Search results for: Hilde D. Miniggio

Authors: Jillian Gardner, Hilde D. Miniggio

Abstract:

The increasing prevalence of obesity has driven the pursuit of alternative weight loss strategies, such as jaw wiring (or ‘slimming wires’), a technique known in the medical community as maxillomandibular fixation, which has evolved beyond its original intention of treating temporomandibular joint disorders. Individuals have increasingly sought and utilized the procedure for weight loss purposes. Although legal in South Africa, this trend presents dentists with ethical dilemmas, as they face requests for interventions that prioritize aesthetic preferences over medical necessity. Drawing on scholarly literature and the four principles framework of Beauchamp and Childress, this ethical analysis offers guidance for dentists facing the ethical dilemma of patient requests for jaw wiring as a weight management intervention. The ethical analysis concludes that dentists who refuse autonomous requests to perform jaw wiring for purely weight loss purposes are ethically justified within the principlist framework in overriding these requests when the principles of non-maleficence and beneficence are at stake. The well-being and health of the patient, as well as societal and professional obligations, justify the refusal to perform jaw wiring purely for weight loss.

Keywords: ethics, jaw wiring, maxillomandibular fixation, principlism, weight loss

Procedia PDF Downloads 56

Authors: Hilde Heim

Abstract:

The textile industry is known for its swift adoption of innovations in fashion technology (Fash-Tech). The industry is also known for its harmful effects on the environment. Opportunely, Fash-Tech is expected to facilitate the turn towards more sustainable practice. However, although several technologies have the potential for advancing sustainable practice, many industry players, whether large or small, are confused and misinformed about Fash-Tech adoption, application, and impact. Through a visual poster presentation, this project aims to map global fashion innovations along the supply chain from fibre production to waste management, thus providing a clearer picture of numbers, scale, and adoption. While the project aims to identify Fash-Tech effectiveness in reaching sustainability goals, it also identifies areas of congestion as well as insufficiency in the accessibility of Fash-Tech. This project intends to help inform future decisions in business, investment, and policy for the advancement of sustainable practice.

Keywords: fashion technology, sustainability, supply chain, enterprise management

Procedia PDF Downloads 240

Authors: Mara Varelaki

Abstract:

In response to the challenge of the environmental crisis the discipline of environmental ethics examines the relation of human beings towards the environment and the value of the non-human constituents of the surrounding world. In the face of this crisis, assumptions regarding human and nature relations ought to be traced and reexamined because they can cause difficulties in diagnosing problematic attitudes towards the environment and non-human animals. This paper presents the claims that European and the Judea-Christian cosmogonic myths place the human figure in the core of the creation of the cosmos, thus verifying a hierarchical structure where humans occupy the top, and they establish a perception of nature as a non-human other. By doing so, these narratives provide some justification to the notion of the human-nature dichotomy and the human domination over other life forms and ecosystems. These anthropocentric assumptions evolved into what Hilde Lindemann terms master narratives and their influence extents to ecocentric ethical theories which attempt, and often fail, to shed the anthropocentrism of the western ethical tradition. The goal of this paper is (1) to trace the anthropocentric assumptions embedded in western thought and (2) articulate how they maintain their grip on our contemporary understanding of the human relation to and position within the environment, thus showing the need for a method of detecting and bracketing anthropocentric assumptions in social narratives and ethical frameworks.

Keywords: cosmogonies, anthropocentrism, human/nature dichotomy, master narratives, ecocentrism

Procedia PDF Downloads 106

Authors: Klazina T. Havinga, Hilde R. H. de Geus

Abstract:

Introduction: Pre-operative coagulation management of Apixaban prescribed patients, a new oral anticoagulant (a factor Xa inhibitor), is difficult, especially when chronic kidney disease (CKD) causes drug overdose. Apixaban is not dialyzable due to its high level of protein binding. An antidote, Andexanet α, is available but expensive and has an unfavorable short half-life. We report the successful extracorporeal removal of Apixaban prior to emergency surgery with the CytoSorb® Hemoadsorption device. Methods: A 89-year-old woman with CKD, with an Apixaban prescription for atrial fibrillation, was presented at the ER with traumatic rib fractures, a flail chest, and an unstable spinal fracture (T12) for which emergency surgery was indicated. However, due to very high Apixaban levels, this surgery had to be postponed. Based on the Apixaban-specific anti-factor Xa activity (AFXaA) measurements at admission and 10 hours later, complete clearance was expected after 48 hours. In order to enhance the Apixaban removal and reduce the time to operation, and therefore reduce pulmonary complications, CRRT with CytoSorb® cartridge was initiated. Apixaban-specific anti-factor Xa activity (AFXaA) was measured frequently as a substitute for Apixaban drug concentrations, pre- and post adsorber, in order to calculate the adsorber-related clearance. Results: The admission AFXaA concentration, as a substitute for Apixaban drug levels, was 218 ng/ml, which decreased to 157 ng/ml after ten hours. Due to sustained anticoagulation effects, surgery was again postponed. However, the AFXaA levels decreased quickly to sub-therapeutic levels after CRRT (Multifiltrate Pro, Fresenius Medical Care, Blood flow 200 ml/min, Dialysate Flow 4000 ml/h, Prescribed renal dose 51 ml-kg-h) with Cytosorb® connected in series into the circuit was initiated (within 5 hours). The adsorber-related (indirect) Apixaban clearance was calculated every half hour (Cl=Qe * (AFXaA pre- AFXaA post/ AFXaA pre) with Qe=plasma flow rate calculated with Ht=0.38 and system blood flow rate 200 ml-min): 100 ml/min, 72 ml/min and 57 ml/min. Although, as expected, the adsorber-related clearance decreased quickly due to saturation of the beads, still the reduction rate achieved resulted in a very rapid decrease in AFXaA levels. Surgery was ordered and possible within 5 hours after Cytosorb initiation. Conclusion: The CytoSorb® Hemoadsorption device enabled rapid correction of Apixaban associated anticoagulation.

Keywords: Apixaban, CytoSorb, emergency surgery, Hemoadsorption

Procedia PDF Downloads 154