major decline in population size approximately 100 years ago, due to intense hunting. After being protected, the population subsequently recovered and today numbers in the thousands. The genetic diversity in the contemporary population has been investigated in considerable detail, and it has been shown that the population consists of several subpopulations that display relatively high levels of genetic variation. However, previous studies have been unable to resolve the degree to which the demographic bottleneck impacted the contemporary genetic structure and diversity. In this study, we used mitochondrial and microsatellite DNA markers from pre- and postbottleneck Scandinavian brown bear samples to investigate the effect of the bottleneck. Simulation and multivariate analysis suggested the same genetic structure for the historical and modern samples, which are clustered into three subpopulations in southern, central and northern Scandinavia. However, the southern subpopulation appears to have gone through a marked change in allele frequencies. When comparing the mitochondrial DNA diversity in the whole population, we found a major decline in haplotype numbers across the bottleneck. However, the loss of autosomal genetic diversity was less pronounced, although a significant decline in allelic richness was observed in the southern subpopulation. Approximate Bayesian computations provided clear support for a decline in effective population size during the bottleneck, in both the southern and northern subpopulations. These results have implications for the future management of the Scandinavian brown bear because they indicate a recent loss in genetic diversity and also that the current genetic structure may have been caused by historical ecological processes rather than recent anthropogenic persecution. © 2015 John Wiley & Sons Ltd.

Daily FOUR score assessment provides accurate prognosis of long-term outcome in out-of-hospital cardiac arrest.

Science.gov (United States)

Weiss, N; Venot, M; Verdonk, F; Chardon, A; Le Guennec, L; Llerena, M C; Raimbourg, Q; Taldir, G; Luque, Y; Fagon, J-Y; Guerot, E; Diehl, J-L

2015-05-01

The accurate prediction of outcome after out-of-hospital cardiac arrest (OHCA) is of major importance. The recently described Full Outline of UnResponsiveness (FOUR) is well adapted to mechanically ventilated patients and does not depend on verbal response. To evaluate the ability of FOUR assessed by intensivists to accurately predict outcome in OHCA. We prospectively identified patients admitted for OHCA with a Glasgow Coma Scale below 8. Neurological assessment was performed daily. Outcome was evaluated at 6 months using Glasgow-Pittsburgh Cerebral Performance Categories (GP-CPC). Eighty-five patients were included. At 6 months, 19 patients (22%) had a favorable outcome, GP-CPC 1-2, and 66 (78%) had an unfavorable outcome, GP-CPC 3-5. Compared to both brainstem responses at day 3 and evolution of Glasgow Coma Scale, evolution of FOUR score over the three first days was able to predict unfavorable outcome more precisely. Thus, absence of improvement or worsening from day 1 to day 3 of FOUR had 0.88 (0.79-0.97) specificity, 0.71 (0.66-0.76) sensitivity, 0.94 (0.84-1.00) PPV and 0.54 (0.49-0.59) NPV to predict unfavorable outcome. Similarly, the brainstem response of FOUR score at 0 evaluated at day 3 had 0.94 (0.89-0.99) specificity, 0.60 (0.50-0.70) sensitivity, 0.96 (0.92-1.00) PPV and 0.47 (0.37-0.57) NPV to predict unfavorable outcome. The absence of improvement or worsening from day 1 to day 3 of FOUR evaluated by intensivists provides an accurate prognosis of poor neurological outcome in OHCA. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Relation between change in blood pressure in acute stroke and risk of early adverse events and poor outcome

DEFF Research Database (Denmark)

Sandset, Else C; Murray, Gordon D; Bath, Philip M W

2012-01-01

The Scandinavian Candesartan Acute Stroke Trial (SCAST) found no benefits of candesartan in acute stroke. In the present analysis we aim to investigate the effect of change in blood pressure during the first 2 days of stroke on the risk of early adverse events and poor outcome....

Home-based versus centre-based cardiac rehabilitation.

Science.gov (United States)

Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Moxham, Tiffany; Zawada, Anna

2010-01-20

The burden of cardiovascular disease world-wide is one of great concern to patients and health care agencies alike. Traditionally centre-based cardiac rehabilitation (CR) programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation. To determine the effectiveness of home-based cardiac rehabilitation programmes compared with supervised centre-based cardiac rehabilitation on mortality and morbidity, health-related quality of life and modifiable cardiac risk factors in patients with coronary heart disease. We updated the search of a previous review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2007, Issue 4), MEDLINE, EMBASE and CINAHL from 2001 to January 2008. We checked reference lists and sought advice from experts. No language restrictions were applied. Randomised controlled trials (RCTs) that compared centre-based cardiac rehabilitation (e.g. hospital, gymnasium, sports centre) with home-based programmes, in adults with myocardial infarction, angina, heart failure or who had undergone revascularisation. Studies were selected independently by two reviewers, and data extracted by a single reviewer and checked by a second one. Authors were contacted where possible to obtain missing information. Twelve studies (1,938 participants) met the inclusion criteria. The majority of studies recruited a lower risk patient following an acute myocardial infarction (MI) and revascularisation. There was no difference in outcomes of home- versus centre-based cardiac rehabilitation in mortality risk ratio (RR) was1.31 (95% confidence interval (C) 0.65 to 2.66), cardiac events, exercise capacity standardised mean difference (SMD) -0.11 (95% CI -0.35 to 0.13), as well as in modifiable risk factors (systolic blood pressure; diastolic blood pressure; total cholesterol

Cardiac Rehabilitation Enhancing Programs in Patients with Myocardial Infarction: A literature Review

Directory of Open Access Journals (Sweden)

Ahyana Ahyana

2013-01-01

Full Text Available Background: Cardiac rehabilitation (CR is a process that involves a multidisciplinary team of health professionals in order to optimize the status of patients’ physical, psychological, social, and vocational well being. The CR program has been proven to influence health outcomes in patients with cardiac diseases, particularly myocardial infarction (MI and stable angina. However, patients’ compliance with cardiac rehabilitation programs remains a challenge.Purpose: The purpose of this study is to review and identify interventions that enhance cardiac rehabilitation behaviors in MI patients.Method: A literature review was conducted by analyzing related research reports published since 2000 to 2012. Only English language articles were included.Result: There were 10 experimental studies and 2 meta-analysis studies. Interventions widely used to enhance cardiac rehabilitation behaviors in MI patients were self-efficacy and self management derived programs. These programs involved interventions that enhance cardiac rehabilitation behaviors, including training exercise, behavioral change, education and psychological support, and lifestyle changing strategies. None have reported the use of culturally tailored intervention. Four phases of cardiac rehabilitation were accepted as each phase represents a different aspect of care: inpatient care, early post discharge period, exercise training, and long term follow up. Critical factors for patients in maintaining an optimum health condition after a cardiac event are, in order, status of patient’s physical, psychological, social, and vocational well being.Conclusion: Cardiac Rehabilitation program has been shown to improve quality of life and decrease mortality in MI patients. The development of culturally specific interventions to increase cardiac rehabilitation behaviors will provide a significant improvement for cardiac patient’s care that ultimately results in better health outcomes. Health care

Mobbing in the Schools. Scandinavian Initiatives in the Prevention and Reduction of Group Violence among Children.

Science.gov (United States)

Juul, Kristen D.

The paper defines the concept of mobbing and notes alternate terms such as bullying, scapegoating, and group violence or aggression. Scandinavian research and literature on mobbing is analyzed, especially as it relates to the incidence of mobbing and characteristics of aggressor and victim. Intervention efforts are described, such as individual…

Linguistic Identity and Career Decision-Making Difficulties among French-Speaking Canadian Students Living in an Anglo-Dominant Context

Science.gov (United States)

Sovet, Laurent; DiMillo, Julia; Samson, André

2017-01-01

Career decision-making difficulties (CDMD) are often faced by students entering their final year of high school, and can further complicate when a student belongs to a minority group, such as a linguistic minority (Francophone) within an Anglo-dominant society (Ontario, Canada). The current study aimed to examine CDMD in 984 Franco-Ontarian grade…

Indicators of Subarachnoid Hemorrhage as a Cause of Sudden Cardiac Arrest

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Joseph Zachariah

2016-03-01

Full Text Available Subarachnoid hemorrhage (SAH may present with cardiac arrest (SAH-CA. We report a case of SAH-CA to assist providers in distinguishing SAH as an etiology of cardiac arrest despite electrocardiogram findings that may be suggestive of a cardiac etiology. SAH-CA is associated with high rates of return of spontaneous circulation, but overall poor outcome. An initially non-shockable cardiac rhythm and the absence of brain stem reflexes are important clues in indentifying SAH-CA.

Cardiac arrest during anesthesia at a University Hospital in Nigeria ...

African Journals Online (AJOL)

Background: We assessed the incidence and outcomes of cardiac arrest during anesthesia in the operating room at our university hospital. A previous study on intraoperative cardiac arrests covered a period from 1994-1998 and since then; anesthetic personnel, equipment, and workload have increased remarkably.

Transcription Factors in Heart: Promising Therapeutic Targets in Cardiac Hypertrophy

OpenAIRE

Kohli, Shrey; Ahuja, Suchit; Rani, Vibha

2011-01-01

Regulation of gene expression is central to cell growth, differentiation and diseases. Context specific and signal dependent regulation of gene expression is achieved to a large part by transcription factors. Cardiac transcription factors regulate heart development and are also involved in stress regulation of the adult heart, which may lead to cardiac hypertrophy. Hypertrophy of cardiac myocytes is an outcome of the imbalance between prohypertrophic factors and anti-hypertrophic factors. Thi...

The new Scandinavian Donations and Transfusions database (SCANDAT2): a blood safety resource with added versatility.

