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A focus group at the University of Huddersfield showed that students were generally open to hypertension drug best 10 mg bisoprolol the idea of receiving text messages about library news and functions arrhythmia occurs when purchase bisoprolol uk, such as a reminder for an overdue book prehypertension during pregnancy purchase generic bisoprolol line. However, they emphasized the importance of only receiving messages that were useful in nature. Social Networking Sites such as Facebook are one of the latest examples of communications technologies that have been widely-adopted by students and, consequently, have the potential to become a valuable resource to support their educational needs. Student usage of Facebook was the subject of a study in which ninety-two undergraduates kept a diary-like log each day for a week. Results published in 2009 showed that students spent approximately 30 minutes on Facebook throughout the day, mostly reading and observing content. In 2007, librarians Sarah Miller and Lauren Jensen offered tips for increasing student response to library services and information via Facebook, such as understanding that Facebook is all about connecting with the students. In fact, in one study13, librarians wanted to determine which source students would use more to ask reference and research related questions: email, phone, instant message, Facebook, or in-person (Mack, Behler, Roberts, & Rimland, 2007, p. Students in this study preferred asking their reference and research related questions using Facebook and email even more than face to face. In 2007, librarians Sarah Miller and Lauren Jensen suggest14, among other things, keeping the profile active, updated, and current; using the newsfeed feature; replying promptly to student questions; sharing favorite books, interests, and quotes; and promoting new databases and library services. Electronic Journal of Academic and Special Librarianship, 8(2) Retrieved from southernlibrarianship. This study provides an insight into the perception and use of emerging technologies by students at the selected educational institutions in Dakshina Kannada (India). St Agnes College and St Aloysius College situated at Mangalore and Sri Dharmasthala Manjunatheswara College, Ujire were selected for the study. The survey included both on-campus and distance-learning students, since the libraries strives to serve the diverse needs of both groups. The investigator personally visited these institutions to collect data from the respondents. Structured questionnaires were employed to collect data from a representative sample of 200 students. The users under both the groups (Master degree and undergraduate students) were randomly selected. Demographic questions, including gender, student classification and faculty they belong to, were asked in the first section of the survey. Participants familiar with a popular technology were also asked to indicate whether they would be interested in library services offered through that specific technology platform. Results and discussions demographics Undergraduate students were the largest group represented in the survey results at over 70 percent of the survey respondents, with 46 percent students pursuing their undergraduate degree through regular courses and 24. The individual areas of study of the respondents were broadly classified into Humanities, Commerce and Science faculties. Almost 54 percent of students used a laptop computer (though the survey did not distinguish between those who personally owned a laptop and those who might borrow one from a family member, roommate, etc). Students were asked to indicate their familiarity with a list of popular or emerging technologies.


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This is because the continuous nature of the process avoids the big swings in fluid balance and electrolytes that characterize dialysis hypertensive disorder purchase genuine bisoprolol on-line. The femoral artery and vein are cannulated and blood passes through the haemofllter under arterial pressure alone arteria y vena poplitea bisoprolol 10 mg fast delivery. Management of the haemoflltered patient A double lumen catheter (Vascath) is inserted into a central vein blood pressure medication depression discount bisoprolol 5mg amex. The replacement fluid pump is programmed to balance the inflow and outflow of fluid to achieve a preset rate of fluid loss. Lactate is the commonest replacement anion, but in lactic acidosis, a lactate-free replacement solution must be employed. There is good evidence of reduced pulmonary, septic, and anastomotic complications in patients fed early. They contain soy polysaccharides that are soluble, but remain undigested passing to the colon where they are fermented by bacteria to produce short chain fatty acids, promoting absorption of sodium and water and reducing diarrhoea. Liquid preparations designed for oral administration should ideally be used as crushed tablets may block the tube. If feed-related, reducing the osmotic load is effective (using half-strength feed or slowing the infusion). It is mandatory to exclude other causes of diarrhoea such as subacute obstruction and infectious causes (particularly Clostridium difflcile). They are given via central lines (subclavian or internal jugular) which may be tunnelled for long-term use. Multiple organ failure Presence of altered organ function in an acutely ill patient such that homeostasis cannot be maintained without intervention. Pathophysiology the pathophysiology involves systems involved in inflammation, immunity, ischaemia, and homeostasis, including complement, clotting and cytokine cascades, cell-mediated immunity, and humoral immunity. It is the pulmonary manifestation of the global physiological insult (rarely occurs in isolation). Investigations these are aimed at excluding differential diagnoses such as overwhelming sepsis, cardiogenic shock, hypovolaemic shock, and hypersensitivity reactions as well as identifying an underlying cause. Prognosis Mortality ranges from 25% to100%, depending on the number and type of organ failures involved, age, and pre-existing comorbidity. Mechanisms of injury these causative agents cause cell damage via a number of mechanisms. Oxygen (ischaemia), glucose (diabetic ketoacidosis), hormones (d trophic hormones results in apoptosis). Coagulative necrosis this is the most common form of necrosis and occurs in all organs. Cells retain their shape as cell proteins coagulate and metabolic activity stops. Colliquative necrosis this occurs in the brain because of the lack of tissue architecture provided by substantial surrounding stroma. Fibrinoid necrosis In malignant hypertension, necrosis of smooth muscle vessel walls allows seepage of plasma into the media and deposition of flbrin. Release of extracellular fat produces an inflammatory response, flbrosis and eventually, in some cases, a palpable mass. Fat is digested by pancreatic lipase to produce fatty acids which precipitate with calcium in the process of saponiflcation. It is the normal means of maintaining the size of an organ in the face of continuing cell turnover or a reduction in size during atrophy. After exposure to ionizing radiation, chemotherapy, smooth muscle cells around atherosclerotic plaque, viral hepatitis. Acute inflammation this is the initial tissue reaction to a wide range of agents: accumulation of neutrophil polymorphs in the extracellular space is diagnostic. Macroscopic appearance Calor, rubor, tumor, dolor, and functio laesa (heat, redness, swelling, pain, and impaired function).

