Temperature management on cardiopulmonary bypass: Is it standardised across Great Britain and Ireland?

Perfusion ◽  
2021 ◽  
pp. 026765912199599
Author(s):  
Lorraine P Browne

Temperature management is an essential element of cardiopulmonary bypass (CPB), as indicated in the Guide to Good Practice in Clinical Perfusion, ‘The safe conduct of CPB requires the clinical perfusionist to measure and control. . . blood temperature. . . during the period of bypass’. To review current practice, we have conducted a research survey into the management of temperature on CPB. Surveys were distributed to each centre in Great Britain and the Republic of Ireland, investigating numerous temperature management practices, to elucidate current practice and assess if recent research into temperature management marry routine clinical practice. Our results demonstrate that nasopharyngeal temperature is the most common (52%) temperature site used across the many centres, which correlates with previous research as a routine site for cerebral temperature management. The arterial outlet of the oxygenator temperature was used in 33% of centres, however, all centres lacked the knowledge to maintain this temperature below 37°C. There was significant variation between all centres, especially regarding rewarming times (20–40 minutes), demonstrating a lack of uniformity among perfusion centres. Interestingly, most centres have been using the same protocol that has been in place over the previous 10 years. To conclude, the practice of temperature management is changing with the awareness of new research. Lower target temperatures are recommended for rewarming, ensuring a lower temperature gradient and a longer mean rewarming time.

2017 ◽  
Vol 79 (03) ◽  
pp. 289-296 ◽  
Author(s):  
Jamie Van Gompel ◽  
R. Wiet ◽  
Nicole Tombers ◽  
Anand Devaiah ◽  
Devyani Lal ◽  
...  

Background Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America. Methods This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care. Results A total of 57 completed surveys were returned. Most respondents claimed to have over 20 years of experience and the majority reported working in an academic practice with an affiliated otolaryngology and/or neurosurgery residency program. Sixty-three percent of respondents claimed to evaluate VS patients in clinic with both an otolaryngologist and neurosurgeon involved. Eighty-six percent of respondents claimed to operate on VS with both an otolaryngologist and neurosurgeon involved, while only 18% of neurosurgeons and 9% of otolaryngologists performed surgery alone. There was a wide range in the number of cases evaluated at each center annually. Similarly, there was wide variation in the number of patients treated with microsurgery and radiation at each center. Additional details regarding management preferences for microsurgery, stereotactic radiosurgery, stereotactic radiotherapy, and conservative observation are presented. Conclusion VS management practices vary between providers and centers. Overall, most centers employ a multidisciplinary approach to management with collaboration between otolaryngology and neurosurgery. Overall, survey responses concur with previous studies suggesting a shift toward conservatism in management.


2018 ◽  
pp. 310-316 ◽  
Author(s):  
Hassan Zeb ◽  
Azhar Hussain ◽  
Muhammad Naveed ◽  
Allah Ditta ◽  
Shakeel Ahmad ◽  
...  

Zinc (Zn) is an essential element for humans, animals and plants, however, its deficiency has been widely reported around the world especially in flooded rice. Adequate amount of Zn is considered essential for optimum growth and development of rice. We hypothesised that management practices like Zn-mineral fertiliser, -compost, and -solubilising bacteria would improve Zn availability and uptake in flooded rice. A series of studies were conducted to find out the comparative efficacy of Zn-enriched composts (Zn-ECs) with Zn solubilising bacteria (ZnSB) vs. ZnSO4 for improved growth, yield and Zn accumulation in rice. There were six treatments viz. control, ZnSB, ZnO (80% Zn), ZnSO4 (33% Zn), Zn-EC80:20 and Zn-EC60:40. In all the treatments, Zn was applied at the rate of 5 kg ha–1 except the control. The treatment Zn-EC60:40 resulted in the maximum Zn release in soil as compared to ZnSO4 and all other treatments during incubation study. The treatment Zn-EC60:40 significantly improved root dry weight, grain yield and 100-grain weight of rice by 15, 22 and 28%, respectively as compared to ZnSO4. The same treatment resulted in the maximum increase in photosynthetic rate (11%), transpiration rate (21%), stomatal conductance (17%), chlorophyll contents (8%) and carbonic anhydrase activity (10%) while a decrease of 27% in electrolyte leakage was observed in comparison with ZnSO4 application. Moreover, the maximum increase in grain quality parameters and Zn bioaccumulation was observed with the application of Zn-EC60:40 in comparison with ZnSO4 application and all other treatments. We conclude that Zn-EC60:40 are not only an effective strategy to improve growth, physiology and yield parameters of rice, but also to improve the grain quality and Zn-bioaccumulation in rice compared to ZnSO4.