Science.gov (United States)

Edgren, Gustaf; Rostgaard, Klaus; Vasan, Senthil K; Wikman, Agneta; Norda, Rut; Pedersen, Ole Birger; Erikstrup, Christian; Nielsen, Kaspar René; Titlestad, Kjell; Ullum, Henrik; Melbye, Mads; Nyrén, Olof; Hjalgrim, Henrik

2015-07-01

Risks of transfusion-transmitted disease are currently at a record low in the developed world. Still, available methods for blood surveillance might not be sufficient to detect transmission of diseases with unknown etiologies or with very long incubation periods. We have previously created the anonymized Scandinavian Donations and Transfusions (SCANDAT) database, containing data on blood donors, blood transfusions, and transfused patients, with complete follow-up of donors and patients for a range of health outcomes. Here we describe the re-creation of SCANDAT with updated, identifiable data. We collected computerized data on blood donations and transfusions from blood banks covering all of Sweden and Denmark. After data cleaning, two structurally identical databases were created and the entire database was linked with nationwide health outcomes registers to attain complete follow-up for up to 47 years regarding hospital care, cancer, and death. After removal of erroneous records, the database contained 25,523,334 donation records, 21,318,794 transfusion records, and 3,692,653 unique persons with valid identification, presently followed over 40 million person-years, with possibility for future extension. Data quality is generally high with 96% of all transfusions being traceable to their respective donation(s) and a very high (>97%) concordance with official statistics on annual number of blood donations and transfusions. It is possible to create a binational, nationwide database with almost 50 years of follow-up of blood donors and transfused patients for a range of health outcomes. We aim to use this database for further studies of donor health, transfusion-associated risks, and transfusion-transmitted disease. © 2015 AABB.

Caseworkers’ discretions of eligibility to social insurance in Denmark and Sweden – signs of Neoliberalism in Scandinavian welfare states?

DEFF Research Database (Denmark)

Møller, Marie Østergaard; Stensöta, Helena

It has been argued that the Scandinavian welfare states have been resilient to trends of globalization and fiscal crises, and that the global pressure of neoliberalism has led to a partial retrenchment rather than a restructuring during last decades. This conclusion is, however, drawn without...... closer attention to the problem of implementation and the fact that many welfare state programs receive their ultimate content through street level contact between citizens and street-level bureaucrats. In this article, we address the question of whether there is an impact of neoliberal trends...... in Scandinavian social policies when paying attention to the everyday work of street level bureaucrats or whether the universal welfare regime ’protects’ against a neoliberal impact. Comparing conclusions on SLBs’ discretionary styles in sickness-benefits casework from two separate studies situated...

Networks of Meaning and the Social Dynamics of Identity. An Example from Early Anglo-Saxon England

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Kathrin Felder

2015-02-01

Full Text Available In the early Anglo-Saxon period, dressing and displaying the body in life and death played an important role in shaping and reinforcing identities and ruling social norms. Studies of the past decades have particularly highlighted the social significance of dressing and staging the body for the event of the funeral. This paper addresses how the production of dress items, the daily act of dressing, and the individuals involved in these practices helped shape the same identities that were enacted in the funeral. It argues that we must consider more explicitly how certain elements of dress became objects of identification through the social dialogue between groups of people who engaged with such objects at earlier stages of their lifecycle. This must include not only those who used dress items as grave goods but also those who produced and wore them. It works towards a framework that captures more fully the social communication and exchange of ideas that shaped and transformed notions of identity. Using data from the author’s research on early Anglo-Saxon girdle-hangers, this paper addresses how different forms of socio-material communication, and different actors involved, can be addressed through the material record of burials. Together these formed the mental networks in which meanings and values were created.

Scandinavian exceptionalism? Civic integration and labour market activation for newly arrived immigrants

DEFF Research Database (Denmark)

Breidahl, Karen Nielsen

2017-01-01

models have been resilient: Based on an in-depth historical and comparative analysis of labour market activation policies targeting newly arrived immigrants in Sweden, Norway, and Denmark since the early 1990s, the article contributes to the overall question: To what extent do the institutional pathways...... of the Scandinavian welfare states prevail when confronted with newcomers? Activation policies targeting newly arrived immigrants exemplifies how the ambition of states to promote functional, individual autonomy is also an important, ongoing process in diverse policy areas of the welfare state and not restricted...

Outcomes After Cardiac Arrest in an Adult Burn Center

Science.gov (United States)

2013-12-07

of in-hospital CA are likely to report widely varying survival rates as a result of study populations with characteristic but distinct demo- graphics ...Rehabil 1997;18:S119. [2] Sandroni C, Nolan J. In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intens Care Med

Early Recognition of Foreign Body Aspiration as the Cause of Cardiac Arrest

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Muhammad Kashif

2016-01-01

Full Text Available Foreign body aspiration (FBA is uncommon in the adult population but can be a life-threatening condition. Clinical manifestations vary according to the degree of airway obstruction, and, in some cases, making the correct diagnosis requires a high level of clinical suspicion combined with a detailed history and exam. Sudden cardiac arrest after FBA may occur secondary to asphyxiation. We present a 48-year-old male with no history of cardiac disease brought to the emergency department after an out-of-hospital cardiac arrest (OHCA. The patient was resuscitated after 15 minutes of cardiac arrest. He was initially managed with therapeutic hypothermia (TH. Subsequent history suggested FBA as a possible etiology of the cardiac arrest, and fiberoptic bronchoscopy demonstrated a piece of meat and bone lodged in the left main stem bronchus. The foreign body was removed with the bronchoscope and the patient clinically improved with full neurological recovery. Therapeutic hypothermia following cardiac arrest due to asphyxia has been reported to have high mortality and poor neurological outcomes. This case highlights the importance of early identification of FBA causing cardiac arrest, and we report a positive neurological outcome for postresuscitation therapeutic hypothermia following cardiac arrest due to asphyxia.

An Interdisciplinary Education Initiative to Promote Blood Conservation in Cardiac Surgery.

Science.gov (United States)

Goda, Tamara S; Sherrod, Brad; Kindell, Linda

Transfusion practices vary extensively for patients undergoing cardiac surgical procedures, leading to high utilization of blood products despite evidence that transfusions negatively impact outcomes. An important factor affecting transfusion practice is recognition of the importance of teams in cardiac surgery care delivery. This article reports an evidenced-based practice (EBP) initiative constructed using the Society of Thoracic Surgery (STS) 2011 Blood Conservation Clinical Practice Guidelines (CPGs) to standardize transfusion practice across the cardiac surgery team at a large academic medical center. Project outcomes included: a) Improvement in clinician knowledge related to the STS Blood Conservation CPGs; and b) Decreased blood product utilization for patients undergoing cardiac surgical procedures. Participants' scores reflected an improvement in the overall knowledge of the STS CPGs noting a 31.1% (p = 0.012) increase in the number of participants whose practice reflected the Blood Conservation CPGs post intervention. Additionally, there was a reduction in overall blood product utilization for all patients undergoing cardiac surgery procedures post intervention (p = 0.005). Interdisciplinary education based on the STS Blood Conservation CPGs is an effective way to reduce transfusion practice variability and decrease utilization of blood products during cardiac surgery.

Urinary tract infection in children after cardiac surgery: Incidence, causes, risk factors and outcomes in a single-center study.

Science.gov (United States)

Kabbani, Mohamed S; Ismail, Sameh R; Fatima, Anis; Shafi, Rehana; Idris, Julinar A; Mehmood, Akhter; Singh, Reetam K; Elbarabry, Mahmoud; Hijazi, Omar; Hussein, Mohamed A

2016-01-01

Nosocomial urinary tract infection (UTI) increases hospitalization, cost and morbidity. In this cohort study, we aimed to determine the incidence, risk factors, etiology and outcomes of UTIs in post-operative cardiac children. To this end, we studied all post-operative patients admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) in 2012, and we divided the patients into two groups: the UTI (UTI group) and the non-UTI (control group). We compared both groups for multiple peri-operative risk factors. We included 413 children in this study. Of these, 29 (7%) had UTIs after cardiac surgery (UTI group), and 384 (93%) were free from UTIs (control group). All UTI cases were catheter-associated UTIs (CAUTIs). A total of 1578 urinary catheter days were assessed in this study, with a CAUTI density rate of 18 per 1000 catheter days. Multivariate logistic regression analysis demonstrated the following risk factors for CAUTI development: duration of urinary catheter placement (purinary tract (CAKUT) (purinary catheter, the presence of CAKUT, and the presence of syndromes comprised the main risk factors for CAUTI. Gram-negative organisms were the main causes for CAUTI, and one-third of them found to be resistant in this single-center study. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Making an APPropriate Care Program for Indigenous Cardiac Disease: Customization of an Existing Cardiac Rehabilitation Program.

Science.gov (United States)

Bradford, DanaKai; Hansen, David; Karunanithi, Mohan

2015-01-01

Cardiovascular disease is a major health problem for all Australians and is the leading cause of death in Aboriginal and Torres Strait Islanders. In 2010, more then 50% of all heart attack deaths were due to repeated events. Cardiac rehabilitation programs have been proven to be effective in preventing the recurrence of cardiac events and readmission to hospitals. There are however, many barriers to the use of these programs. To address these barriers, CSIRO developed an IT enabled cardiac rehabilitation program delivered by mobile phone through a smartphone app and succesfully trialed it in an urban general population. If these results can be replicated in Indigenous populations, the program has the potential to significantly improve life expectancy and help close the gap in health outcomes. The challenge described in this paper is customizing the existing cardiac health program to make it culturally relevant and suitable for Indigenous Australians living in urban and remote communities.

Semantic change and grammaticalization : The development of modal and postmodal meanings in Mainland Scandinavian ma, matte and maste

NARCIS (Netherlands)

Beijering, K.

