How has diabetes hospitalizations/ICU admissions changed with insulin price increasing over the last 20 years?

Chronic illnesses are a global issue and therefore are a more researched topic around the world, especially if they are common among populations. Most of these illnesses require medications to maintain a good quality of life or even in some cases just to survive. In this study, we will be looking at those who meet the expectations of the latter requirement for prescriptions. More specifically, the illness Diabetes Mellitus and how the prices of insulin in the United States of America are forcing Americans to fast their rations of insulin that are covered by insurance. Risking their own lives with complications like Acute Myocardial Infarction. We will focus on the rates of ICU admissions in the USA for the primary diagnosis being AMI and a secondary diagnosis for DM. We will compare that to countries who are honest about their insulin prices and are labeled as more “healthcare affordable”. Along with providing research around the world of the complications and dangers of fasting insulin doses. The price of Insulin should not come at the cost of American lives, or even take away the quality of those lives when we have medications that can easily improve them. Our country willingly lets people die from preventable diseases just so pharmaceutical companies can be greedy on a population that has no other choice. There is enough evidence to prove that rationing one\u27s insulin while they have diabetes mellitus makes them much more likely to be admitted to the ICU fighting for their life with an acute myocardial infarction

Syrgasburar i djursjukvården

Syrgasterapi är en viktig behandling för att stabilisera patienter med andningssvårigheter eftersom låga nivåer av syre i blodet kan orsaka skada på inre organ. Syftet med denna studie var att jämföra två olika syrgasburar med avseende på syrgaskoncentration, temperatur och luftfuktighet. Ett fokus var att mäta hur syrgaskoncentration i syrgasburar påverkas när burarnas dörrar öppnas. Ett annat fokus var betydelsen av andra komponenter i syrgasburars miljö, såsom temperatur och luftfuktighet, vilket undersöktes genom en litteraturgranskning. Denna kandidatuppsats inom djuromvårdnad kombinerar en granskning av befintlig vetenskaplig litteratur med en praktisk studie av två olika syrgasburar. Trots mångfaldig litteratur inom ämnet syrgasterapi finns det mycket få studier utförda på de olika sätten att administrera syrgas till smådjur. Syrgasburarna är en metod med stor brist på vetenskaplig litteratur. Mer forskning skulle hjälpa djurhälsopersonal att ta informerade beslut vid val mellan olika metoder av syrgasterapi. I litteratur beskrivs det att syrgasburar kan användas för att leverera syrgas på ett noninvasivt sätt, med minimal patienthantering. En syrgasterapimetod anpassad för att undvika stress hos patienter föredras då andningspåverkade patienter löper hög risk för allvarliga komplikationer. Trots avsaknad av studier inom veterinärmedicin nämns det ofta i litteratur att temperatur och luftfuktighetsgrad påverkar patienters metabolism och luftvägar. Det diskuteras att syrgasburar ibland misslyckas med att bibehålla optimala nivåer av temperatur och luftfuktighet, vilket kan leda till komplikationer såsom hypertermi och ökade stressnivåer. Dessutom saknas forskning som visar vad de optimala nivåerna är för olika patienter i syrgasbur. Eftersom det sker en minskning av syrgaskoncentration när burens dörr öppnas, begränsas ofta den fysiska kontakten med patienter. Denna studie analyserade syrgaskoncentrationen i två olika burar efter att dörren varit öppen under olika långa tidsperioder. Med start på 40% syrgaskoncentration sjönk Syrgasbur 1 till 37%, 35% respektive 32% efter att buren öppnades under 10, 20 respektive 35 sekunder. Syrgasbur 2 sjönk till 28%, 25% respektive 24% efter samma tidsperioder. Det konstaterades att de två burarnas utformning möjligen påverkade hur snabbt syrgaskoncentrationen sjönk. Tiden som krävdes för burarna att nå 40% syrgaskoncentration igen efter att dörrarna stängdes, var signifikant kortare jämfört med tiden att fylla upp burarna med syrgas från rumsluft. Den kliniska relevansen av denna tidsskillnad kan diskuteras, då tiden för att fylla burarna från rumsluft till 40% syrgaskoncentration var mindre än tre minuter för båda fabrikat. Resultaten visade att syrgaskoncentrationen inte sjunker drastiskt när dörren till buren öppnas i 10 sekunder och därför kan uppfyllnad av syrgasbur innan en patients ankomst övervägas. Dock bör ekonomiska aspekter och miljöaspekter tas i beaktning, eftersom syrgasburar använder en ansenlig mängd syrgas. Resultaten av denna experimentella studie bör ses som ett exempel och inte som representativt för syrgasburar på grund av det begränsade antalet syrgasburar i studien. Däremot är resultaten relevanta för en bättre uppfattning av hur syrgasburarna fungerar och att skillnader kan finnas mellan olika fabrikat. Ytterligare forskning inom syrgasburar och hur dess miljö påverkar patienter av olika djurslag skulle hjälpa djurhälsopersonal att använda syrgasburar mer effektivt.Oxygen therapy is critical in stabilizing patients with respiratory distress, as low levels of oxygen in the bloodstream can cause permanent organ damage. The aim of this study was to compare two different oxygen cages regarding oxygen levels, temperature, and air humidity. One focus was measuring how the