15 research outputs found
Knowledge on the Move: Studies on Mobile Social Education
This book draws on work undertaken by colleagues involved with the Erasmus+ project called SoMoveED, or Social Education on the Move. The broader aim of the project is to develop, implement, and disseminate innovation in the form of a model of mobile social education in higher education, of which this book makes up one small part.The project draws together institutions and organizations from ten European countries (Croatia, the Czech Republic, France, Italy, the Netherlands, Poland, Portugal, Romania, Turkey, and the United Kingdom), including eight universities, two non-governmental organizations and one social enterprise. Approximately 40 people are working on the project, including academic teachers and researchers, entrepreneurs, and social activists. The project’s main objective is to explore and develop ways in which the teaching process can be organized in motion, outside the university walls, with the participation of stakeholders from outside the academic community (citizens, representatives of institutions and organizations, activists, people at risk of marginalization). This model incorporates three important features into the educational process: (1) mobility; (2) participation; and (3) inclusion
Design and characteristics of the prophylactic intra-operative ventricular arrhythmia ablation in high-risk LVAD candidates (PIVATAL) trial
BACKGROUND: The use of a Left Ventricular Assist Device (LVAD) in patients with advanced heart failure refractory to optimal medical management has progressed steadily over the past two decades. Data have demonstrated reduced LVAD efficacy, worse clinical outcome, and higher mortality for patients who experience significant ventricular tachyarrhythmia (VTA). We hypothesize that a novel prophylactic intra-operative VTA ablation protocol at the time of LVAD implantation may reduce the recurrent VTA and adverse events postimplant.
METHODS: We designed a prospective, multicenter, open-label, randomized-controlled clinical trial enrolling 100 patients who are LVAD candidates with a history of VTA in the previous 5 years. Enrolled patients will be randomized in a 1:1 fashion to intra-operative VTA ablation (n = 50) versus conventional medical management (n = 50) with LVAD implant. Arrhythmia outcomes data will be captured by an implantable cardioverter defibrillator (ICD) to monitor VTA events, with a uniform ICD programming protocol. Patients will be followed prospectively over a mean of 18 months (with a minimum of 9 months) after LVAD implantation to evaluate recurrent VTA, adverse events, and procedural outcomes. Secondary endpoints include right heart function/hemodynamics, healthcare utilization, and quality of life.
CONCLUSION: The primary aim of this first-ever randomized trial is to assess the efficacy of intra-operative ablation during LVAD surgery in reducing VTA recurrence and improving clinical outcomes for patients with a history of VTA
1872 London Congress and the Nineteenth Century Prison Reform Movement: An Inquiry into the Discourse of Punishment
This paper is an attempt in understanding the first penal conference in world history. The meeting took place in
1872 in England, the Congress of London was a groundbreaking meeting of professionals, state officials, reformers
of the penitentiary system, and interested philanthropists. The Congress was the culmination of a century’s efforts
instigated by John Howard in the late eighteenth century. The meeting would prove to be the first of a long series
of professionalized conferences on the practices of punishment. There were attempts in gathering the professionals
of the penal system before, that is for sure, however, in convening and legitimizing both the state authority and the
philanthropy of the upper classes it was an insightful examination and a critique of the state penitentiary system
hitherto existed
Kirişsiz döşemelerde zımbalama donatısı
Bu çalışmada özel bir kesme donatısının döşemelerin zımbalama dayanımı üzerindeki etkisi araştırılmıştır. Deney programı yarım ölçekte dört elemandan oluşmaktadır. Dört kenarından mesnetli, izotropik donatılı kare deney elemanları ortadaki monolitik kolona uygulanan eksenel yük altında denenmiştir. Bu deneysel araştırmadan elde edilen sonuçlar diğer araştırmalardan elde edilen sonuçlarla karşılaştırılmıştır. Çalışmada ulaşılan önemli sonuç, önerilen türdeki zımbalama donatısının davranışı sünekleştirmiş ve zımbalama dayanımım artırmış olmasıdır
Liver biopsy: Is the pain for real or is it only the fear of it?