2011-01-01

This paper presents a comparative synchronic corpus investigation of Mainland Scandinavian ma, matte and maste 'must, may'. These modals developed a wide range of different meanings and uses within the realm of necessity, possibility and beyond, i.e., ability, capacity, need, desirability,

A PANEL REGRESSION ANALYSIS OF HUMAN CAPITAL RELEVANCE IN SELECTED SCANDINAVIAN AND SE EUROPEAN COUNTRIES

Directory of Open Access Journals (Sweden)

Filip Kokotovic

2016-06-01

Full Text Available The study of human capital relevance to economic growth is becoming increasingly important taking into account its relevance in many of the Sustainable Development Goals proposed by the UN. This paper conducted a panel regression analysis of selected SE European countries and Scandinavian countries using the Granger causality test and pooled panel regression. In order to test the relevance of human capital on economic growth, several human capital proxy variables were identified. Aside from the human capital proxy variables, other explanatory variables were selected using stepwise regression while the dependant variable was GDP. This paper concludes that there are significant structural differences in the economies of the two observed panels. Of the human capital proxy variables observed, for the panel of SE European countries only life expectancy was statistically significant and it had a negative impact on economic growth, while in the panel of Scandinavian countries total public expenditure on education had a statistically significant positive effect on economic growth. Based upon these results and existing studies, this paper concludes that human capital has a far more significant impact on economic growth in more developed economies.

Current use of nitrous oxide in public hospitals in Scandinavian countries.

Science.gov (United States)

Husum, B; Stenqvist, O; Alahuhta, S; Sigurdsson, G H; Dale, O

2013-10-01

The use of nitrous oxide in modern anaesthesia has been questioned. We surveyed changes in use of nitrous oxide in Scandinavia and its justifications during the last two decades. All 191 departments of anaesthesia in the Scandinavian countries were requested by email to answer an electronic survey in SurveyMonkey. One hundred and twenty-five (64%) of the departments responded; four were excluded. The 121 departments provided 807.520 general anaesthetics annually. The usage of nitrous oxide was reported in 11.9% of cases, ranging from 0.6% in Denmark to 38.6% in Iceland while volatile anaesthetics were employed in 48.9%, lowest in Denmark (22.6%) and highest in Iceland (91.9%). Nitrous oxide was co-administered with volatile anaesthetics in 21.5% of general anaesthetics [2.4% (Denmark) -34.5% (Iceland)]. Use of nitrous oxide was unchanged in five departments (4%), decreasing in 75 (62%) and stopped in 41 (34%). Reasons for decreasing or stopping use of nitrous oxide were fairly uniform in the five countries, the most important being that other agents were 'better', whereas few put weight on its potential risk for increasing morbidity. Decision to stop using nitrous oxide was made by the departments except in four cases. Of 87 maternity wards, nitrous oxide was used in 72, whereas this was the case in 42 of 111 day-surgery units. The use of nitrous oxide has decreased in the Scandinavian countries, apparently because many now prefer other agents. Difference in practices between the five countries were unexpected and apparently not justified on anticipated evidence only. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Intercultural Constellations in Adult Education: Observations on the State of Anglo-German Relations before and after the First World War.

Science.gov (United States)

Friedenthal-Haase, Martha

1993-01-01

A literature review of adult education and Anglo-German connections, 1880-1933, showed that interculturality played an essential role in identity formation at the interface of culture and politics. Adult education developed as an autonomous area of international communication between British and German citizens despite political realities. (SK)

Complexity Matters: On Gender Agreement in Heritage Scandinavian

Science.gov (United States)

Johannessen, Janne Bondi; Larsson, Ida

2015-01-01

This paper investigates aspects of the noun phrase from a Scandinavian heritage language perspective, with an emphasis on noun phrase-internal gender agreement and noun declension. Our results are somewhat surprising compared with earlier research: We find that noun phrase-internal agreement for the most part is rather stable. To the extent that we find attrition, it affects agreement in the noun phrase, but not the declension of the noun. We discuss whether this means that gender is lost and has been reduced to a pure declension class, or whether gender is retained. We argue that gender is actually retained in these heritage speakers. One argument for this is that the speakers who lack agreement in complex noun phrases, have agreement intact in simpler phrases. We have thus found that the complexity of the noun phrase is crucial for some speakers. However, among the heritage speakers we also find considerable inter-individual variation, and different speakers can have partly different systems. PMID:26733114

Standardized EEG interpretation accurately predicts prognosis after cardiac arrest

NARCIS (Netherlands)

Westhall, Erik; Rossetti, Andrea O.; van Rootselaar, Anne-Fleur; Wesenberg Kjaer, Troels; Horn, Janneke; Ullén, Susann; Friberg, Hans; Nielsen, Niklas; Rosén, Ingmar; Åneman, Anders; Erlinge, David; Gasche, Yvan; Hassager, Christian; Hovdenes, Jan; Kjaergaard, Jesper; Kuiper, Michael; Pellis, Tommaso; Stammet, Pascal; Wanscher, Michael; Wetterslev, Jørn; Wise, Matt P.; Cronberg, Tobias; Saxena, Manoj; Miller, Jennene; Inskip, Deborah; Macken, Lewis; Finfer, Simon; Eatough, Noel; Hammond, Naomi; Bass, Frances; Yarad, Elizabeth; O'Connor, Anne; Bird, Simon; Jewell, Timothy; Davies, Gareth; Ng, Karl; Coward, Sharon; Stewart, Antony; Micallef, Sharon; Parker, Sharyn; Cortado, Dennis; Gould, Ann; Harward, Meg; Thompson, Kelly; Glass, Parisa; Myburgh, John; Smid, Ondrej; Belholavek, Jan; Juffermans, Nicole P.; Boerma, EC

2016-01-01

To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society. In this cohort study, 4 EEG specialists, blinded to outcome,

Cardiac Intensive Care Unit Management of Patients After Cardiac Arrest: Now the Real Work Begins.

Science.gov (United States)

Randhawa, Varinder K; Grunau, Brian E; Debicki, Derek B; Zhou, Jian; Hegazy, Ahmed F; McPherson, Terry; Nagpal, A Dave

2018-02-01

Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)-in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post-cardiac arrest syndrome also require diligent observation and management, including post-cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness. There is growing evidence that an early invasive approach to coronary reperfusion with percutaneous coronary intervention, together with active targeted temperature management and optimization of hemodynamic, ventilator, and metabolic parameters, may improve survival and neurologic outcomes in cardiac arrest survivors. Neuroprognostication is complex, as are survivorship issues and long-term rehabilitation. Our paramedics, emergency physicians, and resuscitation specialists are all to be congratulated for ever-increasing success with ROSC… but now the real work begins. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Outcome quality of in-patient cardiac rehabilitation in elderly patients--identification of relevant parameters.

Science.gov (United States)

Salzwedel, Annett; Nosper, Manfred; Röhrig, Bernd; Linck-Eleftheriadis, Sigrid; Strandt, Gert; Völler, Heinz

2014-02-01

Outcome quality management requires the consecutive registration of defined variables. The aim was to identify relevant parameters in order to objectively assess the in-patient rehabilitation outcome. From February 2009 to June 2010 1253 patients (70.9 ± 7.0 years, 78.1% men) at 12 rehabilitation clinics were enrolled. Items concerning sociodemographic data, the impairment group (surgery, conservative/interventional treatment), cardiovascular risk factors, structural and functional parameters and subjective health were tested in respect of their measurability, sensitivity to change and their propensity to be influenced by rehabilitation. The majority of patients (61.1%) were referred for rehabilitation after cardiac surgery, 38.9% after conservative or interventional treatment for an acute coronary syndrome. Functionally relevant comorbidities were seen in 49.2% (diabetes mellitus, stroke, peripheral artery disease, chronic obstructive lung disease). In three key areas 13 parameters were identified as being sensitive to change and subject to modification by rehabilitation: cardiovascular risk factors (blood pressure, low-density lipoprotein cholesterol, triglycerides), exercise capacity (resting heart rate, maximal exercise capacity, maximal walking distance, heart failure, angina pectoris) and subjective health (IRES-24 (indicators of rehabilitation status): pain, somatic health, psychological well-being and depression as well as anxiety on the Hospital Anxiety and Depression Scale). The outcome of in-patient rehabilitation in elderly patients can be comprehensively assessed by the identification of appropriate key areas, that is, cardiovascular risk factors, exercise capacity and subjective health. This may well serve as a benchmark for internal and external quality management.

Clash of pans: pan-Africanism and pan-Anglo-Saxonism and the global colour line, 1919–1945

OpenAIRE

Ledwidge, M.; Parmar, I.

2017-01-01

The article demonstrates both conceptually and empirically that pan-Anglo-Saxonist knowledge networks reconstructed and reimagined an apparently de-racialised, scientific, sober and liberal world order that outwardly abandoned, but did not eradicate the twin phenomena of racism and imperialism. Rather the new liberal (imperial) internationalists, organised in newly formed “think tanks” such as Chatham House and the Council on Foreign Relations, and through their increasingly global elite netw...

Johnston R.J. & Sidaway J.D., eds., Geography and geographers, Anglo-American human geography since 1945

OpenAIRE

Vandeburie, Julien

2014-01-01

This well-known book is in its sixth edition and focuses on Anglo-American geographers, with a historical/thematic point of view. Chapters are presented in the following order: 1. The nature of an academic discipline; 2. Foundations; 3. Growth of systematic studies and the adoption of ’scientific method’; 4. Human geography as spatial science; 5. Humanistic geography; 6. ’Radical geographies’; 7. Postmodern geographies; 8. Feminist geographies; 9. Applied geography and the relevance debate; 1...

Empires, Exceptions, and Anglo-Saxons: Race and Rule between the British and Unites States Empires, 1880-1910. Teaching the JAH.

