Stosowanie metod uproszczonych przy wymiarowaniu wg EC6 a bezpieczeństwo konstrukcji murowych

The article describes the calculation method of masonry walls loaded vertically according to PN-EN 1996-1-1 and PN-EN 1996-3. The Calculation method is given and the differences between Eurocode 6 and "old Polish standard" are indicated. Additionally, the differences between calculations according to exact and simplified method described in Eurocode 6 that show adverse consequences of the use of simplified method. The places (formulas and assumptions), which causes the discrepancies in calculation methods are pointed out in the study.Opracowanie opisuje metodę obliczeń ścian murowanych obciążonych głównie pionowo według norm PN-EN 1996-1-1 oraz PN-EN 1996-3. Podana została metodyka obliczeń oraz wskazano różnice pomiędzy EC 6 oraz dotychczasową polską normą. Omówiono rozbieżności pomiędzy wynikami obliczeń wg metod opisanych w EC 6. Wskazano miejsca, które powodują rozbieżności w metodach obliczeń

Ocena jakości życia pacjentów po udarze mózgu

Introduction. Quality of life (QOL) has been defined as a person’s perception of their social, cultural and self-worth position in the society and its effect on the person’s goals, expectations and apprehensions in life. It is a wide-ranging concept including physical health, mental state, level of independence and social relationships.Aim. The aim of the study was to asses the quality of life of patients after a cerebral stroke.Material and Methods. The study was carried out in a group of 106 patients after a cerebral stroke and hospitalized in the neurological ward. The age of the patients was ranged 32–90 years (mean age 59.12±13.04). Females constituted 56.00% of the studied group. The majority of patients were married (57.55%). The study material was obtained with the use of WHOQOL-Bref scale and Barthel scale.Results. The patients’ assessment of their general quality of life was at a mean level of 3.18±0.943 and their assessment of the state of health was 2.96±0.94. Distribution of the mean values in specific domains of life was as follows: social (55.00±21.61), environmental (54.23±16.67), somatic (53.89±18.17), psychological (46.53±17.23). Evaluation of the patients with Barthel scale classified the majority of them into Category II (51.90%), while Category I included 41.50% of patients; only 6.60% were in the worst state and qualified for Category III.Conclusions. Self-assessment of the patients recovering from a cerebral stroke was at a reduced level. The patients’ functional agility significantly affected their assessment of the quality of life. The type of stroke, education and place of living had a considerable effect on self-assessment of the quality of life in the patients recovering from a cerebral stroke. (JNNN 2017;6(4):163–169)Wstęp. Jakość życia (QOL) została określona jako postrzeganie przez osoby ich pozycji w życiu w kontekście systemów kultury i wartości, w których żyją relacji do ich celów, oczekiwań i obaw. Jest to szeroko pojęta koncepcja obejmująca zdrowie fizyczne, stan psychiczny, poziom niezależności, relacje społeczne.Cel. Celem badań było dokonanie oceny jakości życia pacjentów po udarze mózgu.Materiał i metody. Badania przeprowadzono w grupie 106 pacjentów po przebytym udarze mózgu, hospitalizowanych w oddziale neurologii. Wiek badanych zawierał się w przedziale 32–90 lat (średnia 59,12±13,04). Kobiety stanowiły 56,00% badanej grupy. Większość pacjentów pozostawało w związku małżeńskim (57,55%). Materiał badawczy zebrano za pomocą skali WHOQOL-Bref oraz skali Barthel.Wyniki. Pacjenci ocenili ogólną jakość swojego życia na poziomie średniej 3,18±0,94 a stan swojego zdrowia na 2,96±0,94. Rozkład średnich w poszczególnych dziedzinach jakości życia kształtował się następująco: socjalna (55,00±21,61), środowiskowa (54,23±16,67), somatyczna (53,89±18,17), psychologiczna (46,53±17,23). Dokonując oceny badanych skalą Barthel stwierdzono, że najwięcej badanych znalazło się w kategorii II (51,90%). W kategorii I było 41,50% osób, a tylko 6,60% było w najcięższym stanie i zakwalifikowano je do kategorii III.Wnioski. Samoocena jakości życia przez pacjentów po udarze mózgu była na obniżonym poziomie. Sprawność funkcjonalna badanych znacząco wpływała na samoocenę ich jakości życia. Rodzaj udaru, wykształcenie oraz miejsce zamieszkania miały znaczący wpływ na samoocenę jakości życia przez pacjentów po udarze mózgu. (PNN 2017;6(4):163–169