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Although this can be done in a conscious patient focusing on a visual target arrhythmias buy 5 mg bisoprolol, smooth pursuit eye movements may compensate for head turning; hence the head impulse test (q hypertension 150 100 order bisoprolol 5 mg line. The manoeuvre is easier to blood pressure just before heart attack generic bisoprolol 5 mg do in the unconscious patient, when testing for the integrity of brainstem reexes. In many elderly people the extensor tendons are prominent in the absence of signicant muscle wasting. Cross Reference Wasting Double Elevator Palsy this name has been given to monocular elevation paresis. It may occur in association with pretectal supranuclear lesions either contralateral or ipsilateral to the paretic eye interrupting efferents from the rostral interstitial nucleus of the medial longitudinal fasciculus to the superior rectus and inferior oblique subnuclei. This syndrome has a broad differential diagnosis, encompassing disorders which may cause axial truncal muscle weakness, especially of upper thoracic and paraspinous muscles. Treatment of the underlying condition may be possible, hence investigation is mandatory. They occur sporadically or may be inherited in an autosomal dominant fashion, and are common, occurring in 2% of the population. Drusen are usually asymptomatic but can cause visual eld defects (typically an inferior nasal visual eld loss) or occasionally transient visual obscurations, but not changes in visual acuity; these require investigation for an alternative cause. When there is doubt whether papilloedema or drusen is the cause of a swollen optic nerve head, retinal uorescein angiography is required. Cross References Disc swelling; Papilloedema; Pseudopapilloedema; Visual eld defects 114 Dysarthria D Dynamic Aphasia Dynamic aphasia refers to an aphasia characterized by difculty initiating speech output, ascribed to executive dysfunction. There is a reduction in spontaneous speech, but on formal testing there are no paraphasias, minimal anomia, preserved repetition, and automatic speech. A division into pure and mixed forms has been suggested, with additional phonological, lexical, syntactical, and articulatory impairments in the latter. Some authorities reserve the term for provoked positive sensory phenomena, as opposed to spontaneous sensations (paraesthesia). Dysaesthesia differs from paraesthesia in its unpleasant quality, but may overlap in some respects with allodynia, hyperalgesia, and hyperpathia (the latter phenomena are provoked by stimuli, either non-noxious or noxious). There are many causes of dysaesthesia, both peripheral (including small bre neuropathies, neuroma, and nerve trauma) and central. Dysaesthetic sensations may be helped by agents such as carbamazepine, amitriptyline, gabapentin, and pregabalin. Cross References Allodynia; Hyperalgesia; Hyperpathia; Paraesthesia Dysarthria Dysarthria is a disorder of speech, as opposed to language (cf. Dysarthria is a symptom, which may be caused by a number of different conditions, all of which ultimately affect the function of pharynx, palate, tongue, lips, and larynx, be that at the level of the cortex, lower cranial nerve nuclei or their motor neurones, neuromuscular junction, or bulbar muscles themselves. Dysarthrias affect articulation in a highly reliable and consistent manner, the errors reecting the muscle group involved in the production of specic sounds. Dysdiadochokinesia is a sign of cerebellar dysfunction, especially hemisphere disease, and may be seen in association with asynergia, ataxia, dysmetria, and excessive rebound phenomenon. Cross References Asynergia; Apraxia; Ataxia; Cerebellar syndromes; Dysmetria; Rebound phenomenon Dysexecutive Syndrome the term executive function encompasses a range of cognitive processes including sustained attention, uency and exibility of thought, problem-solving skills, -117 D Dysgeusia and planning and regulation of adaptive and goal-directed behaviour.


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