Science.gov (United States)

OAH Magazine of History, 2002

2002-01-01

Summarizes a teaching document that is part of "Teaching the JAH" (Journal of American History) which corresponds to the article, "Empires, Exceptions, and Anglo-Saxons: Race and Rule between the British and Unites States Empires, 1880-1910" (Paul A. Kramer). Provides the Web site address for the complete installment. (CMK)

Towards the identification of dyestuffs in Early Iron Age Scandinavian peat bog textiles

DEFF Research Database (Denmark)

Mannering, Ulla; Gleba, Margarita; Vanden Berghe, Ina

2009-01-01

A large systematic dye investigation of prehistoric Danish and Norwegian bog textiles was carried out using high performance liquid chromatography with photo diode array detection. After the selection of the most suitable protocol for dye extraction and HPLC analysis for this specific group of ar...... of biological dye sources in Early Iron Age Scandinavia. The results clearly indicate that most Scandinavian peat bog textiles originally were dyed and that already during the 1st millennium BC, the populations in Scandinavia were familiar with the dyeing technology....

Urinary tract infection in children after cardiac surgery: Incidence, causes, risk factors and outcomes in a single-center study

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Mohamed S. Kabbani

2016-09-01

Full Text Available Summary: Nosocomial urinary tract infection (UTI increases hospitalization, cost and morbidity. In this cohort study, we aimed to determine the incidence, risk factors, etiology and outcomes of UTIs in post-operative cardiac children. To this end, we studied all post-operative patients admitted to the Pediatric Cardiac Intensive Care Unit (PCICU in 2012, and we divided the patients into two groups: the UTI (UTI group and the non-UTI (control group. We compared both groups for multiple peri-operative risk factors. We included 413 children in this study. Of these, 29 (7% had UTIs after cardiac surgery (UTI group, and 384 (93% were free from UTIs (control group. All UTI cases were catheter-associated UTIs (CAUTIs. A total of 1578 urinary catheter days were assessed in this study, with a CAUTI density rate of 18 per 1000 catheter days. Multivariate logistic regression analysis demonstrated the following risk factors for CAUTI development: duration of urinary catheter placement (p < 0.001, presence of congenital abnormalities of kidney and urinary tract (CAKUT (p < 0.0041 and the presence of certain syndromes (Down, William, and Noonan (p < 0.02. Gram-negative bacteria accounted for 63% of the CAUTI. The main causes of CAUTI were Klebsiella (27%, Candida (24% and Escherichia coli (21%. Resistant organisms caused 34% of CAUTI. Two patients (7% died in the UTI group compared with the one patient (0.3% who died in the control group (p < 0.05. Based on these findings, we concluded that an increased duration of the urinary catheter, the presence of CAKUT, and the presence of syndromes comprised the main risk factors for CAUTI. Gram-negative organisms were the main causes for CAUTI, and one-third of them found to be resistant in this single-center study. Keywords: Urinary tract infection, Cardiac surgery, Nosocomial

The Maltese ‘Land Registry Certification System’ : Latin and Anglo-Saxon influences : an innovative approach to the economic history of English-speaking nations

OpenAIRE

Di Marco, Elena

2011-01-01

In this article, the author states that the Maltese registry is unique in using both Italian and Anglo-Saxon influences in it's recording system - in itself a valuable source of the country's economic and social history.

Y chromosome evidence for Anglo-Saxon mass migration.

Science.gov (United States)

Weale, Michael E; Weiss, Deborah A; Jager, Rolf F; Bradman, Neil; Thomas, Mark G

2002-07-01

British history contains several periods of major cultural change. It remains controversial as to how much these periods coincided with substantial immigration from continental Europe, even for those that occurred most recently. In this study, we examine genetic data for evidence of male immigration at particular times into Central England and North Wales. To do this, we used 12 biallelic polymorphisms and six microsatellite markers to define high-resolution Y chromosome haplotypes in a sample of 313 males from seven towns located along an east-west transect from East Anglia to North Wales. The Central English towns were genetically very similar, whereas the two North Welsh towns differed significantly both from each other and from the Central English towns. When we compared our data with an additional 177 samples collected in Friesland and Norway, we found that the Central English and Frisian samples were statistically indistinguishable. Using novel population genetic models that incorporate both mass migration and continuous gene flow, we conclude that these striking patterns are best explained by a substantial migration of Anglo-Saxon Y chromosomes into Central England (contributing 50%-100% to the gene pool at that time) but not into North Wales.

Comparing Outcomes of Donation After Cardiac Death Versus Donation After Brain Death in Liver Transplant Recipients with Hepatitis C: A Systematic Review and Meta-Analysis

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Malcolm Wells

2014-01-01

Full Text Available BACKGROUND: Liver transplantation (LT using organs donated after cardiac death (DCD is increasing due, in large part, to a shortage of organs. The outcome of using DCD organs in recipients with hepatits C virus (HCV infection remains unclear due to the limited experience and number of publications addressing this issue.

Increasingly heterogeneous ages at first birth by education in Southern-European and Anglo-American family-policy regimes: A seven-country comparison

Science.gov (United States)

Rendall, Michael; Aracil, Encarnacion; Bagavos, Christos; Couet, Christine; DeRose, Alessandra; DiGiulio, Paola; Lappegard, Trude; Robert-Bobée, Isabelle; Rønsen, Marit; Smallwood, Steve; Verropoulou, Georgia

2010-01-01

Family-policy regimes unfavourable to combining employment with motherhood have been claimed to increase socio-economic differentials in fertility as combining employment and motherhood has become more normative. This claim has to date been explored mainly in reference to ‘liberal’ Anglo-American regimes. Comparing education differentials in age at first birth among native-born women of 1950s and 1960s birth cohorts in seven countries representing three regime types, we find persistence in early first births among low-educated women not only in Britain and the United States but also in Greece, Italy, and Spain. Shifts towards later first births, however, were more extreme in Southern Europe and involved to some extent women at all education levels. The educationally-heterogeneous changes in age patterns of first births seen in the Southern European and Anglo-American family-policy regimes contrast with educationally-homogeneous changes across birth cohorts seen in the study’s two ‘universalistic’ countries, Norway and France. PMID:20954097

Socioeconomic inequalities in oral health in different European welfare state regimes.

Science.gov (United States)

Guarnizo-Herreño, Carol C; Watt, Richard G; Pikhart, Hynek; Sheiham, Aubrey; Tsakos, Georgios

2013-09-01

There is very little information about the relationship between welfare regimes and oral health inequalities. We compared socioeconomic inequalities in adults' oral health in five European welfare-state regimes: Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern. Using data from the oral health module of the Eurobarometer 72.3 survey, we assessed inequalities in two self-reported oral health measures: no functional dentition (less than 20 natural teeth) and edentulousness (no natural teeth). Occupational social class, education and subjective social status (SSS) were included as socioeconomic position indicators. We estimated age-standardised prevalence rates, ORs, the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). The Scandinavian regime showed the lowest prevalence rates of the two oral health measures while the Eastern showed the highest. In all welfare regimes there was a general pattern of social gradients by occupational social class and education. Relative educational inequalities in no functional dentition were largest in the Scandinavian welfare regime (RII=3.81; 95% CI 2.68 to 5.42). The Scandinavian and Southern regimes showed the largest relative inequalities in edentulousness by occupation and education, respectively. There were larger absolute inequalities in no functional dentition in the Eastern regime by occupation (SII=42.16; 95% CI 31.42 to 52.89) and in the Southern by SSS (SII=27.92; 95% CI 17.36 to 38.47). Oral health inequalities in adults exist in all welfare-state regimes, but contrary to what may be expected from theory, they are not smaller in the Scandinavian regime. Future work should examine the potential mechanisms linking welfare provision and oral health inequalities.

Quality assessment of structure and language elements of written responses given by seven Scandinavian drug information centres

DEFF Research Database (Denmark)

Reppe, Linda Amundstuen; Spigset, Olav; Kampmann, Jens Peter

2017-01-01

PURPOSE: The aim of this study was to identify structure and language elements affecting the quality of responses from Scandinavian drug information centres (DICs). METHODS: Six different fictitious drug-related queries were sent to each of seven Scandinavian DICs. The centres were blinded for wh...... on drug-related queries with respect to language and text structure. Giving specific advice and precise conclusions and avoiding too compressed language and non-standard abbreviations may aid to reach this goal....... of responses was generally judged as satisfactory to good. Presenting specific advice and conclusions were considered to improve the quality of the responses. However, small nuances in language formulations could affect the individual judgments of the experts, e.g. on whether or not advice was given. Some...... and explaining pharmacological terms to ensure that enquirers understand the response as intended. In addition, more use of active voice and less compressed text structure would be desirable. CONCLUSIONS: This evaluation of responses to DIC queries may give some indications on how to improve written responses...

Pain: metaphor, body, and culture in Anglo-American societies between the eighteenth and twentieth centuries.

Science.gov (United States)

Bourke, Joanna

2014-10-02

This article explores the relationship between metaphorical languages, body, and culture, and suggests that such an analysis can reveal a great deal about the meaning and experience of pain in Anglo-American societies between the eighteenth and twentieth centuries. It uses concepts within embodied cognition to speculate on how historians can write a history of sensation. Bodies are actively engaged in the linguistic processes and social interactions that constitute painful sensations. Language is engaged in a dialogue with physiological bodies and social environments. And culture collaborates in the creation of physiological bodies and metaphorical systems.