WOS: 000243904600047PubMed ID: 17211704Although percutaneous liver biopsy (PLB) has very low mortality and morbidity rates, it often is considered painful and frightening by the patients. This study was designed to grade the intensity of pain expected before the procedure and experienced during the procedure, and whether there is any correlation between pain and the emotional state of the patient. A total of 118 consecutive patients (aged 19-68 (mean, 44) years), who were undergoing PLB for the first time, were included in the study. Visual Analogue Scale (VAS) was used before the procedure, after the procedure to grade the degree of pain expected, and the degree of the pain experienced respectively. All the patients were evaluated by a questionnaire for their personality and emotional situation by using the Minnesota Multiphasic Personality Inventory Somatization Sub-scale (MMPI-SS). Mean VAS score for expected pain before the procedure was 60 +/- 20 and for the pain experienced during the procedure was 22 +/- 16 (P < 0.0001). Although the expected pain scores of female patients were significantly higher than males (66 +/- 22 vs. 55 +/- 17; P=0.003), there was no difference between female and male patients in the experienced pain scores. The procedure of PLB is expected to be more painful than it really is by the patients, especially by females. Calming the patients by informing them about the procedure and their diseases will probably diminish the expected pain
Results of endoscopic management of anastomotic biliary strictures after orthotopic liver transplantation
Background/aims: Anastomotic biliary strictures are common biliary complications after orthotopic liver transplantation. We assessed the success of endoscopic retrograde cholangio-pancreaticography (ERCP) in the treatment and outcome of post-liver transplantation anastomotic biliary strictures in a university hospital, retrospectively. Methods:Thirty-three ERCPs were performed in 20 of 162 adult liver transplant recipients with duct to duct anastomosis. Results:In five patients, ERCP failed because the stricture could not be passed with guidewire. Four patients were treated with balloon dilatation only; two of them are recurrence-free with a follow-up of 24 and 8 months. Eleven patients had balloon dilatation and plastic stent placement as their primary treatment modality. In six of them, the anastomosis remained patent for the rest of the follow-up (22 ;plusmn; 13 months). Five patients had stricture recurrence after first stenting which necessitated re-stenting; four of them required a third, and three had a fourth stenting. Conclusions: Endoscopic balloon dilatation and stenting are safe and effective means of treatment of anastomotic biliary strictures following liver transplantation.Amaç: Anastomoz bilyer darlıkları karaciğer nakli sonrası sıklıkla ortaya çıkabilen komplikasyonlardır. Karaciğer nakli sonrası ortaya çıkan anastomoz bilyer darlıklarının tedavisinde ERCP'nin başarısını değerlendirdik. Yöntem: İkiyüzonaltı karaciğer nakli hastasının 20'sinde 32 ERCP uygulandı. Bulgular: Hastaların beşinde darlığın kılavuz ile gecikmemesi nedeniyle ERCP başarısız olmuştur. Hastaların dördü sadece balon dilatasyonu ile tedavi edilirken bunlardan ikisi 24 ve 8 aydır nükssüz olarak takip edilmektedir. Sekiz hastaya primer tedavi olarak balon dilatasyonu ile beraber plastik stent uygulanması yapılmıştır. Bunların altısında, takibin geri kalanında (22±13 ay) anastomoz açık kalmıştır. Beşinde ilk stentle-me sonrası darlık nüks etmiş ve tekrar stentleme gerekirken, dördünde üçüncü stentleme ve üçünde dördüncü stentleme ihtiyacı olmuştur. Sonuç: Endoskopik balon dilatasyonu ve stentleme karaciğer nakli sonrası ortaya çıkan anastomoz bilyer darlıklarının tedavisinde etkili ve güvenli bir yoldur
Insertable cardiac monitor‐guided early intervention to reduce atrial fibrillation burden following catheter ablation: Study design and clinical protocol (ICM‐REDUCE‐AF trial)
Abstract Background Percutaneous catheter ablation (CA) to achieve pulmonary vein isolation is an effective treatment for drug‐refractory paroxysmal and persistent atrial fibrillation (AF). However, recurrence rates after a single AF ablation procedure remain elevated. Conventional management after CA ablation has mostly been based on clinical AF recurrence. However, continuous recordings with insertable cardiac monitors (ICMs) and patient‐triggered mobile app transmissions post‐CA can now be used to detect early recurrences of subclinical AF (SCAF). We hypothesize that early intervention following CA based on personalized ICM data can prevent the substrate progression that promotes the onset and maintenance of atrial arrhythmias. Methods This is a randomized, double‐blind (to SCAF data), single‐tertiary center clinical trial in which 120 patients with drug‐refractory paroxysmal or persistent AF are planned to undergo CA with an ICM. Randomization will be to an intervention arm (n = 60) consisting of ICM‐guided early intervention based on SCAF and patient‐triggered mobile app transmissions versus a control arm (n = 60) consisting of a standard intervention protocol based on clinical AF recurrence validated by the ICM. Primary endpoint is AF burden, which will be assessed from ICMs at 15 months post‐AF ablation. Secondary endpoints include healthcare utilization, functional capacity, and quality of life. Conclusion We believe that ICM‐guided early intervention will provide a novel, personalized approach to post‐AF ablation management that will result in a significant reduction in AF burden, healthcare utilization, and improvements in functional capacity and quality of life