2021 ◽  
Author(s):  
Andrzej Kielian

In a time of profound cultural change, Catholic Religious Education (CRE) is challenged to find new ways of engaging with young people. Whilst theoretical reflection is important, it is critical to disseminate good practice in didactics and in preparing textbooks for students. These two go together alongside as an effective work with didactic material entails a good teachers’ preparation. The aim of this book is to present the significance of good religious education in the creation of new social references in the global dimension. The community-building capital of the interactive media is potential that should be made use of in religious education in schools. After all, digital culture is an important “theological place” (locus theologicus). Thus, both the didactics of religious education and broadly understood theological thinking are necessarily confronted with the global culture flows that despite their ambivalence are an opportunity to make theology as well as its transmission in schools more universal, that is catholic, to a larger degree. This “new catholicity” that is achieved thanks to digital communication can effectively lead to the updating of the theological vision of the Church as well as the initiation of new forms of intercultural and interreligious dialogue. This work is analytical-synthetic in nature. The first chapter consists of a general description of the cultural and social changes brought about by technological discoveries in the late twentieth and early twenty-first centuries. This analysis strives to search for an answer to the question about the causes of the change of surrounding in which pupils who are subject to new educational contexts grow up. Meanwhile, the second chapter presents selected elements of digital culture that generate the need for new CRE didactics. The new didactics must be multisensory and intermedial, that is, it must combine various means of expression, such as dance theater, performance, happening, or the use of Internet folklore (netlore) artifacts, especially Internet memes and artmemes on various religious issues, that are created and remixed by the students. The use of such methods in didactic work leads to the translation of the code of religious (theological) language to a more comprehensible and easily assimilated linguistic code of digital culture. The theory of the active search for information by the pupil directed by the teacher that has been elaborated by Richard E. Mayer is the recurring thought in the reflections on didactics. Finally, the last chapter contains a discussion on the adequate model of the textbook: digital or analog. An example of the creation of a religion textbook for a representative of digital culture is the pilot project of the Krakow group of authors of CRE textbooks. It can be called an open source expert model. This consists of a group of experienced teachers (catechists) writing the essential contents of the textbooks. Next, these contents are verified by selected pupils and parents. Only later are the contents proofread, analyzed with respect to their theological accuracy, and, finally, reviewed by valuers of CRE textbooks of the Commission for Catholic Education of the Polish Episcopal Conference. The involvement of students who verify the language used in textbooks and assess the activities and tasks proposed in various exercises, that should take into account multisource and multisensory approach, is an essential element of the new way of developing CRE textbooks. This book is to serve as a forum for discussion on determining topics related to the future of religious education amidst digital culture surroundings and undertaking further research on means of transitioning from the theory of the CRE didactics to living practice in the classroom.


Plant Disease ◽  
2021 ◽  
Author(s):  
Avanish Rai ◽  
Vadivelmurugan Irulappan ◽  
Muthappa Senthil-Kumar

Chickpea is an essential crop for protein nutrition and is grown around the world in rain-fed conditions. However, chickpea cultivation is under threat due to emerging diseases favored by drought stress. Dry root rot (DRR), an economically devastating disease, is an example. Chickpea-specific strains of a necrotic fungal phytopathogen, Macrophomina phaseolina, cause DRR. Microsclerotia of this fungus, which are capable of withstanding harsh environmental conditions, serve as primary inoculum. Initial symptoms are scattered necrotic spots in roots, progressing to rotting and withering lateral roots, accompanied by prematurely dried, straw-colored foliage. The recent rise in global temperature and worsening of drought spells have aggravated DRR outbreaks in chickpea. To date, DRR epidemiology has not been clarified in detail. Also, the literature lacks clarity on M. phaseolina taxonomy, morphology, disease progression, and diagnosis. In this article, research progress on patterns of DRR occurrence in the field and belowground and above-ground symptoms are clarified. In addition, the current understanding of taxonomy and management practices is elaborated. We also summarize knowledge of the impact of drought and high temperature on DRR severity. Further, we provide future perspectives on the importance of host resistance, QTL identification, genotype screening for the identification of resistant genotypes. The article proposes new research priorities and a corresponding plan for the mitigation of DRR.