Aspects of labor market flexicurity in the Mediterranean and Anglo-Saxon models

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Alina Ştefania CHENIC (CREŢU

2013-04-01

Full Text Available In the context of the economic crisis and the challenges of globalization, the paper presents and analyses relevant aspects of labor market flexicurity, especially in the Mediterranean and Anglo- Saxon model. Thus, the labor market in Spain and the United Kingdom has been studied, highlighting the reason behind existing problems, compared to other EU countries, notably in the Euro area (Italy, Greece, Portugal, Germany. Labor market flexicurity highlights labor market flexibility while, at the same time, ensuring safe transition for employees from a job to another. In this context, it should be emphasized that integration in the Economic and Monetary Union involves fulfilling a major condition in order to cope within the Union, namely labor market flexibility.

Astronomical and Atmospheric Observations in the Anglo-Saxon Chronicle and in Bede

Science.gov (United States)

Härke, H.

2012-01-01

Textual sources of the early Middle Ages (fifth to tenth centuries AD) contain more astronomical observations than is popularly assumed. The Anglo-Saxon Chronicle lists some 40 observations of astronomical and atmospheric events for the just over 600 years it covers. But the contexts in which these are set show that eclipses, comets, meteor showers and aurorae were seen as portents of evil events, not as objects of early scientific curiosity. The case of Bede in the early eighth century shows that this was true, to an extent, even for the educated ecclesiastical elite. BedeÕs eclipse records also appear to show that astronomical events could be used to explain unusual phenomena such as the postulated volcanic Ôdust-veilÕ event of AD 536.

Survivors of cardiac arrest with good neurological outcome show considerable impairments of memory functioning.

Science.gov (United States)

Sulzgruber, Patrick; Kliegel, Andreas; Wandaller, Cosima; Uray, Thomas; Losert, Heidrun; Laggner, Anton N; Sterz, Fritz; Kliegel, Matthias

2015-03-01

Deficits in cognitive function are a well-known dysfunction in survivors of cardiac arrest. However, data concerning memory function in this neurological vulnerable patient collective remain scarce and inconclusive. Therefore, we aimed to assess multiple aspects of retrospective and prospective memory performance in patients after cardiac arrest. We prospectively enrolled 33 survivors of cardiac arrest, with cerebral performance categories (CPC) 1 and 2 and a control-group (n=33) matched in sex, age and educational-level. To assess retrospective and prospective memory performance we administrated 4 weeks after cardiac arrest the "Rey Adult Learning Test" (RAVLT), the "Digit-Span-Backwards Test", the "Logic-Memory Test" and the "Red-Pencil Test". Results indicate an impairment in immediate and delayed free recall, but not in recognition. However, the overall impairment in immediate recall was qualified by analyzing RAVLT performance, showing that patients were only impaired in trials 4 and 5 of the learning sequence. Moreover, working and prospective memory as well as prose recall were worse in cardiac arrest survivors. Cranial computed tomography was available in 61% of all patients (n=20) but there was no specific neurological damage detectable that could be linked to this cognitive impairment. Episodic long-term memory functioning appears to be particularly impaired after cardiac arrest. In contrast, short-term memory storage, even tested via free-call, seems not to be affected. Based on cranial computed tomography we suggest that global brain ischemia rather than focal brain lesions appear to underlie these effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Modeling Major Adverse Outcomes of Pediatric and Adult Patients With Congenital Heart Disease Undergoing Cardiac Catheterization: Observations From the NCDR IMPACT Registry (National Cardiovascular Data Registry Improving Pediatric and Adult Congenital Treatment).

Science.gov (United States)

Jayaram, Natalie; Spertus, John A; Kennedy, Kevin F; Vincent, Robert; Martin, Gerard R; Curtis, Jeptha P; Nykanen, David; Moore, Phillip M; Bergersen, Lisa

2017-11-21

Risk standardization for adverse events after congenital cardiac catheterization is needed to equitably compare patient outcomes among different hospitals as a foundation for quality improvement. The goal of this project was to develop a risk-standardization methodology to adjust for patient characteristics when comparing major adverse outcomes in the NCDR's (National Cardiovascular Data Registry) IMPACT Registry (Improving Pediatric and Adult Congenital Treatment). Between January 2011 and March 2014, 39 725 consecutive patients within IMPACT undergoing cardiac catheterization were identified. Given the heterogeneity of interventional procedures for congenital heart disease, new procedure-type risk categories were derived with empirical data and expert opinion, as were markers of hemodynamic vulnerability. A multivariable hierarchical logistic regression model to identify patient and procedural characteristics predictive of a major adverse event or death after cardiac catheterization was derived in 70% of the cohort and validated in the remaining 30%. The rate of major adverse event or death was 7.1% and 7.2% in the derivation and validation cohorts, respectively. Six procedure-type risk categories and 6 independent indicators of hemodynamic vulnerability were identified. The final risk adjustment model included procedure-type risk category, number of hemodynamic vulnerability indicators, renal insufficiency, single-ventricle physiology, and coagulation disorder. The model had good discrimination, with a C-statistic of 0.76 and 0.75 in the derivation and validation cohorts, respectively. Model calibration in the validation cohort was excellent, with a slope of 0.97 (standard error, 0.04; P value [for difference from 1] =0.53) and an intercept of 0.007 (standard error, 0.12; P value [for difference from 0] =0.95). The creation of a validated risk-standardization model for adverse outcomes after congenital cardiac catheterization can support reporting of risk

Social policies and activation in the Scandinavian welfare model: the case of Denmark

DEFF Research Database (Denmark)

Andersen, Torben M.

countries been able to reconcile social objectives with a high employment level? It is argued that the Scandinavian welfare model has a strong employment focus both because it is an important element in social policy based on social inclusion, but also because a collective welfare arrangement is only...... financially viable if (private) employment is sufficiently high. To ensure this, the social safety net includes a number of employment conditionalities (active labour market policies/workfare) to balance income protection with an employment focus. These policies are discussed using Denmark as an example...

The Identification of Texas Anglo, Black and Chicano Child Rearing and Child Care Practices in Relation to Child Care Career Competencies.

Science.gov (United States)

Stewart, Ida Santos; Stone, Norma K.

To identify cultural factors in both child rearing and child care practices which may influence training of preschool day care personnel, the study ascertained cultural differences in Anglo, Black, and Chicano child rearing practices in Texas and differences in how parents, center personnel, and early childhood professionals viewed appropriate…

Cardiac cAMP: production, hydrolysis, modulation and detection

Directory of Open Access Journals (Sweden)

Cédric eBOULARAN

2015-10-01

Full Text Available Cyclic adenosine 3’,5’-monophosphate (cAMP modulates a broad range of biological processes including the regulation of cardiac myocyte contractile function where it constitutes the main second messenger for β-adrenergic receptors’ signaling to fulfill positive chronotropic, inotropic and lusitropic effects. A growing number of studies pinpoint the role of spatial organization of the cAMP signaling as an essential mechanism to regulate cAMP outcomes in cardiac physiology. Here, we will briefly discuss the complexity of cAMP synthesis and degradation in the cardiac context, describe the way to detect it and review the main pharmacological arsenal to modulate its availability.

Chewing lice Trichodectes pinguis pinguis in Scandinavian brown bears (Ursus arctos

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Núria Fandos Esteruelas

2016-08-01

Full Text Available In April 2014 and 2015, we noted localized alopecia (neck, forelimbs, and chest and hyperpigmentation on two adult brown bears (Ursus arctos captured in central-south Sweden for ecological studies under the Scandinavian Brown Bear Research Project. In spring 2015, a brown bear was shot because of human-wildlife conflict in the same region. This bear also had extensive alopecia and hyperpigmentation. Ectoparasites were collected from the affected skin areas in all three individuals and preserved in ethanol for identification. Based on morphological characteristics, the lice were identified as Trichodectes spp. and Trichodectes pinguis pinguis. To our knowledge, these are the first reported cases of chewing lice in free-ranging brown bears in Scandinavia.

Prescribed journeys through life: Cultural differences in mental time travel between Middle Easterners and Scandinavians.

Science.gov (United States)

Ottsen, Christina Lundsgaard; Berntsen, Dorthe

2015-12-01

Mental time travel is the ability to remember past events and imagine future events. Here, 124 Middle Easterners and 128 Scandinavians generated important past and future events. These different societies present a unique opportunity to examine effects of culture. Findings indicate stronger influence of normative schemas and greater use of mental time travel to teach, inform and direct behaviour in the Middle East compared with Scandinavia. The Middle Easterners generated more events that corresponded to their cultural life script and that contained religious words, whereas the Scandinavians reported events with a more positive mood impact. Effects of gender were mainly found in the Middle East. Main effects of time orientation largely replicated recent findings showing that simulation of future and past events are not necessarily parallel processes. In accordance with the notion that future simulations rely on schema-based construction, important future events showed a higher overlap with life script events than past events in both cultures. In general, cross-cultural discrepancies were larger in future compared with past events. Notably, the high focus in the Middle East on sharing future events to give cultural guidance is consistent with the increased adherence to normative scripts found in this culture. Copyright © 2015 Elsevier Inc. All rights reserved.

Highly discrepant proportions of female and male Scandinavian and British Isles ancestry within the isolated population of the Faroe Islands

DEFF Research Database (Denmark)

Als, Thomas D; Jorgensen, Tove H; Børglum, Anders D

2006-01-01

Isles ancestry. In the present study we used 122 new and 19 previously published hypervariable region I sequences of the mitochondrial control region to analyse the genetic diversity of the Faroese population and compare it with other populations in the North Atlantic region. The analyses suggested...... that the Faroese mtDNA pool has been affected by genetic drift, and is among the most homogenous and isolated in the North Atlantic region. This will have implications for attempts to locate genes for complex disorders. To obtain estimates of Scandinavian vs British Isles ancestry proportions, we applied...... a frequency-based admixture approach taking private haplotypes into account by the use of phylogenetic information. While previous studies have suggested an excess of Scandinavian ancestry among the male settlers of the Faroe Islands, the current study indicates an excess of British Isles ancestry among...

