Реабилитация больных с дыхательной недостаточностью: выбор методов и режимов

A choice of a respiratory rehabilitation regimen was studied based on the objective noninvasive investigation of 3 components of the respiratory failure, such as respiratory mechanics disorders, functional failure of inspiratory and expiratory muscles and neurorespiratory drive. The method’s entity is a measurement of airway occlusion pressure.The examination of 112 COPD patients and 42 postoperative patients showed that a separate affection of lung mechanics, respiratory muscles function and central neurorespiratory drive is not almost encountered in the everyday clinical practice. The involvement of each component in the respiratory failure is different. Therefore, an application of the universal complex of respiratory rehabilitation, that is identical for all respiratory failure patients is not quite effective.The choice of respiratory rehabilitation method and schedule based on the functional assessment of the three-component model gives good results, that is confirmed with everyday clinical practice. The high effectiveness of the incentive spirometry and inspiratory and expiratory muscles training as a part of respiratory rehabilitation was displayed.Исследован выбор режимов дыхательной реабилитации, основанный на объективном неинвазивном исследовании 3 компонентов дыхательной недостаточности: нарушения механики дыхания, функциональной недостаточности дыхательных мышц вдоха и выдоха и нейрореспираторной регуляции. Метод основан на измерении окклюзионного давления в дыхательных путях.Обследование 112 больных ХОБЛ и 42 послеоперационных больных показало, что в повседневной клинической практике почти не встречается изолированное повреждение механических свойств легких, функциональной способности дыхательных мышц и центральной нейрореспираторной регуляции. Степень вовлечения в дыхательную недостаточность каждого из этих компонентов бывает различной. Поэтому применение универсального комплекса дыхательной реабилитации не дает должного эффекта.Выбор методов и режимов дыхательной реабилитации, обоснованный функциональной оценкой 3-компонентной модели, в том числе в ходе реабилитации, дает хорошие результаты, подтверждаемые повседневной практикой. Продемонстрирована высокая эффективность побудительной спирометрии и тренировки мышц вдоха и выдоха в ходе дыхательной реабилитации

Comparative prevalence of atopic sensitization in the border areas between Russia and Finland

Current century has been highlighted with rise in allergic pathology, and environment markedly affects it via epigenetic mechanisms. Allergy research in Russia and Finland has been conducted for many years, of larger scale recorded in the latter, still being maintained over time. Atopy prevalence was studied in the border areas in both countries. The level of total, dietary, inhaled IgE level, as well as dietary and inhalation range were examined. The Phadiatop® radio allergen sorbent test was used (UniCAP 1000 v.2; Pharmacia Upjohn, Uppsala, Sweden), with cut-off point: IgE > 110 kUA/l and sIgE > 2.5 kUa/l and 0.35 kUA/l. The study was subdivided into 2 stages conducted during 2003 and 2010/2012 timeframe. Stage 1 was performed with children from Finland (n = 344), Russia (n = 427), aged 7—15 years, whereas stage 2 — 180 subjects (Finland, n = 98, Russia, n = 82). Results. It was found that total IgE level was higher in children from Finland. The inhaled sIgE in 2003 and 2010/2012 was higher among children from Finland, p = 0.019 and p = 0.027, showing temporal elevation. In 2003, dietary sIgE was higher among those from Finland (27.6% and 18.3%), p = 0.142, whereas in 2010/2012 it was decreased by 2- and 3-fold in subjects from Finland and Russia, respectively. In 2003, high atopy rate against dust mites, cats, timothy, birch, and dogs was found in Russia, which was increased at stage 2. Such parameter was most evidently elevated for timothy — by 2-fold, p = 0.176, wormwood — by 2-fold, p = 0.312, equine allergens — by 2-fold, p = 0.563, canine allergens — by 1.5-fold, mite — by 1.5-fold, p = 0.220. In 2003, atopy rate in Finland to canine allergens reached 26.5%, timothy — 24.5%, birch — 20.4%, feline allergens — 20.4%. In 2010, it was noted rise in atopy rate mainly to dust mites — by 2-fold, equine allergens — by 2-fold. In 2003, atopy rate in Russia to egg, milk, and wheat prevailed, whereas in Finland it was mostly found against milk, nuts, wheat, eggs, in both cases declined in dynamics. Interestingly, no sensitization to fish in subjects from Russia and Finland was observed at both stages. Finally, at the stage 2 dietary atopy rate was declined in both countries. Differences in atopic sensitization as well as during 7—9 year follow-up observation were preserved between both subject cohorts from Finland and Russia

