492 research outputs found

    Land, freedom and the making of the medieval West

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    In the course of the fifth and sixth centuries, barbarian warbands acquired property rights in the former provinces of the Roman west, in a process that established the broad structural characteristics of early medieval society in western Europe: that is the central contention of this essay. Focusing on the western Mediterranean heartlands of the Imperial government and senatorial aristocracy, it argues that these property transfers were fundamental to the emergence of ethnic identity as the crucial political marker in the post-Roman west. Latent conflict over the respective rights and obligations of barbarian ‘guests’ and their provincial ‘hosts’ structured the first attempts at post-Roman state-formation in the west, for the nature of the ‘hospitality’ offered to barbarian warbands accommodated within the Empire became a matter of contention as second and third generation ‘guests’ continued to enjoy the fruits of the property of their ‘hosts’. Interpreting these new social relationships in the light of established legal forms, barbarian kings identified agreed mechanisms for the legitimate transfer of Roman property to their followers: this process allowed Roman landowners to seek remedies for illegitimate or violent seizure, but at the price of acknowledging a significant redistribution of land to a new class of barbarian soldiers whose liberty was rooted in their military service. The result was the emergence, by the seventh century, of regionalised and militarised elites who appropriated the language of ethnicity to legitimate their position

    Design of a brush cutter blade and its integration into a semi mechanized sugarcane harvesting system.

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    Thesis (M.Sc.Eng.)-University of KwaZulu-Natal, 2007Sugarcane is an important crop for South Africa. It provides employment and valuable foreig

    Oxycodone Ingestion Patterns in Acute Fracture Pain: a Pilot Study Using a Digital Pill

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    Background: Opioids are prescribed for acute pain as needed, but no data exists on how patients take opioids after discharge from the ED. This places the onus of dosing on the patient and contributes to variable prescribing by ED physicians. ED opioid prescriptions serve as a source for unintentional exposure and contribute to the opioid epidemic. We deployed a digital pill to measure opioid ingestion patterns in individuals discharged after acute fractures. Methods: This pilot study involved individuals without chronic opioid use (i.e. prescribed opioids \u3e 1 week) who were discharged from the ED following acute fracture. Participants were trained to use a digital pill system comprising a single pill (5 mg oxycodone tablet + radiofrequency emitter) and a hip mounted receiver. Upon contact with gastric contents, the digital pill transmitted a radio signal to the receiver, which relayed time of ingestion via cellular 3G signal in real-time to a cloud based server. Participants were instructed to take 1-2 oxycodone digital pills as needed every 8 hours for pain. Participants returned unused medication at orthopedic follow up or 1 week post discharge where any discrepancies between digital pill data and pill counts were reconciled. Results: We enrolled 10 participants (mean age 42). 50% of fractures were managed operatively and 50% were managed nonoperatively. The system recorded ingestions with 85% accuracy. Participants ingested a mean 43 mg oxycodone during the 1 week study period with dose de-escalation occurring after 24 hours. Participants ingested a mean 75.8% of their 1 week total dose in the first 72 hours. 40% of participants stopped taking opioids by 96 hours. 40% of participants remained on opioids 1 week after injury; all required operative treatment. Conclusions: This is the first study to determine opioid ingestion patterns in ED patients discharged with acute fracture pain. Participants self-tapered opioids after 24 hours, most ingestion occurred in the first 72 hours, and a substantial proportion (40%) stopped ingesting oxycodone by 96 hours. Our data shows individuals may require less opioid analgesics than previously considered for acute fracture pain. Additional studies should address ingestion patterns in other painful conditions and development of ED-based interventions to minimize outpatient opioid use while controlling pain
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