Extracorporeal life support in pediatric cardiac patients

Directory of Open Access Journals (Sweden)

Matteo Di NARDO

2016-10-01

Full Text Available Extracorporeal Life Support (ECLS is a valuable tool in the management of neonates and older children with severe cardiac or respiratory failure. In this review, we focus on ECLS when used for neonatal and pediatric cardiac disease. Strict selection of patients and timely deployment are necessary to optimize outcomes. Although every attempt should be made to deploy ECLS urgently rather than emergently, extracorporeal cardiopulmonary resuscitation (ECPR is being increasingly used and reasonable survival rates have been achieved after initiation of ECLS during active compressions of the chest following in-hospital cardiac arrest. Contraindications to ECLS are falling over time, although lethal chromosomal abnormalities, severe irreversible brain injury, and extremely low gestational age and weight (<32 weeks gestation or <1.5 kg remain firm contraindications.

Cardiac computed tomography in patients with acute coronary syndrome

International Nuclear Information System (INIS)

Schlett, C.L.; Bamberg, F.

2014-01-01

Currently, cardiac computed tomography (CT) is increasingly being implemented into clinical algorithms, primarily due to substantial technical advances over the last decade. Its use in the setting of suspected acute coronary syndrome is of particular relevance, given the high degree of accumulating scientific evidence of improving patient outcomes. Performing cardiac CT requires specific knowledge on the available scan acquisitions and patient preparation. Also, expertise is required in order to interpret the coronary and extra-coronary findings adequately. The present article provides an overview of the different aspects on the use of cardiac CT in the setting of acute coronary syndrome.

Diurnal variations in incidence and outcome of out-of-hospital cardiac arrest including prior comorbidity and pharmacotherapy: a nationwide study in Denmark.

Science.gov (United States)

Karlsson, Lena I M; Wissenberg, Mads; Fosbøl, Emil L; Hansen, Carolina Malta; Lippert, Freddy K; Bagai, Akshay; McNally, Bryan; Granger, Christopher B; Christensen, Erika Frischknecht; Folke, Fredrik; Rajan, Shahzleen; Weeke, Peter; Nielsen, Søren L; Køber, Lars; Gislason, Gunnar H; Torp-Pedersen, Christian

2014-09-01

To investigate diurnal variations in incidence and outcomes following out-of-hospital cardiac arrest (OHCA). OHCA of presumed cardiac etiology were identified through the nationwide Danish Cardiac Arrest Registry (2001-2010). Time of day was divided into three time periods: daytime 07.00-14.59; evening 15.00-22.59; and nighttime 23.00-06.59. We identified 18,929 OHCA patients, aged ≥18 years. The median age was 72 years (IQR 62-80) and the majority were male (67.5%). OHCA occurrence varied across time periods, with 43.9%, 35.7% and 20.6% occurring during daytime, evening and nighttime, respectively. Nighttime patients were more likely to have: severe comorbidity (i.e. COPD), arrest in private home (87.2% vs. 69.0% and 73.0% daytime and evening, respectively), non-witnessed arrest (51.2% vs. 48.4% and 43.7%), no bystander CPR (75.9% vs. 68.4% and 66.1%), longer time interval from recognition of OHCA to rhythm analysis (12 min vs. 11 min and 11 min), and non-shockable heart rhythm (80.1% vs. 70.3% and 69.4%), all p<0.0001. Nighttime patients were less likely to achieve return of spontaneous circulation on arrival at the hospital (7.5% vs. 14.8% and 15.1%) and 1-year survival (2.8% vs. 7.2% and 7.1%), p<0.0001. Overall, the lower 1-year survival rate persisted after adjusting for patient-related and cardiac-arrest related characteristics mentioned above (OR 0.47, 95%CI 0.37-0.59; OR 0.51, 95%CI 0.40-0.65, compared to daytime and evening, respectively). We found nighttime patients to have a lower survival compared to daytime and evening that persisted when adjusting for patient-related and cardiac-arrest related characteristics including comorbidities. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Atresia of the bilateral pulmonary veins: a rare and dismal anomaly identified on cardiac CT

Energy Technology Data Exchange (ETDEWEB)

Goo, Hyun Woo; Park, Sang-Hyub; Koo, Hyun Jung; Cho, Young Hoon; Lee, Eunsol [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of)

2014-08-15

Imaging findings of bilateral pulmonary vein atresia have not been described. To describe cardiac CT findings and clinical outcomes of bilateral pulmonary vein atresia. Three newborns with bilateral pulmonary vein atresia were encountered at our institution during a period of 8 years. We evaluated prenatal echocardiographic findings, clinical presentations, postnatal echocardiographic findings, chest radiographic findings, cardiac CT findings and clinical outcomes. All newborns presented immediately after birth with severe cyanosis, respiratory distress and acidosis that were unresponsive to medical management. Prenatal and postnatal echocardiographic studies and chest radiography were misleading, inconclusive or nonspecific in making the diagnosis in these children; however cardiac CT clearly demonstrated atresia of the bilateral pulmonary veins with multiple small mediastinal collateral veins and pulmonary edema. Surgical treatments were not feasible for this anomaly. Their clinical outcomes were universally dismal and all infants died within 3 days. Cardiac CT provides an accurate diagnosis of bilateral pulmonary vein atresia and leads to prompt treatment decision in these children. (orig.)

Atresia of the bilateral pulmonary veins: a rare and dismal anomaly identified on cardiac CT

International Nuclear Information System (INIS)

Goo, Hyun Woo; Park, Sang-Hyub; Koo, Hyun Jung; Cho, Young Hoon; Lee, Eunsol

2014-01-01

Imaging findings of bilateral pulmonary vein atresia have not been described. To describe cardiac CT findings and clinical outcomes of bilateral pulmonary vein atresia. Three newborns with bilateral pulmonary vein atresia were encountered at our institution during a period of 8 years. We evaluated prenatal echocardiographic findings, clinical presentations, postnatal echocardiographic findings, chest radiographic findings, cardiac CT findings and clinical outcomes. All newborns presented immediately after birth with severe cyanosis, respiratory distress and acidosis that were unresponsive to medical management. Prenatal and postnatal echocardiographic studies and chest radiography were misleading, inconclusive or nonspecific in making the diagnosis in these children; however cardiac CT clearly demonstrated atresia of the bilateral pulmonary veins with multiple small mediastinal collateral veins and pulmonary edema. Surgical treatments were not feasible for this anomaly. Their clinical outcomes were universally dismal and all infants died within 3 days. Cardiac CT provides an accurate diagnosis of bilateral pulmonary vein atresia and leads to prompt treatment decision in these children. (orig.)

[Relationship between previous severity of illness and outcome of in-hospital cardiac arrest].

Science.gov (United States)

Serrano, M; Rodríguez, J; Espejo, A; del Olmo, R; Llanos, S; Del Castillo, J; López-Herce, J

2014-07-01

To analyze the relationship between previous severity of illness, lactic acid, creatinine and inotropic index with mortality of in-hospital cardiac arrest (CA) in children, and the value of a prognostic index designed for adults. The study included total of 44 children aged from 1 month to 18 years old who suffered a cardiac arrest while in hospital. The relationship between previous severity of illness scores (PRIMS and PELOD), lactic acid, creatinine, treatment with vasoactive drugs, inotropic index with return of spontaneous circulation and survival at hospital discharge was analyzed. The large majority (90.3%) of patients had a return of spontaneous circulation, and 59% survived at hospital discharge. More than two-thirds (68.2%) were treated with inotropic drugs at the time of the CA. The patients who died had a higher lactic acid before the CA (3.4 mmol/L) than survivors (1.4 mmol/L), P=.04. There were no significant differences in PRIMS, PELOD, creatinine, inotropic drugs, and inotropic index before CA between patients who died and survivors. A high lactic acid previous to cardiac arrest could be a prognostic factor of in-hospital cardiac arrest in children. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Scandinavian Fellowship for Oral Pathology and Oral Medicine : statement on oral pathology and oral medicine in the European Dental Curriculum

NARCIS (Netherlands)

Kragelund, C.; Reibel, J.; Hadler-Olsen, E. S.; Hietanen, J.; Johannessen, A. C.; Kenrad, B.; Nylander, K.; Puranen, M.; Rozell, B.; Salo, T.; Syrjanen, S.; Soland, T. M.; van der Waal, I.; van der Wal, J. E.; Warfvinge, G.

Background: For many years, dentists have migrated between the Scandinavian countries without an intentionally harmonized dental education. The free movement of the workforce in the European Union has clarified that a certain degree of standardization or harmonization of the European higher

[Consideration of early rehabilitation in the treatment of post-cardiac arrest syndrome].

Science.gov (United States)

Kurihara, Masaki; Ogasawara, Sadanobu; Kadowaki, Aya; Onizuka, Shouzaburou; Samejima, Mituhiro

2011-04-01

Resumption of spontaneous circulation (ROSC) after cardiac arrest is an unnatural pathophysiological state. In 2008, ILCOR has proposed "post-cardiac arrest syndrome (PCAS)". Clinicians must focus on treating to reverse the pathophysiological manifestations of PCAS in bed. Immobility, deconditioning, and weakness are common problems in patients with critical illness. Therapeutic strategies have to be identified to give patients after ROSC the best chance for survival with good neurological function. Concerning the beneficial effects of early mobilization after stroke, and the efficacy of a strategy for whole-body rehabilitation in the earliest days of critical illness on functional outcomes, the intervention of early rehabilitation care by an interdisciplinary team seems to contribute to good long-time outcome of post-cardiac arrest patients.