V*-algebras, independence algebras and logic

Independence algebras were introduced in the early 1990s by specialists in semigroup theory, as a tool to explain similarities between the transformation monoid on a set and the endomorphism monoid of a vector space. It turned out that these algebras had already been defined and studied in the 1960s, under the name of v*-algebras, by specialists in universal algebra (and statistics). Our goal is to complete this picture by discussing how, during the middle period, independence algebras began to play a very important role in logic

A multilevel neo-institutional analysis of infection prevention and control in English hospitals: coerced safety culture change?

Despite committed policy, regulative and professional efforts on healthcare safety, little is known about how such macro-interventions permeate organisations and shape culture over time. Informed by neo-institutional theory, we examined how inter-organisational influences shaped safety practices and inter-subjective meanings following efforts for coerced culture change. We traced macro-influences from 2000 to 2015 in infection prevention and control (IPC). Safety perceptions and meanings were inductively analysed from 130 in-depth qualitative interviews with senior- and middle-level managers from 30 English hospitals. A total of 869 institutional interventions were identified; 69% had a regulative component. In this context of forced implementation of safety practices, staff experienced inherent tensions concerning the scope of safety, their ability to be open and prioritisation of external mandates over local need. These tensions stemmed from conflicts among three co-existing institutional logics prevalent in the NHS. In response to requests for change, staff flexibly drew from a repertoire of cognitive, material and symbolic resources within and outside their organisations. They crafted 'strategies of action', guided by a situated assessment of first-hand practice experiences complementing collective evaluations of interventions such as 'pragmatic', 'sensible' and also 'legitimate'. Macro-institutional forces exerted influence either directly on individuals or indirectly by enriching the organisational cultural repertoire

Nora Virus Persistent Infections Are Not Affected by the RNAi Machinery

Drosophila melanogaster is widely used to decipher the innate immune system in response to various pathogens. The innate immune response towards persistent virus infections is among the least studied in this model system. We recently discovered a picorna-like virus, the Nora virus which gives rise to persistent and essentially symptom-free infections in Drosophila melanogaster. Here, we have used this virus to study the interaction with its host and with some of the known Drosophila antiviral immune pathways. First, we find a striking variability in the course of the infection, even between flies of the same inbred stock. Some flies are able to clear the Nora virus but not others. This phenomenon seems to be threshold-dependent; flies with a high-titer infection establish stable persistent infections, whereas flies with a lower level of infection are able to clear the virus. Surprisingly, we find that both the clearance of low-level Nora virus infections and the stability of persistent infections are unaffected by mutations in the RNAi pathways. Nora virus infections are also unaffected by mutations in the Toll and Jak-Stat pathways. In these respects, the Nora virus differs from other studied Drosophila RNA viruses

Breast cancer risk among women with psychiatric admission with affective or neurotic disorders: a nationwide cohort study in Denmark

There is a considerable interest in the possible relationship between psychosocial factors and the onset of breast cancer. This cohort study was based upon two nationwide and population-based central registers: The Danish Psychiatric Central Register, which contains all cases of psychiatric admissions, and The Danish Cancer Registry, which contains all cases of cancer. The register-linkage was accomplished by using a personal identification number. The study population comprised all women admitted to psychiatric departments or psychiatric hospitals in Denmark between 1969 and 1993 with an affective or a neurotic disorder. Overall, 66 648 women comprising 199 910 admissions and 775 522 person-years were included. The incidence of breast cancer in the cohort was compared with the national breast cancer incidence rates adjusted for age and calendar time. In all, 1270 women with affective or neurotic disorders developed breast cancer subsequent to the first admission as compared with the 1242 women expected, standardized incidence ratio (SIR) = 1.02 (95% confidence interval 0.97–1.08). None of the hypothetical risk factors: type of diagnosis, age or calendar period at cohort entry, age at breast cancer, alcohol abuse, alcohol/drug abuse without further specification, total number of admissions, total length of admissions, or time from first admission showed a statistically significant effect on the relative risk of breast cancer. We found no support for the hypothesis that women admitted to a psychiatric department with an affective or a neurotic disorder subsequently have an increased risk of breast cancer. © 1999 Cancer Research Campaig