Nursing care for a patient after an ischemic stroke

Introduction and aim of the study. More than half of ischemic strokes occur above the age of 65, so a stroke is above all a disease of an old age. The problem of a stroke is crucial, because apart from a high mortality rate it also entails a disability. The aim of the study was to determine the scope of nursing care for the patient after an ischemic stroke. Methods and materials. The study was based on the case study method with the use of the following research techniques: documentation analysis, an interview, measurement and observation. Moreover, the study tools applied comprised: an individualized nursing care plan, Barthel Scale, Glasgow Scale, Dutch Scale, the authors’ own test examining the patient’s knowledge. Criteria for the care categories. Findings. After the interview, the biopsychosocial status of the patient was assessed. Nursing diagnoses were made using the empirical data for this purpose. Conclusions. The sudden occurrence of the disease, hospitalization and lack of support from relatives is a difficult and critical situation for the patient, and it disturbs normal functioning in all spheres: biological, psychological and a social one

The nurse's role in patient care after laparoscopic cholecystectomy using ICNP®. Case study

INTRODUCTION. Cholelithiasis is a disease occurring very often and affects people of all ages, occurs in both young people as well as in the elderly. Due to such a high incidence of this disease every nurse should be able to identify nursing problems occurring in a patient before and after surgery to remove the gallbladder and be able to solve them. PURPOSE. The aim of the study was to analyze the tasks of nurses and use of ICNP® in the care of the patient after laparoscopic cholecystectomy. MATERIAL AND METHODS. In a study on 12.10.2018 r. And 11.12.2018 r. The method used was an individual case. Were used research techniques such as documentation analysis, interview, measurement, observation. Meetings were held in Lublin, the Independent Public Clinical Hospital No. 4. Person test was 58 - year-old woman after laparoscopic cholecystectomy. The study used research tools such as card individualized nursing care developed by the staff of the Faculty of Health Sciences, Medical University of Lublin, Barthel Index, Scale Norton, Fagerström test, according to test. Starzyńska, test by checking their knowledge about the disease and skills in preparation for self-care after leaving the hospital, criteria for the categories of care and VAS. RESULTS. As a result of careful analysis of the health situation of the patient lists 11 negative diagnoses based on classifications ICNP. Also developed a plan of nursing care. CONCLUSIONS.The patient after laparoscopic cholecystectomy requires medical care, nursing, rehabilitation, preventive education and for faster recovery and eliminate complications

Nurse's participation in the care of patients after a blind brainous impact, under long-term care

Introduction. The most important principle of long-term care is the complexity of activities performed and supervised by a nurse. Due to the large deficit of nurses on the labor market and the insufficient level of their qualifications, ensuring professional performance of nursing tasks is difficult. Often, such care is required in patients who have had an ischemic stroke. Purpose. The aim of the study was to determine the scope of nursing activities towards a patient after an ischemic stroke in long-term care conditions. Material and methods. In the study conducted on 1.12.2018 and 2.12.2018, the individual case method was used research techniques such as: documentation analysis, interview, measurement, observation were used. The meetings took place in a home environment. The examined patient was a 66-year-old man after an ischemic stroke. The study used research tools such as: Personalized nursing care card developed by employees of the Faculty of Health Sciences of the Medical University of Lublin, Barthel Scale, Glasgow Scale, Norton Scale, BMI Index, Scale of assessment of basic everyday activities ADL, Own test checking the patient's knowledge / guardian, Criteria for care category and VAS Scale. Results. As a result of a thorough analysis of the patient's health situation, three positive and nine negative diagnoses were specified. A nursing care plan has also been developed. Conclusions. A patient after ischemic stroke who is qualified for long-term care requires holistic care and nursing due to a significant deficit of self-care. Keywords: nursing care, patient, stroke, long-term care