Mapping VIPS Concepts for Nursing Interventions to the ISO Reference Terminology Model for Nursing Actions: A Collaborative Scandinavian Analysis

DEFF Research Database (Denmark)

Lauge Berring, Lene; Ehnfors, Margareta; Angermo, Lilly

2005-01-01

The aims of this study were to analyze the coherence between the concepts for nursing interventions in the Swedish VIPS model for nursing recording and the ISO Reference Terminology Model for Nursing Actions and to identify areas in the two models for further development. Seven Scandinavian experts...

Cardiac Function in 7-8-Year-Old Offspring of Women with Type 1 Diabetes

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Maarten Rijpert

2011-01-01

Full Text Available Offspring of type 1 diabetic mothers (ODMs are at risk of short-term and long-term complications, such as neonatal macrosomia (birth weight >90th percentile, hypertrophic cardiomyopathy, and cardiovascular morbidity in later life. However, no studies have been performed regarding cardiac outcome. In this study, we investigated cardiac dimensions and function in 30 ODMs at 7-8 years of age in relation to neonatal macrosomia and maternal glycemic control during pregnancy and compared these with those in a control group of 30 children of nondiabetic women. We found that cardiac dimensions and systolic and diastolic function parameters in ODMs were comparable with those in controls. Neonatal macrosomia and poorer maternal glycemic control during pregnancy were not related to worse cardiac outcome in ODM. We conclude that cardiac function at 7-8 years of age in offspring of women with type 1 diabetes is reassuring and comparable with that in controls.

No evidence for cardiac dysfunction in Kif6 mutant mice.

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Abdul Hameed

Full Text Available A KIF6 variant in man has been reported to be associated with adverse cardiovascular outcomes after myocardial infarction. No clear biological or physiological data exist for Kif6. We sought to investigate the impact of a deleterious KIF6 mutation on cardiac function in mice. Kif6 mutant mice were generated and verified. Cardiac function was assessed by serial echocardiography at baseline, after ageing and after exercise. Lipid levels were also measured. No discernable adverse lipid or cardiac phenotype was detected in Kif6 mutant mice. These data suggest that dysfunction of Kif6 is linked to other more complex biological/biochemical parameters or is unlikely to be of material consequence in cardiac function.

Cardiac troponin I (CTnI level among children with epileptic seizures

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Ahmed Anwer Attia Khattab

2014-09-01

Conclusion: Cardiac troponin I is a perfect tool for early detection of cases with myocardial dysfunction in epileptic patients – cardiac troponin I is significantly increased in children with epilepsy especially the complicated epilepsy. Cardiac injury in epileptic children is more common in patients with early onset epilepsy, positive prenatal problem, idiopathic epilepsy, abnormal imaging and EEG – elevated TnI levels may be of value in assessing the severity and eventual outcome and mortality risk of the disease in children with epilepsy.

Scandinavian Fellowship for Oral Pathology and Oral Medicine: statement on oral pathology and oral medicine in the European Dental Curriculum

NARCIS (Netherlands)

Kragelund, C.; Reibel, J.; Hadler-Olsen, E.S.; Hietanen, J.; Johannessen, A.C.; Kenrad, B.; Nylander, K.; Puranen, M.; Rozell, B.; Salo, T.; Syrjänen, S.; Soland, T.M.; van der Waal, I.; van der Wal, J.E.; Warfvinge, G.

2010-01-01

Background:  For many years, dentists have migrated between the Scandinavian countries without an intentionally harmonized dental education. The free movement of the workforce in the European Union has clarified that a certain degree of standardization or harmonization of the European higher

Structures, processes and outcomes of the Aussie Heart Guide Program: A nurse mentor supported, home based cardiac rehabilitation program for rural patients with acute coronary syndrome.

Science.gov (United States)

Frohmader, Terence J; Lin, Frances; Chaboyer, Wendy P

2018-03-01

Cardiac rehabilitation has a number of benefits for patients, yet participation in it is sub-optimal, especially in regional Australia. Innovative models of cardiac rehabilitation are needed to improve participation. Providing nurse mentors to support patients transitioning from hospital to home represents a new model of service delivery in Australia. To explore the impact of a home-based cardiac rehabilitation program in assisting patients to recover from Acute Coronary Syndrome and meeting the expectations of nurse mentors delivering the program. This case study was underpinned by the structure, process and outcomes model and occurred in three Australian hospitals 2008-2011. Thirteen patients recovering from acute coronary syndrome were interviewed by telephone and seven nurse mentors completed a survey after completing the program. Mentor perceptions concerning the structures of the home-based CR program included the timely recruitment of patients, mentor training to operationalise the program, commitment to development of the mentor role, and the acquisition of knowledge and skills about cognitive behavioural therapy and patient centred care. Processes included the therapeutic relationship between mentors and patients, suitability of the program and the promotion of healthier lifestyle behaviours. Outcomes identified that patients were satisfied with the program's audiovisual resources, and the level of support and guidance provided by their nurse mentors. Mentors believed that the program was easy to use in terms of its delivery. Patients believed the program assisted their recovery and were satisfied with the information, guidance and support received from mentors. There were positive signs that the program influenced patients' decisions to change unhealthy lifestyle behaviours. Outcomes highlighted both rewards and barriers associated with mentoring patients in their homes by telephone. Experience gained from developing a therapeutic relationship with

Switserland en die beginsel van nie-inmenging in die internasionale reg tydens die Anglo-Boereoorlog, 1899-1902

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A. Raath

2005-07-01

Full Text Available Switzerland and the principle of non-intervention in international law during the Anglo-Boer War, 1899-1902 The outbreak of the Anglo-Boer War on 11 October 1899 hit the world like a bomb blast. The news of the war produced strong anti-British sentiments in certain quarters: not only did poets, writers and politicians of international stature, as well as the press, exert strong influence on the public, nations also pressurised their governments to side against Britain. This article investigates the complex position of Switzerland in terms of its official policy of non-intervention in the international world. The following concomitant aspects are also investigated: the pressure exerted on Swiss authorities to express sympathy with the Boer Republics; the growing awareness of the humanitarian implications of Britain’s scorched-earth policy of massing together the civil population of the Boer Republics, and the resultant pleas to stop these methods of warfare. The Swiss position of non-intervention in international affairs was severely tested in its efforts to remain legally neutral in the international arena. Switzerland’s decision to remain neutral in the war, was finally determined by various factors in the sphere of inter-national law and politics. The developments in Switzerland during the war reflect the transition from positivism towards a stronger humanitarian spirit in international law and politics.

Cross-craft interactions between metal and glass working: slag additions to early Anglo-Saxon red glass

Science.gov (United States)

Peake, James R. N.; Freestone, Ian C.

Opaque red glass has been extensively studied over the years, but its compositional complexity and variability means that the way in which it was manufactured is still not fully understood. Previous studies have suggested the use of metallurgical by-products in its manufacture, but until now the evidence has been limited. SEM-EDS analysis of glass beads from the early Anglo-Saxon cemetery complex at Eriswell, southeast England, has provided further insights into the production and technology of opaque red glass, which could only have been possible through invasive sampling. The matrix of the red glasses contains angular particles of slag, the main phases of which typically correspond to either fayalite (Fe2SiO4) or kirschsteinite (CaFeSiO4), orthosilicate (olivine-type) minerals characteristic of some copper- and iron-smelting slags. This material appears to have been added in part as a reducing agent, to promote the precipitation of sub-micrometer particles of the colorant phase, copper metal. Its use represents a sophisticated, if empirical, understanding of materials and can only have resulted through deliberate experimentation with metallurgical by-products by early glass workers. Slag also seems to have been added as a source of iron to colour `black' glass. The compositions of the opaque red glasses appear to be strongly paralleled by Merovingian beads from northern Europe and Anglo-Saxon beads from elsewhere in England, suggesting that this technology is likely to have been quite widespread.

Personality predictors of mortality in cardiac transplant candidates and recipients.

Science.gov (United States)

Brandwin, M; Trask, P C; Schwartz, S M; Clifford, M

2000-08-01

Emotional factors are generally recognized as impacting the care of end-stage heart disease and mortality following cardiac transplants. Equally important, however, are predictors of pretransplant mortality. The current study examined the utility of the Millon Behavioral Health Inventory (MBHI) as a predictor of pre- and posttransplant mortality. A total of 103 cardiac transplant candidates were assessed with the MBHI as part of a pretransplant evaluation that included baseline demographic variables and cardiac status. Time to transplant and mortality status at 1 and 5 years was also obtained. Cluster analysis of MBHI response scores elicited two clusters characterized by high and low distress. Cluster membership predicted survival status at 1-year and 5-year follow-up, with high distress cluster patients having significantly higher mortality in both the total sample and a subgroup of patients who did receive a heart transplant. These results support the value of the MBHI for assessing personality attributes that may dispose toward unfavorable outcome in heart transplant candidates. Further understanding of psychosocial contributions to illness course and outcome may enable more effective selection of treatment interventions with cardiac patients.

Does Age Influence Cardiac Resynchronization Therapy Use and Outcome?

