Modern approaches to the correction of hemodynamic disorders in patients with severe combined trauma

Background. The choice of a rational program of infusion therapy for severe trauma remains an urgent problem. Crystalloid solutions are used as the main infusion media, but data on the effect of balanced multicomponent solutions on the hemodynamic profile in patients with severe trauma in the literature are almost absent. The aim: to investigate the possibility of correction of hemodynamic disorders in patients with severe combined trauma with the use of a modern multicomponent drug based on a 6% solution of sorbitol (reosorbilact). Material and methods: a total of 60 patients with severe combined trauma and the clinic of degree I–II traumatic shock aged 18 to 46 years were examined. Patients were divided into two groups: 1st group (n = 30) – patients who included in the standard complex of intensive care (IС) reosorbilact at a dose of 8–10 ml/kg body weight; 2nd group (n = 30) – patients who underwent a standard IС complex. Results: administration of reosorbilact resulted in a decrease in extracellular fluid volume, an increase in BCC and a transition from hypokinetic to eukinetic circulation within 3 hours of infusion and persisted for up to 6 hours after infusion (p < 0.01). The introduction of adrenomimetics were required: before the study in groups 1 and 2 – 7 (23.3 %) and 6 (20.0 %) patients, after 6 hours – respectively 1 (3.3 %) and 4 (13.3 %), and one day after the introduction of reosorbilact no patient required the introduction of adrenomimetics, whereas in group 2 such patients were 3 (10.0 %, p < 0.05). Conclusions. The use of balanced multicomponent solutions based on sorbitol is accompanied by a change in the hypokinetic type of blood circulation to eukinetic, lack of interhydration hyperhydration, rapid stabilization of hemodynamic parameters and reduced need for adrenomimetic support. Conflict of interest: absent

Critical Fungicide Spray Period for Citrus Black Spot Control in São Paulo State, Brazil

The period of citrus black spot (CBS) control used in South Africa (SA) and Australia, from October to January or February, has not been as effective in São Paulo (SP), Brazil. This study aimed to evaluate different periods of protection and determine the critical period for CBS control in SP. A field trial was carried out for two seasons in a mature Valencia sweet orange orchard located in Mogi Guaçu, SP. Spray programs with a total of 60, 100, 140, 180, and 220 days of fruit protection (DFP) were evaluated. CBS symptoms and fruit drop decreased exponentially as the length of the period of protection increased. The reductions in CBS intensity and crop loss with these programs ranged from 34 to 96 and 50 to 77%, respectively. The programs with 180 and 220 DFP, which protected the fruit from September to March and May, showed the highest cost benefit. The critical period needed for CBS control in SP is longer than that in SA and Australia. The results obtained with the present study are helpful for scheduling a more efficient and rational program for CBS control not only in SP but also in other tropical and subtropical regions with similar weather conditions.

Å beslutte med henblikk på risiko? – Når politikken dytter ansvaret over på barnevernets ansatte

