To assess incidence and magnitude of the "lower inflection point" of the chest wall, the sigmoidal equation was used in 36 consecutive patients intubated and mechanically ventilated with acute lung injury (ALI). They were 21 primary and 5 secondary ALI, 6 unilateral pneumonia, and 4 cardiogenic pulmonary edema. The lower inflection point was estimated as the point of maximal compliance increase. The low constant flow inflation method and esophageal pressure were used to partition the volume-pressure curves into their chest wall and lung components on zero end-expiratory pressure. The sigmoidal equation had an excellent fit with coefficients of determination >0.90 in all instances. The point of maximal compliance increase of the chest wall ranged from 0 to 8.3 cmH2O (median 1 cmH2O) with no difference between ALI groups. The chest wall significantly contributed to the lower inflection point of the respiratory system in eight patients only. The occurrence of a significant contribution of the chest wall to the lower inflection point of the respiratory system is lower than anticipated. The sigmoidal equation is able to determine precisely the point of the maximal compliance increase of lung and chest wall.
ResumoEste artigo busca elaborar uma definição para o conceito de "consumo de experiência", estabelecendo sua distinção daquilo que seria a "experiência de consumo". Para isso, serão utilizadas referências teóricas da antropologia do consumo, como Colin Campbell (2001) e Grant McCraken (2003. Em linhas gerais, a diferença entre o "consumo de experiência" e a "experiência do consumo" reside, principalmente, em que o primeiro pressupõe a total imersão do indivíduo em um ambiente alusivo a uma memória anterior e ao deslocamento do significado de identidades, objetos, ambientes, entre outros elementos constitutivos do mundo real. O "consumo de experiência", ainda que vivenciado coletivamente, será sempre subjetivamente elaborado. Palavras-Chave: "Consumo de experiência"; "Experiência de consumo"; Narrativas de consumo. Campbell (2001) and Grant McCraken (2003) will be used. Summing up, the difference between "consumption of experience" and "experience of consumption" is mainly that the former involves full immersion of the individual in a elusive environment at a previous memory and resources of displacement of identities, objects, environments, and other elements of the real world. The "consumption of experience", although experienced collectively, is always subjectively configured. Abstract This paper aims to draft a definition for the concept of "consumption of experience", establishing a distinction of what would be the "experience of consumption". For this, theoretical references of the consumer anthropology such as Colin
BACKGROUND:To maximize the likelihood of successful long-term mechanical ventilation (MV) in patients with neuromuscular diseases, ventilator characteristics and settings must be chosen carefully, taking into account both medical requisites and the patient's preference and comfort. OBJECTIVES: To evaluate patients' knowledge about and comfort with their long-term MV; to compare patients' and prescribers' opinions and expectations regarding long-term MV; and to compare the equipment used by the patients to the prescribers' current MV prescription. METHODS: Neuromuscular patients receiving long-term MV, and home MV prescribers in Belgium and France were asked to respond to a questionnaire survey specifically developed for the study. RESULTS: Completed questionnaires were collected from 209 patients (mean age 35.4 ؎ 15.9 y, range 3-86 y), ventilated since 11 ؎ 17 year, and 45 MV prescribers. One hundred sixty-three (78%) patients correctly designated their MV mode as a volume or pressure controlled mode. When an inspiratory trigger was available, 92% of the patients were able to use it, but only 69% were satisfied. Prescribers were more prone than patients to use new technologies such as an emergency-release system for the noninvasive interface (1-10 visual analog scale score 9.2 ؎ 1.5 vs 6.8 ؎ 3.3, P < .001), a humidification system (8.6 ؎ 1.4 vs 7.8 ؎ 2.6, P ؍ .02), a contactor for providing larger inspiratory volumes (8.4 ؎ 1.7 vs 6.0 ؎ 3.0, P ؍ .009), a built-in cough assistance mode (9.2 ؎ 1.4 vs 5.5 ؎ 3.5, P < .001), new options to improve speech, or new MV modes such as a volume-targeted pressure control. CONCLUSIONS: The opinions of patients and prescribers differed about the ideal home ventilator. Patients were less prone to use new technologies, mainly because of a lack of information, underlining the need for regular MV update in patients receiving long-term MV.
Observando uma rede virtual de relacionamento, o Orkut, é possível identificar um sistema de classificação determinado pela forma com que os usuários interagem dentro das comunidades. O wannabe é um dos tipos que fazem parte desse universo. Os principais objetivos deste artigo são analisar de que forma a adolescência constrói sua identidade a partir de processos de distinção e controle social na Internet, tomando os aspectos relacionados ao gênero e ao corpo como centrais para a discussão, e refletir sobre os significados atribuídos, nessa fase da vida, a conceitos como "estilo de vida" e "estado de espírito" dentro de dois tipos de comunidades virtuais: a dos "góticos", tribo urbana detentora de uma dada feminilidade, e a das "pró-anas", estritamente virtual, que defende as práticas da anorexia como um estilo de vida.
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