Science.gov (United States)

Heidenreich, Paul A; Tsai, Vivian; Bao, Haikun; Curtis, Jeptha; Goldstein, Mary; Curtis, Lesley; Hernandez, Adrian; Peterson, Pamela; Turakhia, Mintu P; Masoudi, Frederick A

2015-06-01

This study sought to describe the use of CRT-D and its association with survival for older patients. Many patients who receive cardiac resynchronization therapy with defibrillator (CRT-D) in practice are older than those included in clinical trials. We identified patients undergoing ICD implantation in the National Cardiovascular Disease Registry (NCDR) ICD registry from 2006 to 2009, who also met clinical trial criteria for CRT, including left ventricular ejection fraction (LVEF) ≤35%, QRS ≥120 ms, and New York Heart Association (NYHA) functional class III or IV. NCDR registry data were linked to the social security death index to determine the primary outcome of time to death from any cause. We identified 70,854 patients from 1,187 facilities who met prior trial criteria for CRT-D. The mean age of the 58,147 patients receiving CRT-D was 69.4 years with 6.4% of patients age 85 or older. CRT use was 80% or higher among candidates in all age groups. Follow-up was available for 42,285 patients age ≥65 years at 12 months. Receipt of CRT-D was associated with better survival at 1 year (82.1% vs. 77.1%, respectively) and 4 years (54.0% vs. 46.2% , respectively) than in those receiving only an ICD (p different for different age groups (p = 0.86 for interaction). More than 80% of older patients undergoing ICD implantation who were candidates for a CRT-D received the combined device. Mortality in older patients undergoing ICD implantation was high but was lower for those receiving CRT-D. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Archival Education in Scandinavian Countries İskandinav Ülkelerinde Arşivcilik Eğitimi

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Muhammet Hanefi Kutluoğlu

2008-03-01

Full Text Available Every country has responsibilities to provide the necessary personnel needed for their archival inheritance by education. Education can be shaped through tradition, historical inheritance and scientific necessities by defining the right educational method. Scandinavian countries have determined different education models based on their tradition, historical inheritance and requirements. In this article we focused on the formation of archival tradition, application of archival education in Scandinavian countries and the influence of the developments taking place in Europe on these countries. The relation between the archival education in European and Scandinavian countries is evaluated through a comparative method, and similarities to other countries are also evaluated. Finally, the present situation of archival education and the measures needed in this field are taken into consideration. Her ülkenin kendi belgesel mirasını oluşturan arşivlerin personel ihtiyaçlarını eğitim yoluyla giderme sorumluluğu bulunmaktadır. Eğitim ise, gelenek, tarihi miras ve bilimsel gereklilikler doğrultusunda şekillendirilebilir ve buna paralel olarak uygun bir eğitim modeli seçilebilir. İskandinav ülkeleri de gelenek, ihtiyaç ve tarihi miras doğrultusunda kendilerine mahsus birden fazla model belirleme yoluna gitmişlerdir. Bu çalışmada, İskandinav ülkelerinde arşivcilik geleneğinin nasıl oluştuğu, arşivcilik eğitiminin nasıl yürütüldüğü ve Avrupa'da yaşanan gelişmelerden nasıl etkilendiği üzerinde durulmuştur. Böylelikle, Avrupa ülkelerinde uygulanan arşivcilik eğitimiyle İskandinav ülkeleri arşivcilik eğitimi arasındaki ilgi karşılaştırmalı bir yöntemle ele alınmış, buradaki eğitimin diğer ülkelerdeki uygulamalara yakınlığı ve benzerliği belirlenmeye çalışılmıştır; son olarak, arşivcilik eğitiminin mevcut durumu ve bu konuda nelerin yapılması gerektiği değerlendirilmesine yer

Scandinavian clinical practice guidelines on general anaesthesia for emergency situations

DEFF Research Database (Denmark)

Gadegaard Jensen, Anders; Callesen, T; Hagemo, J S

2010-01-01

Emergency patients need special considerations and the number and severity of complications from general anaesthesia can be higher than during scheduled procedures. Guidelines are therefore needed. The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care...... Medicine appointed a working group to develop guidelines based on literature searches to assess evidence, and a consensus meeting was held. Consensus opinion was used in the many topics where high-grade evidence was unavailable. The recommendations include the following: anaesthesia for emergency patients...... breathing for 3 min or eight deep breaths over 60 s and oxygen flow 10 l/min should be used. Pre-oxygenation in the obese patients should be performed in the head-up position. The use of cricoid pressure is not considered mandatory, but can be used on individual judgement. The hypnotic drug has a minor...

Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest

DEFF Research Database (Denmark)

Nielsen, Niklas; Wetterslev, Jørn; Cronberg, Tobias

2013-01-01

Background Unconscious survivors of out-of-hospital cardiac arrest have a high risk of death or poor neurologic function. Therapeutic hypothermia is recommended by international guidelines, but the supporting evidence is limited, and the target temperature associated with the best outcome...... is unknown. Our objective was to compare two target temperatures, both intended to prevent fever. Methods In an international trial, we randomly assigned 950 unconscious adults after out-of-hospital cardiac arrest of presumed cardiac cause to targeted temperature management at either 33°C or 36°C....... The primary outcome was all-cause mortality through the end of the trial. Secondary outcomes included a composite of poor neurologic function or death at 180 days, as evaluated with the Cerebral Performance Category (CPC) scale and the modified Rankin scale. Results In total, 939 patients were included...

Survival in patients without acute ST elevation after cardiac arrest and association with early coronary angiography

DEFF Research Database (Denmark)

Dankiewicz, J; Nielsen, N; Annborn, M

2015-01-01

PURPOSE: To investigate whether early coronary angiography (CAG) after out-of-hospital cardiac arrest of a presumed cardiac cause is associated with improved outcomes in patients without acute ST elevation. METHODS: The target temperature management after out-of-hospital cardiac arrest (TTM) trial...... showed no difference in all-cause mortality or neurological outcome between an intervention of 33 and 36 °C. In this post hoc analysis, 544 patients where the admission electrocardiogram did not show acute ST elevation were included. Early CAG was defined as being performed on admission or within...... early CAG was not significantly associated with survival. CONCLUSIONS: In this post hoc observational study of a large randomized trial, early coronary angiography for patients without acute ST elevation after out-of-hospital cardiac arrest of a presumed cardiac cause was not associated with improved...

Prognostic value of sympathetic innervation and cardiac asynchrony in dilated cardiomyopathy

International Nuclear Information System (INIS)

Manrique, Alain; Hitzel, Anne; Vera, Pierre; Bernard, Mathieu; Bauer, Fabrice; Menard, Jean-Francois; Sabatier, Remi; Jacobson, Arnold; Agostini, Denis

2008-01-01

The purpose of the study is to examine prognostic values of cardiac I-123 metaiodobenzylguanidine (MIBG) uptake and cardiac dyssynchrony in patients with dilated cardiomyopathy (DCM). Ninety-four patients with non-ischemic DCM underwent I-123 MIBG imaging for assessing cardiac sympathetic innervation and equilibrium radionuclide angiography. Mean phase angles and SD of the phase histogram were computed for both right ventricular (RV) and left ventricular (LV). Phase measures of interventricular (RV-LV) and intraventricular (SD-RV and SD-LV) asynchrony were computed. Most patients were receiving beta-blockers (89%) and angiotensin-converting enzyme inhibitors (88%). One patient (1%) was lost to follow-up, six had cardiac death (6.4%), eight had heart transplantation (8.6%), and seven had unplanned hospitalization for heart failure (7.5%; mean follow-up: 37 ± 16 months). Patients with poor clinical outcome were older, had higher The New York Heart Association functional class, impaired right ventricular ejection fraction and left ventricular ejection fraction, and impaired cardiac I-123 MIBG uptake. On multivariate analysis, I-123 MIBG heart-to-mediastinum (H/M) uptake ratio <1.6 was the only predictor of both primary (cardiac death or heart transplantation, RR = 7.02, p < 0.01) and secondary (cardiac death, heart transplantation, or recurrent heart failure, RR = 8.10, p = 0.0008) end points. In patients receiving modern medical therapy involving beta-blockers, I-123 MIBG uptake, but not intra-LV asynchrony, was predictive of clinical outcome. The impact of beta-blockers on the prognostic value of ventricular asynchrony remains to be clarified. (orig.)

Facility-level association of preoperative stress testing and postoperative adverse cardiac events.

Science.gov (United States)

Valle, Javier A; Graham, Laura; Thiruvoipati, Thejasvi; Grunwald, Gary; Armstrong, Ehrin J; Maddox, Thomas M; Hawn, Mary T; Bradley, Steven M

2018-06-22

Despite limited indications, preoperative stress testing is often used prior to non-cardiac surgery. Patient-level analyses of stress testing and outcomes are limited by case mix and selection bias. Therefore, we sought to describe facility-level rates of preoperative stress testing for non-cardiac surgery, and to determine the association between facility-level preoperative stress testing and postoperative major adverse cardiac events (MACE). We identified patients undergoing non-cardiac surgery within 2 years of percutaneous coronary intervention in the Veterans Affairs (VA) Health Care System, from 2004 to 2011, facility-level rates of preoperative stress testing and postoperative MACE (death, myocardial infarction (MI) or revascularisation within 30 days). We determined risk-standardised facility-level rates of stress testing and postoperative MACE, and the relationship between facility-level preoperative stress testing and postoperative MACE. Among 29 937 patients undergoing non-cardiac surgery at 131 VA facilities, the median facility rate of preoperative stress testing was 13.2% (IQR 9.7%-15.9%; range 6.0%-21.5%), and 30-day postoperative MACE was 4.0% (IQR 2.4%-5.4%). After risk standardisation, the median facility-level rate of stress testing was 12.7% (IQR 8.4%-17.4%) and postoperative MACE was 3.8% (IQR 2.3%-5.6%). There was no correlation between risk-standardised stress testing and composite MACE at the facility level (r=0.022, p=0.81), or with individual outcomes of death, MI or revascularisation. In a national cohort of veterans undergoing non-cardiac surgery, we observed substantial variation in facility-level rates of preoperative stress testing. Facilities with higher rates of preoperative stress testing were not associated with better postoperative outcomes. These findings suggest an opportunity to reduce variation in preoperative stress testing without sacrificing patient outcomes. © Article author(s) (or their employer(s) unless otherwise

Preprocedural High-Sensitivity Cardiac Troponin T and Clinical Outcomes in Patients With Stable Coronary Artery Disease Undergoing Elective Percutaneous Coronary Intervention.