Surgical treatment of left laryngeal hemiplegia in horses, using a nerve (N. cervicalis 1)

Deckblatt-Impressum Inhalt Abkürzungen Einleitung Schrifttum Eigene Untersuchungen Ergebnisse Diskussion Zusammenfassung Summary Literaturverzeichnis Anhang Danksagung SelbständigkeitserklärungDie Transplantation des Nervus cervicalis 1 als operative Therapie der Hemiplegia laryngis sinistra wurde zuerst von FULTON et al. (1991 und 1992) veröffentlicht. Die hier beschriebene Operationsmethode basiert auf den Erkenntnissen aus diesen Veröffentlichungen. Bei dieser Transplantationstechnik wird versucht über den Spendernerven, den Nervus cervicalis 1 die physiologische Arbeit des Musculus cricoarytaenoideus dorsalis bei Belastung wieder herzustellen. Während dieser Arbeit wurden zuerst anatomische Vorstudien an 32 Pferdeköpfen mit Halsanteilen zur Optimierung der Operationsmethode durchgeführt. Diese auf die erwähnte Art erprobte Operationstechnik wurde anschließend an 12 Patienten der Klinik für Pferde, Allgemeine Chirurgie und Radiologie der Freien Universität Berlin ausgeführt. Die zur Optimierung dieser Methode durchgeführten Veränderungen sind in der vorliegenden Arbeit zusammengefasst und beschrieben. Die Anwendung dieser Operationsmethode wird sicherlich zukünftig an Bedeutung gewinnen, da sie momentan die einzige Methode ist, die die physiologischen Abläufe bei der Hemiplegia laryngis sinistra bei Belastung wieder herzustellen vermag. Die beschriebenen Änderungen dieser Methode beruhen auf dem Versuch diese Operation zu standardisieren und zukünftig als eine Alternative zu den bekannten Kehlkopfpfeifer- operationen in der Pferdechirurgie zu etablieren.The transplantation of the nervus cevicalis 1 as a surgical method of treating hemiplegia laryngis sinistra was first published by Fulton et al. (1991 and 1992). The surgical method described in this publication is based on the findings in those publications. This technique of transplanting the nervus cervicalis 1 as a donor nerve attempts to restore the function of the musculus cricoarytenoideus dorsalis under stress. In the course of this work preliminary anatomic studies of 32 horses heads including parts of the neck were made in order to optimize the surgical method. This surgical technique was then performed on 12 patients from the Clinic for Horses, General Surgery and Radiology of the University of Berlin (FU Berlin). The changes to the surgical method to optimize it are summarized and described in this paper. This surgical method will certainly gain in importance as, at the moment, it is the only method of restoring the physiological functions of hemiplegia laryngis sinistra under stress. The changes to this method as described here are based on an attempt to standardize the operation and establish an alternative to the known therapies of hemiplegia laryngis in horse surgery

Anti-Semitism in Yugoslavia (1919–1945)

Ispitivanju fenomena antisemitizma u Jugoslaviji 1919—1945. autor pristupa na osnovi sheme dinamike antisemitizma iz knjige Ch. Glock and R. Stark, Christian Beliefs and Antisemitism. Isto tako, na osnovu teze H. Arendt, vrši se razlikovanje između modernog političkog antisemitizma od tradicionalnog religioznog antijevrejstva. Metoda kojom se autor služi u deskripciji antisemitizma u međuratnoj Jugoslaviji je analiza sadržaja arhivske građe, kao i sekundarnih izvora. Osnovna teza članka je da se u Kraljevini Jugoslaviji antisemitizam javljao na nivou ubeđenja (pritajena individualna mržnja koja se nikada ne iskazuje otvoreno) i osećanja (etnička i religiozna distanca spram Jevreja). U vrijeme fašizacije Evrope i jačanja utjecaja Njemačke i Italije na unutrašnje odnose u Jugoslaviji, ova dinamika antisemitizma zadobila je nivo akcije, prvo kao sastavni dio ideologije vodećih političkih stranaka, a zatim kao mere državno-pravne diskriminacije prema Jevrejima (»Koroščevi zakoni«). Na taj način, zaključuje autor u trećem djelu članka, pripremljena je podloga za fizičku akciju u obliku genocida nad jugoslavenskim Jevrejima do kojeg je došlo u svim djelovima okupirane zemlje tokom drugog svetskog rata.The author follows the scheme of the dynamics of anti-Semitism of the book Christian Beliefs and Antisemitism by Glock and Stark in his analysis of the phenomenon of anti-Semitism in Yugoslavia from 1919 to 1945. Besides, a distinction is made between modern political anti-Semitism and traditional religious anti-Judaism on the basis of Hanna Arendt’s premise. The method applied by author in his description of anti-Semitism in Yugoslavia between two world wars consists of the contents analysis of public records (archives) and secondary sources. The basic assertion of the article is the following: anti-Semitism was manifested on the level of convictions (suppressed individual hatred which was never openly displayed) and feelings (ethnical and religious reserve towards the Jews) in the Kingdom of Yugoslavia. During the period of the fascistization of Europe and of the increased influence of Germany and Italy on internal affairs in Yugoslavia, the dynamics of anti-Semitism expanded into the level of action, at first as a component of the ideology of the dominant political parties, and consequently as governmental and leval measures of discrimination with respect to Jews (»the statutes of Korošec «). In such a manner, as the author concludes in the third part of the article, the foundation of the physical action against the Yugoslav Jews in the form of genocide had been prepared, and it was carried out throughout the occupied country during the World War Second

