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The purpose of this randomized, double-blind study was to evaluate the efficacy of midazolam and propofol for postoperative sedation and early extubation following cardiac surgery. ASA physical status II-III patients scheduled to undergo elective first-time cardiac surgery with an ejection fraction > 45% were eligible. All patients received a standardized sufentanil/isoflurane anaesthesia. During cardiopulmonary bypass 100 micrograms.kg-1.min-1 propofol was substituted for isoflurane. Upon arrival in the Intensive Care Unit (ICU), patients were randomized to either 10 micrograms.kg-1.min-1 propofol (n = 21) or 0.25 microgram.kg-1.min-1 midazolam (n = 20). Infusion rates were adjusted to maintain sedation within a predetermined range (Ramsay 2-4). The infusion was terminated after four hours. Patients were weaned from mechanical ventilation and their tracheas extubated when Haemodynamic stability, haemostasis, normothermia and mental orientation were confirmed. Haemodynamic measurements, arterial blood gas tensions and pulmonary function tests were recorded at specified times. There were no differences between the two groups for the time spent at each level of sedation, number of infusion rate adjustments, amount of analgesic and vasoactive drugs, times to awakening and extubation. The costs of propofol were higher than those of midazolam. There were no differences in haemodynamic values, arterial blood gas tensions and pulmonary function. We conclude that midazolam and propofol are safe and effective sedative agents permitting early extubation in this selected cardiac patient population but propofol costs were higher.

To compare the hemodynamic effects of sevoflurane when used for induction and maintenance of anesthesia with a total intravenous technique in patients with known coronary artery disease (CAD). Thirty patients undergoing elective coronary artery bypass graft (CABG) were randomly allocated to receive either sevoflurane (S group, n = 15) at a minimal concentration of 4% in oxygen for induction and at 0.5-2 MAC end-tidal concentration for maintenance, or a total intravenous technique (T group, n = 15) consisting of midazolam for induction and propofol for maintenance. In both groups, anesthesia was supplemented with sufentanil and muscle relaxation with cis-atracurium. Hemodynamic measurements included systemic and pulmonary pressures, heart rate, mixed venous oxygen saturation and cardiac output at the following times: pre-induction, 7 and 25 min post-induction, chest closure, one hour after surgery and pre and post tracheal extubation. More patients in the S group (8/15) presented bradycardia in the induction period (T:2/15) (P = 0.05). During maintenance of anesthesia, treatment of hypertension was more frequent in the T group (12/15) than in the S group (6/15) (P = 0.025). All other parameters were comparable. Induction of anesthesia in patients with CAD, VCRII with sevoflurane supplemented by sufentanil provided hemodynamic responses comparable with those of TIVA although bradycardia was observed more often with sevoflurane. Intraoperative control of systemic blood pressure was achieved with fewer interventions with a sevoflurane/sufentanil maintenance than with a propofol/sufentanil technique in CABG surgery.

PurposeTo compare the hemodynamic effects of sevoflurane when used for induction and maintenance of anesthesia with a total intravenous technique in patients with known coronary artery disease (CAD).MethodsThirty patients undergoing elective coronary artery bypass graft (CABG) were randomly allocated to receive either sevoflurane (S group, n = 15) at a minimal concentration of 4% in oxygen for induction and at 0.5-2 MAC end-tidal concentration for maintenance, or a total intravenous technique (T group, n = 15) consisting of midazolam for induction and propofol for maintenance. In both groups, anesthesia was supplemented with sufentanil and muscle relaxation with cis-atracurium. Hemodynamic measurements included systemic and pulmonary pressures, heart rate, mixed venous oxygen saturation and cardiac output at the following times: pre-induction, 7 and 25 min post-induction, chest closure, one hour after surgery and pre and post tracheal extubation.ResultsMore patients in the S group (8/15) presented bradycardia in the induction period (T:2/15) (P = 0.05). During maintenance of anesthesia, treatment of hypertension was more frequent in the T group (12/15) than in the S group (6/15) (P = 0.025). All other parameters were comparable.ConclusionInduction of anesthesia in patients with CAD, VCRII with sevoflurane supplemented by sufentanil provided hemodynamic responses comparable with those of TIVA although bradycardia was observed more often with sevoflurane. Intraoperative control of systemic blood pressure was achieved with fewer interventions with a sevoflurane/sufentanil maintenance than with a propofol/sufentanil technique in CABG surgery.

The COVID-19 pandemic has drastically changed the lives of countless members of the general population. Older adults are known to experience loneliness, age discrimination, and excessive worry. It is therefore reasonable to anticipate that they would experience greater negative outcomes related to the COVID-19 pandemic given their increased isolation and risk for complications than younger adults. This study aims to synthesize the existing research on the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults. The secondary objective is to investigate the impact of the COVID-19 pandemic, and associated isolation and protective measures, on older adults with Alzheimer disease and related dementias. A rapid review of the published literature was conducted on October 6, 2020, through a search of 6 online databases to synthesize results from published original studies regarding the impact of the COVID-19 pandemic on older adults. The Human Development Model conceptual framework-Disability Creation Process was used to describe and understand interactions between personal factors, environmental factors, and life habits. Methods and results are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement. A total of 135 records were included from the initial search strategy of 13,452 individual studies. Of these, 113 (83.7%) studies were determined to be of level 4 according to the levels of evidence classification by the Centre for Evidence-Based Medicine. The presence of psychological symptoms, exacerbation of ageism, and physical deterioration of aged populations were reported in the included studies. Decreased social life and fewer in-person social interactions reported during the COVID-19 pandemic were occasionally associated with reduced quality of life and increased depression. Difficulties accessing services, sleep disturbances, and a reduction of physical activity were also noted. Our results highlight the need for adequate isolation and protective measures. Older adults represent a heterogeneous group, which could explain the contradictory results found in the literature. Individual, organizational, and institutional strategies should be established to ensure that older adults are able to maintain social contacts, preserve family ties, and maintain the ability to give or receive help during the current pandemic. Future studies should focus on specific consequences and needs of more at-risk older adults to ensure their inclusion, both in public health recommendations and considerations made by policy makers.