levels of oxygen in oxygen cages are affected upon opening the cages’ doors. Another focus was on how other elements in the oxygen cages’ environment, such as temperature and air humidity can affect a patient, which was investigated through a literature review. This bachelor’s thesis in veterinary nursing combines a literature review with an experimental study on two different oxygen cages. Despite an abundance of literature on the topic of oxygen therapy, there are very few studies conducted on the various methods of oxygen supplementation for veterinary patients. Furthermore, literature rarely includes the study of oxygen cages and there is a lack of experimental studies on such devices. More research would help the animal health personnel to take informed decisions when choosing between the different methods of oxygen therapy. According to literature, oxygen cages can provide supplemental oxygen in a non-invasive way, with minimum patient handling. Stress-free oxygen therapy is preferred on dyspnoeic patients due to their high risk of respiratory complications. Several review articles assert that temperature and humidity levels are important for the patient’s metabolism and airways, despite the lack of scientific studies on veterinary patients. It is discussed that oxygen cages can fail in maintaining optimal levels in temperature and humidity, which can lead to complications like hyperthermia or increased stress levels. Yet no studies were found which show what the optimal levels are for different kinds of patients in oxygen cages. Often the contact with patients in oxygen cages is limited due to the risk of lowering oxygen levels upon opening the cage’s door. The present experimental study analysed the oxygen levels in two different cages, after opening their doors for different amounts of time. Starting at 40% oxygen concentration, Cage 1 had 37%, 35%, 32% respectively, left after the door was opened for 10, 20, 35 seconds, respectively. Cage 2 however dropped to 28%, 25%, 24% respectively, after the same time intervals. It can be assumed that cage design affects how fast the oxygen levels decrease. The time required for the cages to reach 40% again, after the doors were closed, was significantly shorter than the time required to fill up the cages from room oxygen levels. Nevertheless, the clinical significance of this time difference can be discussed, as filling the cages from room oxygen levels to a 40% oxygen concentration took less than 3 minutes for both models. The results show that oxygen levels do not drop drastically upon opening the cage for 10 seconds, and therefore preparing the oxygen cage before the patient’s arrival can safely be considered. However, financial and environmental aspects should be considered while taking such a decision, as oxygen cages use a considerate amount of oxygen. The results of this experimental study should be seen as an example and not representative for oxygen cages, as the study was conducted on a limited number of cages. Nevertheless, the findings are relevant for a better understanding of how oxygen cages work and the potential variance in oxygen levels between different models. Further research, both on the oxygen levels but also on the effects of the cages’ environment on different patients, would provide the animal health personnel with a more effective employment of oxygen cages

Stroke thrombectomy : new devices, imaging, scoring system and outcomes in the older population

Ph. D.In the past several years there have been major developments in the interventional treatment of acute ischaemic stroke. This thesis consists of four projects that I developed throughout my graduate studies. I started by working on setting up a phase 2 multicentre, randomised, controlled trial to assess the technical safety and efficacy of two new devices to be used in endovascular treatment: the ERIC retriever and the SOFIA distal access catheter. The trial has not yet finished, but partial results are presented. I went on to investigate the role of imaging in hyperacute stroke management. I developed a validated case archive of computed tomography angiography scans which was used for a radiological course. Assessing trainees reports pre- and post-training showed that there was a significant improvement in rates of major errors and this study concluded that an intensive hands-on radiological course was effective. While the trial was running, I developed a new technical index of thrombectomy difficulty. This score uses computed tomography angiographic images to evaluate key factors for predicting the expected procedural difficulty. The results demonstrated an excellent inter-rater reliability making this potentially a powerful tool to help with decision making and procedural planning. Due to limited evidence for mechanical thrombectomy in the older population, I worked on a study to assess the safety and efficacy of this treatment. Patients had more comorbidities, more tandem occlusions, but still good reperfusion rates with a similar safety profile to the younger population. Clinical results at 3 months were poorer than in the younger population, but milder presenting clinical deficits and good reperfusion rates were predictors of good outcomes. This thesis will first discuss stroke with a review of the evidence for performing mechanical thrombectomy. The projects undertaken during my studies will be discussed and I will finish with a succinct conclusion