Wybrane aspekty jakości życia pielęgniarek pracujących w oddziałach neurologicznych

Introduction. The term “quality of life” (QL) initially defined “good life” determined by the resource of owned material goods. Later, it was extended to the term “to be” instead of just “to have”. Nurses perform a responsible job, often requiring sacrifices. They work with seriously ill patients at the neurology ward. Working with an ill patient is very difficult. A nurse carrying out her professional tasks is subject to numerous challenges, both mental and physical, which may affect the quality of life of this professional group.Aim. The aim of the study was to assess the quality of life of nurses working at neurological departments.Material and Methods. The study was conducted in a group of 109 nurses working at the neurological departments of hospitals in Lublin and Chelm. The study used a standardized research tool: WHOQOL-Bref scale.Results. The surveyed nurses evaluated the overall quality of life and health status on the same level, respectively: 3.70±0.70 and 3.60±0.80. The field of social relations was the highest rated (71.70±16.10), while the lowest assessed field of psychological (61.00±13.30).Conclusions. The quality of life of nurses working at neurological wards was at the average level. The surveyed nurses assessed highest the quality of life as the highest in terms of social relations. The level of professional education significantly differentiated the quality of life of the surveyed nurses. The higher the education, the better the quality of life. (JNNN 2016;5(4):151–155)Wstęp. Termin „jakość życia” (QL — quality of life) określał początkowo „dobre życie” determinowane przez zasób posiadanych dóbr materialnych. Następnie poszerzono je na obszar „być” zamiast tylko „mieć”. Pielęgniarki wykonują odpowiedzialną pracę, często wymagającą poświęceń. Na oddziale neurologicznym pracują z osobami ciężko chorymi. Praca z człowiekiem chorym jest bardzo trudna. Pielęgniarka realizując swoje zadania zawodowe podlega licznym obciążeniom zarówno psychicznym jak i fizycznym, co może mieć wpływ na poziom jakości życia tej grupy zawodowej.Cel. Celem badań było dokonanie oceny jakości życia pielęgniarek pracujących na oddziałach neurologicznych.Materiał i metody. Badania przeprowadzono w grupie 109 pielęgniarek pracujących na oddziałach neurologicznych szpitali w Lublinie i w Chełmie. W pracy wykorzystano wystandaryzowane narzędzie badawcze: skalę WHOQOL-Bref.Wyniki. Badane pielęgniarki ogólną jakość życia oraz stan zdrowia oceniły na podobnym poziomie, odpowiednio: 3,70±0,70 oraz 3,60±0,80. Dziedzina relacji społecznych była najwyżej oceniona (71,70±16,10), natomiast najniżej respondenci ocenili dziedzinę psychologiczną (61,00±13,30).Wnioski. Jakość życia pielęgniarek pracujących na oddziałach neurologicznym kształtowała się na przeciętnym poziomie. Badane pielęgniarki najwyżej oceniły jakość życia w zakresie relacji społecznych. Poziom wykształcenia zawodowego istotnie różnicował jakość życia badanych pielęgniarek. Im wyższe wykształcenie, tym lepsza ocena jakości życia. (PNN 2016;5(4):151–155

The significant impact of age on the clinical outcomes of laparoscopic appendectomy : results from the Polish Laparoscopic Appendectomy multicenter large cohort study