The Dynamics of Managerial Ideology: Analyzing the Cuban Case

After the collapse of state socialism in Eastern Europe, management researchers devoted considerable energy to investigate ways to smooth transition to market economies. But one country of the former Soviet bloc, Cuba resisted transition and reaffirmed loyalty to communism. Little is known about management in Cuba on the managerial impacts of the combination of two major environmental forces: the American embargo and the Soviet Union collapse, both of which have challenged the sustainability of the communist regime. This study intends to approach one particular aspect of management in Cuba: the relationship between national ideology and management practice. To analyze these topics, direct qualitative data from focus groups with Cuban managers and management professors was obtained and complemented with documentary analysis. Results suggest that the dynamics of managerial ideology can be understood as the interplay of several processes operating at distinct levels: institutional, professional, organizational and individual. The study provides a nested, multi-level understanding of management and organization as parts of a wider institutional context, which is both a source of constraint and a non-tangible resource to be used by ideological bricoleurs. The interplay between the acceptance of ideology and its use as a practical resource is a potential source of change. As such, the same professional class (managers) may be both a source of continuity and a trigger of change - a finding that is line with institutional theory’s claim that it is necessary to understand both institutionalization and de-institutionalization for understanding organizational change and continuity.N/

From Interactions to Institutions: Microprocesses of Framing and Mechanisms for the Structuring of Institutional Fields

Despite the centrality of meaning to institutionalization, little attention has been paid to how meanings evolve and amplify to become institutionalized cultural conventions. We develop an interactional framing perspective to explain the microprocesses and mechanisms by which this occurs. We identify three amplification processes and three ways frames stack up or laminate that become the building blocks for diffusion and institutionalization of meanings within organizations and fields. Although we focus on “bottom-up” dynamics, we argue that framing occurs in a politicized social context and is inherently bidirectional, in line with structuration, because microlevel interactions instantiate macrostructures. We consider how our approach complements other theories of meaning making, its utility for informing related theoretical streams, and its implications for organizing at the meso and macro levels

Dengue Virus Type 2 Infections of Aedes aegypti Are Modulated by the Mosquito's RNA Interference Pathway

A number of studies have shown that both innate and adaptive immune defense mechanisms greatly influence the course of human dengue virus (DENV) infections, but little is known about the innate immune response of the mosquito vector Aedes aegypti to arbovirus infection. We present evidence here that a major component of the mosquito innate immune response, RNA interference (RNAi), is an important modulator of mosquito infections. The RNAi response is triggered by double-stranded RNA (dsRNA), which occurs in the cytoplasm as a result of positive-sense RNA virus infection, leading to production of small interfering RNAs (siRNAs). These siRNAs are instrumental in degradation of viral mRNA with sequence homology to the dsRNA trigger and thereby inhibition of virus replication. We show that although dengue virus type 2 (DENV2) infection of Ae. aegypti cultured cells and oral infection of adult mosquitoes generated dsRNA and production of DENV2-specific siRNAs, virus replication and release of infectious virus persisted, suggesting viral circumvention of RNAi. We also show that DENV2 does not completely evade RNAi, since impairing the pathway by silencing expression of dcr2, r2d2, or ago2, genes encoding important sensor and effector proteins in the RNAi pathway, increased virus replication in the vector and decreased the extrinsic incubation period required for virus transmission. Our findings indicate a major role for RNAi as a determinant of DENV transmission by Ae. aegypti

The multiplicity of performance management systems:Heterogeneity in multinational corporations and management sense-making

This field study examines the workings of multiple performance measurement systems (PMSs) used within and between a division and Headquarters (HQ) of a large European corporation. We explore how multiple PMSs arose within the multinational corporation. We first provide a first‐order analysis which explains how managers make sense of the multiplicity and show how an organization's PMSs may be subject to competing processes for control that result in varied systems, all seemingly functioning, but with different rationales and effects. We then provide a second‐order analysis based on a sense‐making perspective that highlights the importance of retrospective understandings of the organization's history and the importance of various legitimacy expectations to different parts of the multinational. Finally, we emphasize the role of social skill in sense‐making that enables the persistence of multiple systems and the absence of overt tensions and conflict within organizations