51 research outputs found
RĂ©incarnations de Stendhal dans le roman contemporain
Le but de ce travail a Ă©tĂ© celui de retrouver et analyser la rĂ©interprĂ©tation du personnage Stendhal dans le roman contemporain. Les quatre textes Ă la base de cette rĂ©flexion sur la rĂ©incarnation de lâauteur grenoblois dans un contexte fictionnel ont Ă©tĂ© choisis selon un critĂšre spĂ©cifique : il sâagit de quatre fictions biographiques oĂč le protagoniste - ou un des protagonistes - est Henri Beyle, alias Stendhal. FrĂ©dĂ©ric Vitoux, Marco Fabio Apolloni, Philippe Sollers et GĂ©rard GuĂ©gan ont donnĂ© Ă Stendhal la possibilitĂ© de revivre sur la scĂšne de leurs romans, de sâexprimer aprĂšs un siĂšcle et demi de sa disparue et, finalement, de devenir leur alter-ego. AprĂšs dâavoir conduit une lecture et une analyse approfondies des quatre romans, on a construit une archive de la prĂ©sence stendhalienne dans la fiction contemporaine en mettant en Ă©vidence tous les Ă©lĂ©ments et les idĂ©es reçues que constituent lâimaginaire stendhalien dont on dispose aujourdâhui
molecular and morphological identification of an uncommon centrolophid fish
AbstractThe use of both morphological and molecular methods has allowed a fast and reliable species assignment of a fish that local fishermen with over thirty years of experience had never seen before. The identified species, Schedophilus medusophagus, is rare along Italian coasts, and this is the first documented record in the Central Tyrrhenian Sea for over 35 years. Its abundance should be evaluated on a continuous basis, as it might reflect biological consequences of environmental and climatic change. The mitochondrial sequences obtained in this study constitute a useful molecular tag for future research and may contribute to the phylogenetic debate on the status of the genus Schedophilus, of which S. medusophagus is the type species. Based on the existing literature, these preliminary molecular data support the hypothesis that the genus is not monophyletic
Developing the Double Diamond Process for Implementation
This paper details overarching methodological insights resulting from several Inclusive Design projects in healthcare spanning ten years. A number of lessons have emerged, both practical and methodological, and are applicable to future design work in healthcare and the implementation of innovation.
The Double Diamond methodology was used in all projects, increasingly run in parallel / mixed with an agile approach and PDSA cycles, where rapid iterations of the methodology are run in series.
The final phase of the Double Diamond concerns delivery. The exact form that âdeliveryâ takes is unique to each project and partnership, but merits careful examination. Implementation of innovation is notoriously difficult in healthcare (Morris et al, 2011). Typically this is seen as post-âdesignâ, and necessarily requires the commitment of any healthcare project partner. Whilst some of the best innovations win design awards, many award winning designs are not adopted into front line use. There may be more to be done in design terms. The practices of co-research, co-creation and co-design are well used. Co-implementation efforts should start well before the end of the âDiscoverâ phase. These efforts may involve the identification of implementation stakeholders (standard practice in much co-design), but also funding bodies, the development of business cases and the adoption of commercial constraints in the design.
Adoption of innovation in healthcare takes time, and is fraught with many complicating factors. Many lauded design outputs are not in use, pointing to poor implementation strategies. The above benefits of the Double Diamond must be applied to implementation in order to help adoption. This not only means involving the relevant stakeholders and identifying the relevant funds for implementation earlier in the process, but crucially designing the output with an implementation strategy in mind. This practice of âco-implementationâ will improve future adoption of innovations
What is the feasibility and patient acceptability of a digital system for arm and hand rehabilitation after stroke? A mixed-methods, single-arm feasibility study of the âOnTrackâ intervention for hospital and home use
Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study
Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ℠0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe
RĂ©incarnations de Stendhal dans le roman contemporain
Le but de ce travail a Ă©tĂ© celui de retrouver et analyser la rĂ©interprĂ©tation du personnage Stendhal dans le roman contemporain. Les quatre textes Ă la base de cette rĂ©flexion sur la rĂ©incarnation de lâauteur grenoblois dans un contexte fictionnel ont Ă©tĂ© choisis selon un critĂšre spĂ©cifique : il sâagit de quatre fictions biographiques oĂč le protagoniste - ou un des protagonistes - est Henri Beyle, alias Stendhal. FrĂ©dĂ©ric Vitoux, Marco Fabio Apolloni, Philippe Sollers et GĂ©rard GuĂ©gan ont donnĂ© Ă Stendhal la possibilitĂ© de revivre sur la scĂšne de leurs romans, de sâexprimer aprĂšs un siĂšcle et demi de sa disparue et, finalement, de devenir leur alter-ego. AprĂšs dâavoir conduit une lecture et une analyse approfondies des quatre romans, on a construit une archive de la prĂ©sence stendhalienne dans la fiction contemporaine en mettant en Ă©vidence tous les Ă©lĂ©ments et les idĂ©es reçues que constituent lâimaginaire stendhalien dont on dispose aujourdâhui
Utilizzo di marcatori molecolari per la classificazione di un Teleosteo poco comune nel Tirreno centrale
Review of threatened Malagasy freshwater fishes in zoos and aquaria: The necessity of an ex situ conservation network-A call for action
Madagascar's biota is characterized by an extraordinary species richness, with a high degree of endemism. The island's freshwater habitats harbor numerous micro-endemic species, restricted to particular regions and thus particularly at risk of extinction, due to deforestation, overfishing, and introduction of exotic species. The present study investigates for which threatened Malagasy freshwater fish species ex situ populations have already been established, as a baseline to prioritize actions to develop an effective ex situ conservation breeding network. Populations in zoos and aquaria were primarily determined using the Zoological Information System. Of 173 fish species recorded from Malagasy freshwater habitats, 123 exclusively inhabit freshwater; 79 of these are endemic to Madagascar, and 50 are classified as threatened. Our survey found 21 Malagasy freshwater fish species kept in zoos worldwide, of which 19 are endemic and threatened (22 if counting species kept by private breeders). Nine of the 19 Malagasy freshwater fish species kept in zoos have successfully reproduced within the 12 months preceding our survey. The ex situ conservation activities for threatened Malagasy freshwater fishes thus have not improved significantly since the strong start in the early 2000s. More than half of the 50 threatened endemic Malagasy freshwater fish species (viz. 31 species) are not kept ex situ, including 11 species ranked as Critically Endangered. Based on these findings we call for a better distribution of offspring among institutions, including private breeders in the framework of citizen conservation initiatives; a closer connection of ichthyological field research in Madagascar with conservation breeding efforts to set up ex situ populations-both in Madagascar and abroad-of species not yet kept in captivity; and the development of effective, integrated in situ and ex situ conservation strategies
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