Taxic Revisions

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72423/1/j.1096-0031.2001.tb00112.x.pd

Outcome in patients perceived as receiving excessive care across different ethical climates: a prospective study in 68 intensive care units in Europe and the USA

Purpose: Whether the quality of the ethical climate in the intensive care unit (ICU) improves the identification of patients receiving excessive care and affects patient outcomes is unknown. Methods: In this prospective observational study, perceptions of excessive care (PECs) by clinicians working in 68 ICUs in Europe and the USA were collected daily during a 28-day period. The quality of the ethical climate in the ICUs was assessed via a validated questionnaire. We compared the combined endpoint (death, not at home or poor quality of life at 1 year) of patients with PECs and the time from PECs until written treatment-limitation decisions (TLDs) and death across the four climates defined via cluster analysis. Results: Of the 4747 eligible clinicians, 2992 (63%) evaluated the ethical climate in their ICU. Of the 321 and 623 patients not admitted for monitoring only in ICUs with a good (n = 12, 18%) and poor (n = 24, 35%) climate, 36 (11%) and 74 (12%), respectively were identified with PECs by at least two clinicians. Of the 35 and 71 identified patients with an available combined endpoint, 100% (95% CI 90.0–1.00) and 85.9% (75.4–92.0) (P = 0.02) attained that endpoint. The risk of death (HR 1.88, 95% CI 1.20–2.92) or receiving a written TLD (HR 2.32, CI 1.11–4.85) in patients with PECs by at least two clinicians was higher in ICUs with a good climate than in those with a poor one. The differences between ICUs with an average climate, with (n = 12, 18%) or without (n = 20, 29%) nursing involvement at the end of life, and ICUs with a poor climate were less obvious but still in favour of the former. Conclusion: Enhancing the quality of the ethical climate in the ICU may improve both the identification of patients receiving excessive care and the decision-making process at the end of life

A História da Alimentação: balizas historiográficas

Os M. pretenderam traçar um quadro da História da Alimentação, não como um novo ramo epistemológico da disciplina, mas como um campo em desenvolvimento de práticas e atividades especializadas, incluindo pesquisa, formação, publicações, associações, encontros acadêmicos, etc. Um breve relato das condições em que tal campo se assentou faz-se preceder de um panorama dos estudos de alimentação e temas correia tos, em geral, segundo cinco abardagens Ia biológica, a econômica, a social, a cultural e a filosófica!, assim como da identificação das contribuições mais relevantes da Antropologia, Arqueologia, Sociologia e Geografia. A fim de comentar a multiforme e volumosa bibliografia histórica, foi ela organizada segundo critérios morfológicos. A seguir, alguns tópicos importantes mereceram tratamento à parte: a fome, o alimento e o domínio religioso, as descobertas européias e a difusão mundial de alimentos, gosto e gastronomia. O artigo se encerra com um rápido balanço crítico da historiografia brasileira sobre o tema

La Nécropole de Lommel-Kattenbosch

de Laet Sigfried J., Mariën Marcel E. La Nécropole de Lommel-Kattenbosch. In: L'antiquité classique, Tome 19, fasc. 2, 1950. pp. 309-363

Morphological studies in Zygophyllaceae II. The floral development and vascular anatomy of Peganum harmala

Floral development and vascular anatomy are investigated in Peganum harmala, emphasizing its unusual androecium with 15 stamens. Sepals arise successively; petals emerge simultaneously with five antesepalous stamens. The five stamen pairs arise in the space between the petals and the antesepalous stamens. The gynoecium arises from three carpel primordia with evidence of two reduced carpels. Placentae are axile and each bears two double rows of ovules. A weakly developed nectary surrounds the base of the ovary. The antepetalous stamen traces diverge from a common supply to petals and sepal laterals, independent of the antesepalous stamen traces. The androecium of Peganum is described as a derived obdiplostemonous form, differing from the complex haplostemonous androecium of Nitraria. ''Congenital dedoublement'' cannot adequately explain the origin of the paired antepetalous stamens; two stamens can arise either by the splitting of a common primordium or independently, and both ways of inception are best understood as extremes of a gradation. The systematic position of Peganum is discussed in relation to other Zygophyllaceae using a cladistic analysis with Ptelea (Rutaceae) and Quassia (Simaroubaceae) as outgroups. The basal division in the Zygophyllaceae is between Peganum and the rest of the family.status: publishe

Cladistics of Gentianaceae: a morphological approach

The infrafamilial relationships of the Gentianaceae are investigated by means of a cladistics analysis of 84 phenotypic characers, based mainly on data from the literature. The 41 genera that were selected for the analysis, including the formerly loganiaceous genera Anthocleista and Fagraea and the monotypic genus Saccifolium, are a fair representation of the character diversity in the family. The diverse genus Gentiana is represented by six of its sections. As outgroups we used Strychnos and Geniostoma (Loganiaceae), Gelsemium (Gelsemiaceae), and two genera each of Apocynaceae and Rubiaceae. In the strict consensus cladogram of all most-parsimonious trees Gentianaceae has an unresolved basal trichotomy between Saccifolium (of tribe Saccifolieae), Potaliinae, and a major clade including all other genera. In this clade only tribe Gentianeae and subtribe Chironiinae of tribe Chironieae (Ixanthus excepted) are recocgnized as monophyletic gro ups. Within tribe Gentianeae, subtribe Gentianinae is nested in paraphyletic tribe Swertiinae. The relationships between the representatives of Exaceae, Canscorinae and Coutoub einae (Chironieae), and Helieae are almost completely unresolved. An interesting exception is the sister-group relationship between Exacum and Cotylanthera. Two complementary explanations for the lack of resolution in most parts of the cladogram are discussed: (1) the morphological characters of most tropical members of the family are insufficiently known, and (2) morphological characters are not well suited to resolve the more basal relationships in Gentianaceae.status: publishe

Archéologie 1954, 1

Revue critique des publications et trouvailles archéologiques intéressant le territoire actuel de la Belgique et les régions limitrophes : 1. Généralités. — 2. Paléolithique et mésolithique. — 3. Néolithique et âges des métaux. — 4. Époque gallo-romaine. — 5. Époque mérovingienne et périodes postérieures.De Laet Sigfried Jan, Faider-Feytmans Germaine, Trips E., Roosens Héli, Moisin P. Archéologie 1954, 1. In: L'antiquité classique, Tome 23, fasc. 1, 1954. pp. 168-191

Archéologie 1956, 2

Revue critique des publications, fouilles et trouvailles archéologiques intéressant le territoire actuel de la Belgique et les régions limitrophes : 1. Généralités. — 2. Époque préhistorique et protohistorique. — 3. Époque gallo-romaine. — 4. Époque mérovingienne et moyen âge.de Laet Sigfried J., Faider-Feytmans Germaine, N. J., Amand M., Delerive H., Trips E. Archéologie 1956, 2. In: L'antiquité classique, Tome 25, fasc. 2, 1956. pp. 420-451