Transitions in Medical Education

Transitions in medical education have been shown to increase unprofessional behaviours in learners but little is known about the experiences of first year Canadian Family Medicine residents or their preceptors. This qualitative descriptive study explored the experiences and feelings of Family Medicine preceptors and first year Family Medicine residents (FMRs) surrounding the transition to residency. Semi-structured interviews were conducted with 10 preceptors and 9 FMRs. The findings highlighted the complex but predominantly positive experiences during this transition in addition to competing and often evolving feelings experienced by both groups. Both studies noted the lack of support for preceptors and FMRs during transitional times and the importance of a learner-centered approach to transitions with an emphasis on peer and early, meaningful Family Medicine connections. These findings generate learner-centered recommendations to increase learner connectivity to Family Medicine, support this transition for both groups, and may improve patient safety and care

Komunizam i država u djelu Karla Marxa

Autor analizira shvatanje države, kao oblika otuđenog života u Marksovom opusu, polazeći od konstatacije da se pod tim pojmom označava onaj oblik ove političke institucije koji se javlja s apsolutističkom monarhijom, odnosno prvim oblicima robne proizvodnje. Za Marksa, država je iluzorna zajednica jer je ona izraz iluzornog opšteg interesa nastalog apstrahovanjem od sfere građanskog društva: u modernom građanskom društvu Marks razlikuje dve sfere, građansko društvo, tj. sferu čovekove empirijske egzistencije, i sferu države, tj. osamostaljenog zajedničkog interesa. Konstatujući da je za Marksa-filozofa država prividna zajednica, surogat zajednice koji se osamostaljuje naspram individuuma, autor analizira Marksov koncept prevazilaženja (Aufhebung) države i konstatuje imenentne ograničenosti toga koncepta koji se manifestuju, pre svega, u nedostatku analize funkcionisanja modernog industrijskog društva. Naime, umesto traženja mogućih empirijskih modusa prevazilaženja ove političke institucije, Marks gradi — i to sasvim nedosledno — jedan apstraktni (Pariška komuna kakva bi ona mogla da bude) prevazilaženja države, što onda dovodi do toga da se ceo problem prenosi sa nivoa političke filozofije na nivo mogućih operacionalizacija ideja komunizma.The author analyses the concept of state as a form of alienated life in the works of Karl Marx, starting from the assessment of state denoting that form of political institution which emerged within absolutist monarchy, that is, together with the first forms of commodity production. State is an illusory community for Marx, for it is an expression of the illusory common interest conceived by an abstraction from the sphere of bourgeois society: in the modern bourgeois society Marx differentiates two spheres, that of the bourgeois society (i.e. the sphere of the human empirical existence) and the sphere of state (i.e. independently developed common interest). Asserting that state is fictitious community for Marx — the philosopher — a surrogate of a community becoming autonomous as opposed to the individual — the author analyses Marx\u27es concept of the superseding of state (Aufhebung), and he ascertains the inherent limitations of that concept which are manifested, primarily, in the lack of any analysis of the functioning of the modem industrial society. Specifically, instead of seeking possible empirical modes of superseding such a political institution, Marx is developing — and without any consistency — an abstract model (the Commune of Paris as it could have been) of the superseding of state, which leads to the relocation of the whole problem from the level of political philosophy to the level of possible operationalizations of the idea of communism