Acute appendicitis (AA) is the most common surgical emergency and can occur at any age. Nearly all of the studies comparing outcomes of appendectomy between younger and older patients set cut-off point at 65 years. In this multicenter observational study, we aimed to compare laparoscopic appendectomy for AA in various groups of patients with particular interest in the elderly and very elderly in comparison to younger adults. Our multicenter observational study of 18 surgical units assessed the outcomes of 4618 laparoscopic appendectomies for AA. Patients were divided in 4 groups according to their age: Group 1- 8 days. Logistic regression models comparing perioperative results of each of the 3 oldest groups compared with the youngest one showed significant differences in odds ratios of symptoms lasting >48hours, presence of complicated appendicitis, perioperative morbidity, conversion rate, prolonged LOS (>8 days). The findings of this study confirm that the outcomes of laparoscopic approach to AA in different age groups are not the same regarding outcomes and the clinical picture. Older patients are at high risk both in the preoperative, intraoperative, and postoperative period. The differences are visible already at the age of 40 years old. Since delayed diagnosis and postponed surgery result in the development of complicated appendicitis, more effort should be placed in improving treatment patterns for the elderly and their clinical outcome

Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy : results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

Laparoscopic appendectomy (LA) for treatment of acute appendicitis has gained acceptance with its considerable benefits over open appendectomy. LA, however, can involve some adverse outcomes: morbidity, prolonged length of hospital stay (LOS) and hospital readmission. Identification of predictive factors may help to identify and tailor treatment for patients with higher risk of these adverse events. Our aim was to identify risk factors for serious morbidity, prolonged LOS and hospital readmission after LA. A database compiled information of patients admitted for acute appendicitis from eighteen Polish and German surgical centers. It included factors related to the patient characteristics, peri- and postoperative period. Univariate and multivariate logistic regression models were used to identify risk factors for serious perioperative complications, prolonged LOS, and hospital readmissions in acute appendicitis cases. 4618 laparoscopic appendectomy patients were included. First, although several risk factors for serious perioperative complications (C-D III-V) were found in the univariate analysis, in the multivariate model only the presence of intraoperative adverse events (OR 4.09, 95% CI 1.32-12.65, p = 0.014) and complicated appendicitis (OR 3.63, 95% CI 1.74-7.61, p = 0.001) was statistically significant. Second, prolonged LOS was associated with the presence of complicated appendicitis (OR 2.8, 95%CI: 1.53-5.12, p = 0.001), postoperative morbidity (OR 5.01, 95% CI: 2.33-10.75, p < 0.001), conversions (OR 6.48, 95% CI: 3.48-12.08, p < 0.001) and reinterventions after primary procedure (OR 8.79, 95% CI: 3.2-24.14, p < 0.001) in the multivariate model. Third, although several risk factors for hospital readmissions were found in univariate analysis, in the multivariate model only the presence of postoperative complications (OR 10.33, 95% CI: 4.27-25.00), reintervention after primary procedure (OR 5.62, 95% CI: 2.17-14.54), and LA performed by resident (OR 1.96, 95%CI: 1.03-3.70) remained significant. Laparoscopic appendectomy is a safe procedure associated with low rates of complications, prolonged LOS, and readmissions. Risk factors for these adverse events include complicated appendicitis, postoperative morbidity, conversion, and re-intervention after the primary procedure. Any occurrence of these factors during treatment should alert the healthcare team to identify the patients that require more customized treatment to minimize the risk for adverse outcomes

Medycyna i Społeczeństwo. Materiały konferencyjne

Ze wstępu: "Z inicjatywy i pod patronatem Krakowskiej Szkoły Wyższej im. Andrzeja Frycza Modrzewskiego w Krakowie odbyła się w styczniu 2003 r. konferencja naukowa lekarzy, farmaceutów, biochemików, filozofów, fizjopatologów, farmakologów i klinicystów, których rozważania skupiały się wokół obszernego tematu „MED YCYNAISPOŁECZEŃSTWO Spotkanie otworzył JM Rektor Prof. KSW dr hab. Zbigniew Maciąg. Rektor wyraził podziękowanie wykładowcom i wyraził głęboką nadzieję, że kolejny numer wydawnictwa Szkoły Acta Academiae Modrevianae, złożony z wybranych prac prezentowanych na konferencji, służył będzie społeczeństwu."(...