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Prise en charge ambulatoire des mastectomies
Objectif de l'étude : Evaluer la faisabilité des mastectomies sur le mode ambulatoire à l'Institut de Cancérologie de l'Ouest René Gauducheau. Matériel et Méthode : Etude de cohorte prospective incluant 109 patientes prises en charge pour une mastectomie quelque soit le geste axillaire. Résultats : Les suites opératoires sont bien tolérées sur le plan de la douleur pour 99% des patientes et des nausées vomissements post-opératoires pour 94% des patientes le soir de l'intervention. 30% de l'ensemble des patientes auraient accepté a priori une prise en charge ambulatoire. Plus de 50% l'auraient acceptée en cas de mastectomie simple (p=0,0018). 71% de l'ensemble des patientes ont un score de Chung supérieur ou égal à 9 le soir de l'intervention. Les principaux facteurs physiques limitant le retour à domicile sont la fatigue et la gestion du drain à domicile. Conclusion : Ces résultats ainsi que l'analyse de la littérature nous semblent en faveur d'une prise en charge des mastectomies en ambulatoire pour des patientes volontaires et sélectionnées.
From Alfred the Great to Stephen
Twenty-two collected essays on late Anglo-Saxon and Norman history.
Citizens and Kings
Portraiture was at a crossroads from 1770-1830, a period when the influence of monarchs and aristocrats waned in favor of the new pioneers of democracy. This catalogue traces the evolving presentation of the portrait sitter, with sumptuous full-color reproductions of works by masters presented alongside lesser-known but equally intriguing pieces. An international team of scholars provides valuable information on sitters as well as artists, plus discussions of key works from the Enlightenment and revolutionary period.
The United Nations World Water Development Report – N° 5 - 2014
The WWDR 2014 on Water and Energy is now an annual and thematic report with a focus on different strategic water issues each year. It is shorter in the order of 100 pages with a standardized structure and data and case studies annexes related to the theme. The WWDR 2014 will be launched during the main World Water Day celebrations in Tokyo, Japan on 21 March 2014. Water and energy are closely interconnected and highly interdependent. Trade-offs need to be managed to limit negative impacts and foster opportunities for synergy. Water and energy have crucial impacts on poverty alleviation both directly, as a number of the Millennium Development Goals depend on major improvements in access to water, sanitation, power and energy sources, and indirectly, as water and energy can be binding constraints on economic growth the ultimate hope for widespread poverty reduction. This fifth edition of the United Nations World Water Development Report (WWDR 2014) seeks to inform decision-makers
Food Packaging and Shelf Life
The importance of food packaging hardly needs emphasizing since only a handful of foods are sold in an unpackaged state. With an increasing focus on sustainability and cost-effectiveness, responsible companies no longer want to over-package their food products, yet many remain unsure just where reductions can effectively be made. Food Packaging and
Food Loss and Waste Reduction
Focusing on the crucial sustainability challenge of reducing food loss at the level of consumer society, this volume provides an in-depth, research-based overview of this multifaceted problem. It considers the myriad environmental, economic, social, and ethical factors associated with the enormous amount of food waste, which also end up wasting water, air, electricity, and fuel, which are necessary for food processing. This book uniquely examines the social and cultural views of food waste management, shedding new light on the topic by emphasizing the consumer/household perspective throughout. Drawing on a wide variety of disciplines, the book presents philosophical reflections, practical examples and case studies, and potential solutions to the problem of increasing food waste.
Introduction to Programming in Python
Today, anyone in a scientific or technical discipline needs programming skills. Python is an ideal first programming language, and Introduction to Programming in Python is the best guide to learning it. Princeton University’s Robert Sedgewick, Kevin Wayne, and Robert Dondero have crafted an accessible, interdisciplinary introduction to programming in Python that emphasizes important and engaging applications, not toy problems. The authors supply the tools needed for students to learn that programming is a natural, satisfying, and creative experience. This example-driven guide focuses on Python’s most useful features and brings programming to life for every student in the sciences, engine...