Pressure Injury Documentation and Reporting: A Quality Gap

Abstract Problem: Inaccurate and incomplete pressure injury (PrI) assessment and documentation leads to inaccurate reporting of PrI quality reporting measures to the Centers for Medicare and Medicaid Services. Inaccurate, incomplete documentation of pressure injuries and wounds adversely affects the quality of care, financial reimbursement, and hospital reputation as well as increasing the risk of litigation to medical providers. Barriers to accurate and complete documentation by the nurses were inaccuracy in identification of PrIs Stage 1 or greater and knowing what and where to document the information in the electronic medical record. Context: This quality improvement project attempted to improve nurse admission skin assessment and documentation skills in a 48-bed inpatient rehabilitation hospital (IRH). The IRH is a regional referral center for 22 hospitals in the health care system. They are a specialty unit caring for persons who are at high risk of developing pressure injuries due to their diagnoses of acquired brain injuries, strokes, spinal cord injuries and other neurological disorders. Interventions: The interventions for this project were the development and implementation of an interactive wound assessment education program and wound/PrI documentation algorithm. Measures: A bundle of three measures included accurate identification of PrI’s, complete documentation on the Shift Rehab Flow Sheet, and the Wound Flow Sheet. The medical records of 100% of newly admitted patients were reviewed for accurate identification and completeness of wound and PrI documentation, as verified by 2 RNs, and confirmed by the Certified Wound Ostomy Continence nurse’s documentation. Results: The overall goal of this quality improvement project was to have complete, accurate identification and documentation of 80% of pressure injuries by the nurse at the point of the patients admission to the rehabilitation unit. This quality improvement project resulted in an increase in accurate and complete pressure injury identification and documentation to 100% for the past five months. Documentation for non-pressure related wounds rose from a baseline of 20% to 78% over a 9-month period. Using Improvement Science and Evidence Based Practice that included the implementation of an interactive education program, and the use of a Wound Documentation Algorithm, a significant improvement was seen in this units accuracy and completeness of documentation. Conclusions: In our environment of value-based payment and focus on patient-centered care, it is essential that nurses are knowledgeable and can competently assess and accurately document and treat pressure injuries in a timely manner. The avoidance of litigation costs and potential financial penalties imposed by regulating agencies such as the Centers for Medicare and Medicaid Services, is well worth the time and investment of this quality improvement project for the patients, nurses and IRH

The Sandbox, The Zoo story, The American dream

Thesis (M.A.)--Boston Universit

The Fairground as a Geopolitical Playground: the Zagreb International Trade Fair and Cold War Circumstances

Zagreb is a city with centuries-old tradition of annual fairs where the first modern international trade fair was or- ganized as early as 1864. The history of Zagreb International Trade Fair begins back in 1909, when its predecessor, trade show named Zagreb Convention was founded and its first exhibition was held next year. Over the years the Fair changed its locations several times, due to physical limitations of the place available and lack of space needed. With the last relocation to its current location on the right bank of the Sava River, close to the cardinal city axis, Zagreb Fair gained far greater importance, propelling also further development of the city and giving decisive impulse to immediate construction of emerging Novi Zagreb. The construction of the first stage of new Trade Fair started in summer 1956 according to the spatial concept by architect Marijan Haberle. In only 115 days till the vernissage a number of 13 pavilions were built, there of 7 made for foreign countries by selected national architects. For the following event in 1957 the new Fair was completed, i.e. substantially enlarged to the extension plan by Božidar Rašica to comprise a total of 21 exhibition pavilions: nine for domestic exhibitors designed by renowned Croatian architects, and ten other ones for foreign exhibitors (USA, Austrian, BRD and DDR) in addition to the already ­existing one and also one more for collective foreign shows as well as one for domestic representatives of foreign industries. In the upcoming decade or so several new pavilions were built, the others changed owners or users. Above all, however­ (new) Zagreb Trade Fair, generously arranged, embellished in time with fine landscaping and a number of open-air sculptural accents, was not only a prestigious international commercial event. Its premises became an ­unrivaled arena for most direct head-to-head competition of radically opposed Western and Eastern worlds, involving­ (following the establishment of Non-Aligned Movement 1961), also 3rd World countries in the famous AYA – Africa­ -Yugoslavia-Asia exhibition hall