Das Web-TV und seine Fan-Communities

Das Internetfernsehen hat sich in den letzten Jahren immer mehr in der Gesellschaft etabliert und ist durch qualitative und quantitative Entwicklungen zu einem festen Bestandteil im Bereich des Bewegtbild-Konsums geworden. Durch die rapide Entwicklung dieses relativ jungen Mediums ist die Aktualität von wissenschaftlichen Arbeiten nur von kurzer Dauer. Der allgemeine wissenschaftliche Stand ist, dass das Internetfernsehen keine verdrängende Wirkung auf das klassische Fernsehen ausübt, sondern eher eine parallele Entwicklung in der nahen Zukunft abzusehen ist. In dieser Arbeit wird neben Grundlagen wie Begriffserklärungen und Umrissen der gesellschaftlichen Etablierung des Mediums die gegenwärtige Situation des Internetfernsehens im Vergleich zum klassischen Fernsehen behandelt. Dabei wird anhand von Beispielen unterschiedlicher Web-TV-Anbieter ein Überblick über die Diversität der Web-TV-Plattformen und deren Aufbau und Content gegeben. Zudem werden das veränderte Sehverhalten und die verstärkte Involvierung der NutzerInnen des Internetfernsehens beleuchtet und ebenfalls durch Beispiele erläutert. Diese beziehen sich auf diverse Formate, Aktivitäten von Fan-Communitys und genrespezifische Serienvergleiche. Das Internetfernsehen wird sich in naher Zukunft immer weiter entwickeln und ausbreiten. Es stellt allerdings, entgegen häufiger Vermutungen, keine direkte Konkurrenz zum klassischen Fernsehen dar, da der Zugang ein Anderer ist und die Intentionen des Publikums unterschiedlich sind. Zudem werden die Inhalte zwar zu einem großen Teil identisch mit denen des klassischen Fernsehens bleiben, aber zusätzlich wird es einen Platz für vermehrte zielgruppenorientierte Sparteninhalte geben und experimentelle Produktionen, die zum Beispiel eine aktive Involvierung des Publikums erfordern.Web-TV has improved in quality and quantity in the last years and has settled as a visual entertainment medium. Because of the rapid development of this medium there is only a certain amount of current academic works. Academics in that field have argued that web-TV could be a threat for classic TV, but is rather improving parallel to it. Next to a basic explanation of topic relevant basics, the current situation of web-TV is compared to classic TV. The examples of diverse international web-TV providers give an overview of different kinds of layout and content. The changes in viewing behavior and the evolving involvement of the audience of web-TV are analyzed and supported by examples. These examples are connected to different formats, user activities, fan-communities and comparisons of different genres of TV shows. Web-TV will develop and increase in the near future, but it will not compete with classic TV. Both mediums will rather progress side by side because the intentions and expectations of the audience are differing from one another. Most of the content is and will stay identical, but web-TV is providing space for specific target groups, experimental content and higher involvement of the audience