PurposeThe purpose of this paper is to provide a portrait of the main managerial and organizational determinants of organizational capability to innovate (OCI). Despite its importance, research on the subject seems limited, and little attempt has been made, over the years, to offer an in-depth and simultaneous analysis of these particular determinants, as well as an exploration of the underlying and complex mechanisms explaining their relationships to OCI.Design/methodology/approachA systematic review of articles published between 1991 and 2018 was conducted in ProQuest (ABI/INFORM Collection) and Scopus databases. A total of 64 articles were selected and analysed through the use of a coding grid.FindingsResults highlight five key OCI determinants, namely: leadership, support, communication, culture, and learning. By using the dynamic capabilities theory (DCT) as a framework, this research suggests ways to better understand the dynamic action of these determinants as well as their contributions to OCI. Findings also suggest that OCI should be defined at the confluence of three perspectives (human, procedural and environmental aspects) to embrace the multiple facets of this complex construct. Proposals for future research are provided on how OCI can be better examined.Originality/valueThis research helps to understand the five core determinants through an integrated and holistic view and represents the first attempt to systematically analyse the scientific literature on OCI through the DCT lens.

PurposeThe purpose of this paper is to provide a portrait of the main managerial and organizational determinants of organizational capability to innovate (OCI). Despite its importance, research on the subject seems limited, and little attempt has been made, over the years, to offer an in-depth and simultaneous analysis of these particular determinants, as well as an exploration of the underlying and complex mechanisms explaining their relationships to OCI.Design/methodology/approachA systematic review of articles published between 1991 and 2018 was conducted in ProQuest (ABI/INFORM Collection) and Scopus databases. A total of 64 articles were selected and analysed through the use of a coding grid.FindingsResults highlight five key OCI determinants, namely: leadership, support, communication, culture, and learning. By using the dynamic capabilities theory (DCT) as a framework, this research suggests ways to better understand the dynamic action of these determinants as well as their contributions to OCI. Findings also suggest that OCI should be defined at the confluence of three perspectives (human, procedural and environmental aspects) to embrace the multiple facets of this complex construct. Proposals for future research are provided on how OCI can be better examined.Originality/valueThis research helps to understand the five core determinants through an integrated and holistic view and represents the first attempt to systematically analyse the scientific literature on OCI through the DCT lens.

L’intimidation liée au poids s’observe fréquemment à l’école secondaire. L’objectif de la présente étude est d’explorer le point de vue d’adolescents sur ce phénomène et les stratégies visant à le contrer. Pour ce faire, des entrevues ont été réalisées auprès de 19 jeunes, âgés de 14 à 17 ans. Elles exploraient ce type d’intimidation, les facteurs explicatifs, les conséquences et l’efficacité des stratégies d’intervention. Les jeunes interrogés suggèrent que l’intimidation en lien avec le poids est subtile et qu’elle a d’importantes conséquences. Des stratégies visant à mobiliser les adultes et les pairs envers les jeunes qui subissent l’intimidation et à apporter un soutien émotionnel sont à préconiser, alors que les sanctions et la surveillance sont à éviter.

Recoverin is a protein involved in the phototransduction cascade by regulating the activity of rhodopsin kinase through a calcium-dependent binding process at the surface of rod outer segment disk membranes. We have investigated the interaction of recoverin with zwitterionic phosphatidylcholine bilayers, the major lipid component of the rod outer segment disk membranes, using both 31 P and 19 F solid-state nuclear magnetic resonance (NMR) and infrared spectroscopy. In particular, several novel approaches have been used, such as the centerband-only detection of exchange (CODEX) technique to investigate lipid lateral diffusion and 19 F NMR to probe the environment of the recoverin myristoyl group. The results reveal that the lipid bilayer organization is not disturbed by recoverin. Non-myristoylated recoverin induces a small increase in lipid hydration that appears to be correlated with an increased lipid lateral diffusion. The thermal stability of recoverin remains similar in the absence or presence of lipids and Ca 2+ . Fluorine atoms have been strategically introduced at positions 4 or 12 on the myristoyl moiety of recoverin to, respectively, probe its behavior in the interfacial and more hydrophobic regions of the membrane. 19 F NMR results allow the observation of the calcium–myristoyl switch, the myristoyl group experiencing two different environments in the absence of Ca 2+ and the immobilization of the recoverin myristoyl moiety in phosphatidylcholine membranes in the presence of Ca 2+ .

L’intérêt pour la prédiction du développement ultérieur de l’enfant, à partir de la période périnatale, n’est pas récent. Le pari de la science actuelle est qu’en comprenant les mécanismes, les processus et les facteurs qui sont impliqués dans cette prédiction, nous pouvons mieux soutenir le développement de nos enfants. Au-delà des stratégies d’intervention fondée sur la bonne volonté, les travaux en cours nous permettent de croire que la prévention réalisée en période périnatale aurait, en partie, cette incidence espérée.Par l’entremise de cet ouvrage pluridisciplinaire, nous souhaitons outiller les personnes intervenantes, étudiantes et professionnelles à propos des facteurs de risque périnataux et des interventions préventives qui y sont associés. Nous espérons ainsi pouvoir mobiliser des efforts collectifs à tous les niveaux pour que nos actions envers les enfants puissent se réaliser à la hauteur de nos possibilités et de nos ambitions.