2013 ◽  
Vol 53 (9) ◽  
pp. 924 ◽  
Author(s):  
A. D. Fisher ◽  
J. R. Webster

Pasture-based dairying in New Zealand and Australia has come under increasing animal welfare scrutiny as a result of changing public expectations for farm animal management. Concurrently, efficiency-driven changes in dairy management practices and a broadening of the feedbase beyond traditionally grazed pasture have resulted in increased intensification and stocking density within the dairy industries. This intensification has included a higher proportion of grain concentrates in the diet (particularly in Australia), and the greater management of cows off pasture and even in housing (particularly in New Zealand). Research to assess the animal welfare implications of these changes and to recommend good practice management has concentrated on issues of cow environments and cow feeding, including body condition. Research has shown that cows may be managed for a few hours per day on concrete surfaces without compromising their lying behaviour and other indicators of welfare, but that longer periods off pasture require the provision of a well drained and comfortable lying surface. Other research has defined the extremes of hot and cold/wet conditions beyond which cows benefit from provision of adequate shade and shelter. Research on cow body condition has indicated that welfare responses are aligned with measures of health and productivity in supporting the need to maintain a minimum body condition before calving and during the subsequent weight loss period of early lactation. Continued research, extension and industry adoption will enable dairy producers to address community expectations as they continue to change their farming practices.


2011 ◽  
Vol 24 (4) ◽  
pp. 470-476
Author(s):  
Vera I. Saburova

Aspects of the current practice of prenatal diagnostics in Russia are surveyed. In the light of this, various ethical concerns are highlighted: (1) the requirement of parental informed consent to testing is not always sufficiently respected either in state regulation or in the practice of physicians; (2) not all Russian physicians are aware of international guidelines or standards of good practice in areas such as non-directive counselling, patient confidentiality with respect to genetic information and the patient’s right to maintain control over his or her information; (3) abortion is viewed increasingly as an aspect of preventive medicine.


2017 ◽  
Vol 39 (4) ◽  
pp. 612-617 ◽  
Author(s):  
Kaitlin A Pruskowski ◽  
Julie A Rizzo ◽  
Beth A Shields ◽  
Rodney K Chan ◽  
Ian R Driscoll ◽  
...  

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jamini Ranjan Meher ◽  
Rohita Kumar Mishra

Purpose This study aims to identify the key contributing factors of knowledge management (KM) practices with respect to an employee benefit. The research is designed to gain insight into the KM practices of Indian information technology (IT) firms and evaluate its effects on employee perceived benefit (EPB) and employee satisfaction (ES). Design/methodology/approach This study focuses on the cause and effect relationship between the variables. In this research study, a structured questionnaire is administered and accumulated responses from executives, software developers and knowledge managers from five IT firms with the help of google form. The sample size was 339 for this study. Confirmatory factor analysis and partial least square (PLS)-structural equation modeling have been used to analyze the data with the help of SMART-PLS software. Findings The well-fitted model describes the importance of KM practices with respect to increasing employee benefit and satisfaction. The hypothesized model is empirically investigated and it is also supported by the analysis. The KM practices have significant effects on EPBs. Employee benefits have a significant effect on ES. The result shows that the benefits of KM practices are more intended toward the sources of motivation where they can increase their capability with the help of KM practices. Research limitations/implications Benefit leads to the motivation and satisfaction of employees. The work itself can be a highly motivating dimension with the help of proper KM practices. The managers’ prime responsibility is to focus on collaborative work with regularizing the exchange of knowledge, where new knowledge can be created and, do better for the organization. Originality/value This research study offers a new direction of motivation to work. The employee can be highly motivated if he can be benefited from the work itself. This study gives an approach to satisfy the employee with the help of KM practices. Perceived benefit is considered as an essential element for this study.


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