Acolhimento no ar: comunicação popular de/para migrantes venezuelanos em Roraima

This research aims to describe the presence of Spanish, translanguage and transculturality in popular communication spaces commanded by Venezuelan migrants in Boa Vista-RR, Brazil. With an increasingly strong frontier and migration context in Roraima, the flexible use of linguistic repertoires highlights the constitutive overdiversity of the state, to the extent that alternative media emerge as instruments of belonging to crisis migrants, and can collaborate with integration and welcoming of these groups in the new society. The theoretical framework here adopted follows the hybrid and transdiciplinar characteristics of Applied Linguistics; regarding the methodological framework, the qualitative approach was used, with bibliographical, documentary and field research. Results point to the growth of popular communication radio spaces commanded by Venezuelans and intended to welcoming their compatriots, using the Spanish language and translanguage in a natural way. In such scenario, the visualization of the languages-cultures of crisis migrants is increasing in Roraima along with the bond of belonging in the local community.Esta investigación tiene como objetivo describir la presencia de la lengua española, del translenguaje y de la transculturalidad en espacios de comunicación popular comandados por migrantes venezolanos en Boa Vista-RR. Con un contexto de frontera y migración cada vez más fuerte en la sociedad roraimense, el uso flexible de repertorios linguísticos resalta la superdiversidad constitutiva del estado, en la medida en que los medios de comunicación alternativos surgen como instrumentos de pertenecimiento de los migrantes de crisis, colaborando con la integración y la acogida de esos grupos en la nueva sociedad. El marco teórico sigue las características híbrida y transdisciplinar de la Lingüística Aplicada (LA); en lo que se refiere al marco metodológico, fue usado el abordaje cualitativo, con investigación bibliográfica, documental y de campo. Los resultados apuntan para el crecimiento de espacios radiofónicos de comunicación popular comandados por venezolanos y destinados a la acogida de tal público, con uso de la lengua española y del translenguaje de manera natural; en ese escenario, la visibilización de las lenguas-culturas de los migrantes de crisis está aumentando en Roraima junto con el vínculo de pertenecimiento en la comunidad local.Esta pesquisa objetiva descrever a presença da língua espanhola, da translinguagem e da transculturalidade em espaços de comunicação popular comandados por migrantes venezuelanos em Boa Vista-RR. Com um contexto de fronteira e migração cada vez mais forte na sociedade roraimense, o uso flexível de repertórios linguísticos ressalta a superdiversidade constitutiva do estado, na medida em que os meios de comunicação alternativos emergem como instrumentos de pertencimento dos migrantes de crise, podendo colaborar com a integração e o acolhimento desses grupos na nova sociedade. O marco teórico segue as características híbrida e transdiciplinar da Linguística Aplicada (LA); no que tange ao arcabouço metodológico, foi usada a abordagem qualitativa com pesquisa biblográfica, documental e de campo. Os resultados apontam para o crescimento de espaços radiofônicos de comunicação popular comandados por venezuelanos e destinados ao acolhimento de tal público, com uso da língua espanhola e da translinguagem de maneira natural; nesse cenário, a visibilização das línguas-culturas dos migrantes de crise está aumentando em Roraima junto com o vínculo de pertencimento na comunidade local

REFLEXÕES SOBRE LÍNGUA E INTERCULTURALIDADE EM UMA ESCOLA DA FRONTEIRA BRASIL/VENEZUELA

O objetivo geral deste artigo foi discutir como é o relacionamento entre docentes e discentes em sala de aula com crianças de diferentes línguas e culturas. Para isso, foi realizado um estudo de caso com crianças de 5 e 6 anos de idade, estudantes do nível Jardim II, em uma escola brasileira na fronteira do Brasil com a Venezuela. O problema de pesquisa é o ambiente escolar bilíngue e transcultural do grupo em questão. Após a pesquisa bibliográfica e de campo, com análise qualitativa, os resultados destacam a importância da educação intercultural para uma efetiva interação entre grupos diferentes, mostrando que a relação entre docentes e discentes na referida escola ainda é de imposição da cultura dominante

PORTUGUÊS COMO LÍNGUA DE ACOLHIMENTO EM RORAIMA: DA FALTA DE FORMAÇÃO ESPECÍFICA À NECESSIDADE SOCIAL

A atual realidade linguística dos habitantes do Estado de Roraima está marcada pela intercompreensão ou translinguagem, graças à desenfreada imigração venezuelana. Apesar de haver certa comunicação, pelo fato do espanhol e do português serem línguas próximas, os venezuelanos procuram os cursos de português oferecidos pelas instituições públicas, com o objetivo de aprenderem a língua e assim ampliarem as possibilidades de inserção no mercado de trabalho. Nessa perspectiva, surge a necessidade de um ensino de língua portuguesa mais voltado para o social, com forma de acolher o imigrante de língua e cultura diferentes. No entanto, poucos professores roraimenses têm formação específica para ensinar português como língua não materna. Dessa forma, surgiu a necessidade de pesquisar quais Instituições de Ensino Superior oferecem cursos aos imigrantes e qual a formação oferecida nessa área. A metodologia foi qualitativa e os resultados mostraram que nem a UERR, a UFRR e o IFRR têm, nas suas grades curriculares, disciplinas obrigatórias voltadas para o ensino de LP a estrangeiros. No entanto, as duas primeiras, oferecem cursos desde 2006 e 2007, respectivamente, com professores e acadêmicos envolvidos no ensino e na pesquisa nessa área, porém, na perspectiva de PLAc, as duas instituições iniciaram apenas em 2017.