Artikkelens tema er hvordan barnevernet, gjennom sine kommunikative beslutninger, skaper praksis. Mer konkret har jeg undersøkt hvordan saksbehandlerne i barnevernetsundersøkelser kommer frem til beslutninger gjennom å forholde seg til ulike forventninger. Gjennom analysen synliggjøres det hvordan barnevernetsundersøkelser langt på veiblir styrt av forventninger den enkelte saksbehandler og forelder ønsker å innfri. Disse handler for eksempel om å ha minst en samtale med barnet, samt å følge en undersøkerplan. Dermed blir det å ikke følge undersøkerplanen eller det å ikke snakke med barnet sett som usikre handlingsvalg mot målet om å sikre ”den gode undersøkelse”. Barnevernets beslutninger vil dermed inngå i et i et rasjonaliseringsprogram hvor hensikten eller målet er å unngå risiko. På den måten synes barnevernetsundersøkelser å være styrt av en risikopolitikk som tjenerhensikten å være på den sikre siden og hvor fremtidens nødvendige uvisshetblirbarnevernets problem. Risikopolitikken bringer barnevernetinn i enpraksis det ikke selv har definert og setter dermed barnevernetinn i en tilstandav fare. Politikken påleggerbarnevernet å omsette alle svake punkter tilforebyggelsesprogrammer med den hensikten å sikre ”den gode praksis”. Detbetyr en praksis hvor standardisering og maler blir de mest opplagte svarene.På den måtenblir det barnevernet som organisasjon som bærer ansvaret foreventuelle feilvurderinger – ikke den politikken som ligger til grunn for handlingene.Ansvaret dyttes dermed over på barnevernets ansatte. Søgeord: Niklas Luhmann, risikopolitikk, barnevern, beslutninger, sosialtarbeid ENGELSK ABSTRACT: Hilde AnetteAamodt: Making decisions due to “risk” The purpose of this article is to analyze how child welfare services create practice through communicative decisions. It analyzes how caseworkers in child welfare investigations arrive at their decisions by dealing with different expectations. The analysis showed that child welfare investigations are controlled to a great extent by a predetermined template that defines what will happen during these investigations. The caseworkers have clear expectations as they attempt to follow fulfill the plan. These include having at least one conversation with the child, as well as following the examination template. Therefore not doing one or either of these is considered an unsafe action as regards “doing a good examination.” Decisions about the child’s welfare will therefore be part of a rational program, where the purpose or goal is to avoid risk. In that way, child welfare investigations appear to be governed by a risk policy that serves the purpose of being on the safe side, and where any uncertainties in the future become the problem of the welfare agency. This risk policy means that the child welfare service practice is not clearly defined, hence endangering child welfare. The policy requires the child welfare service to transform all weak points in the prevention programs to ensure “good practice”. This means that standardization and templates are the most obvious answers to good practice. In this way, the child welfare service is an organization which bears responsibility itself for any errors of judgment – not the policies themselves. Responsibility is hence transferred to the child welfare service employees. Keywords: NiklasLuhmann, risk politics, social work, child welfare, decisions

Informacinių technologijų valstybinio brandos egzamino praktinių užduočių ypatumai

Informacinių technologijų valstybinio brandos egzamino sudėtis: IT ir programavimo testas sudaro 50 %, praktinės programavimo užduotys – 50 %. Egzamino programoje numatyta, kad egzamino medžiaga turi tenkinti tokius reikalavimus: žinios ir supratimas – 30 %, praktiniai įgūdžiai – 30 % ir problemų sprendimas – 40 %. Testu tikrinamos žinios ir praktiniai įgūdžiai, praktinėmis užduotimis tikrinamas mokinių gebėjimas savarankiškai, priimti sprendimus, parašyti racionalią programą. Straipsnyje nagrinėjama užduoties sprendimo būdo parinkimo, duomenų struktūrų sukūrimo ir gebėjimų taikyti algoritmus svarba rengiant mokinius informacinių technologijų valstybiniam brandos egzaminui.The Peculiarities of Practical Tasks of Information Technology State ExaminationJonas Blonskis, Renata Burbaitė, Valentina Dagienė SummaryThe composition of Information Technologies State examination (IT SE) is the following: the test of IT and programming composes 50 % and practical programming tasks – 50 %. In the examination program, it is determined that the examination material has to meet the following requirements: knowledge and understanding – 30 %, practical skills – 30 % and problem solving – 40 %. While the test examines the knowledge and practical skills, the practical tasks are used to examine pupils’ ability to think independently, make decisions and write a rational program. It involves selecting a way to solve the task, creating data structures and realizing algorithms to work with data in the mentioned structures, and ability to fi nd nonstandard ways of algorithms application. Some teachers also ascribe task diffi culty to the aforementioned.

Lubricated Friction of Rubber. II. Interaction of Rubber and Sliding Surfaces

Skid resistance of tires on wet pavements in an important component of tire safety; it is important to evaluate it precisely under conditions which are pertinent to actual use. The closest approximations to practical conditions are provided by measures of side force coefficient or by locked wheel sliding, both of which are related to problems of vehicle control. However, both of these require that a test vehicle be provided with four identical tires, that a surface large enough to test on be available, and that all test conditions including the nature of the surface be reproducible. For any rational program of research, costs of comparing materials of tire and of road would mount astronomically unless a controlled laboratory test were available which is well correlated with field experience, so that many variables can be studied conveniently in the laboratory. Such a test is available in the applications of the Portable Skid Resistance Tester. Results with this apparatus have been shown to correlate well with those from tests of vehicles on roads over a range of road properties, correlations apparently being with properties of a patterned tire. The results have been further shown to be well correlated with accident statistics. This report will show that correlations with tests on vehicles are valid over a wide variation in rubber properties as well.