ESCOLARIZAÇÃO EM CONTEXTO BILÍNGUE NA FRONTEIRA BRASIL/VENEZUELA

Este artigo mostra como acontece a escolarização em contexto bilíngue de minorias linguísticas em uma escola de educação infantil localizada na fronteira do Brasil com a Venezuela. Por meio de uma pesquisa de cunho etnográfico, especificamente um recorte de um trabalho maior, foi possível analisar como as crianças denominadas “brasileiras venezuelanas” se comunicam entre si, com os colegas e professores, além de verificar casos de alternância de língua, mudanças de códigos e empréstimos linguísticos nas turmas do primeiro nível de educação infantil. O contexto é sociolinguisticamente complexo, aonde o português e o espanhol estão em contato direto em todos os âmbitos da instituição escolar. Dentre os autores utilizados para o embasamento teórico estão Cavalcanti (1999), Maher (2007) e Mello (1999)

Interculturalidad y variaciones linguísticas del español en una escuela en la frontera Brasil/Venezuela

Esta investigación fue realizada en los salones de los últimos años del bachillerato en la Escuela Estadal Cícero Viera Neto, localizada en el municipio de Pacaraima-Roraima-Brasil, con la finalidad de investigar como son abordadas la interculturalidad así como las variaciones lingüísticas de la lengua española en esa institución. Analizamos los problemas que conllevan a no trabajar las diversidades lingüísticas y culturales que caracterizan al español. La base metodológica que nos dio soporte a la investigación fue el abordaje cualitativo y el estudio de campo. Como resultados evidenciamos que las actividades interculturales poco ocurren en la escuela, a pesar de ser un ambiente rico en diversidad. La variación lingüística que es trabajada en clases de español es la peninsular, sin preocupación con la realidad lingüística de los alumnos y de la región de frontera

Interculturalidade e variações linguisticas do espanhol em uma escola da fronteira Brasil/Venezuela

This research was carried out in the rooms of the last years of high school at the Cícero Viera Neto State School, located in the municipality of Pacaraima-Roraima-Brazil, in order to investigate how interculturality is approached as well as the linguistic variations of the Spanish language in this area. institution. We analyze the problems that lead to not working the linguistic and cultural diversities that characterize Spanish. The methodological base that supported the research was the qualitative approach and the field study. As results we show that intercultural activities happen little in school, despite being an environment rich in diversity. The linguistic variation that is worked on in Spanish classes is peninsular, without concern for the linguistic reality of students and the border region.Esta investigación fue realizada en los salones de los últimos años del bachillerato en la Escuela Estadal Cícero Viera Neto, localizada en el municipio de Pacaraima-Roraima-Brasil, con la finalidad de investigar como son abordadas la interculturalidad así como las variaciones lingüísticas de la lengua española en esa institución. Analizamos los problemas que conllevan a no trabajar las diversidades lingüísticas y culturales que caracterizan al español. La base metodológica que nos dio soporte a la investigación fue el abordaje cualitativo y el estudio de campo. Como resultados evidenciamos que las actividades interculturales poco ocurren en la escuela, a pesar de ser un ambiente rico en diversidad. La variación lingüística que es trabajada en clases de español es la peninsular, sin preocupación con la realidad lingüística de los alumnos y de la región de frontera.Esta pesquisa foi realizada nas salas dos últimos anos do ensino médio na Escola Estadual Cícero Viera Neto, localizada no município de Pacaraima-Roraima-Brasil, com a finalidade de pesquisar como são abordadas a interculturalidade assim como as variações linguísticas da língua espanhola nessa instituição. Analisamos os problemas que levam a não trabalhar as diversidades linguísticas e culturais que caracterizam o espanhol. A base metodológica que nos deu suporte à pesquisa foi a abordagem qualitativa e o estudo de campo. Como resultados evidenciamos que as atividades interculturais acontecem pouco na escola, apesar de ser um ambiente rico em diversidade. A variação linguística que é trabalhada nas aulas de espanhol é a peninsular, sem preocupação com a realidade linguística dos alunos e da região de fronteira