Social inclusion and valued roles : a supportive framework

The aim of this paper is to examine the concepts of social exclusion, social inclusion and their relevance to health, well-being and valued social roles. The article presents a framework, based on Social Role Valorization (SRV), which was developed initially to support and sustain socially valued roles for those who are, or are at risk of, being devalued within our society. The framework incorporates these principles and can be used by health professionals across a range of practice, as a legitimate starting point from which to support the acquisition of socially valued roles which are integral to inclusio

Aortic stent-grafting: successful introduction into the combined procedure for coronary artery bypass grafting and aortic aneurysm repair

Objectives: Coronary artery bypass grafting (CABG) and combined stent-grafting (SG) were evaluated to reduce morbidity and mortality of patients with descending or infrarenal aortic aneurysm. Methods: CABG and SG (thoracic n=6, infrarenal n=36) were performed during the same hospitalization in 42 patients (mean age of 73±14 years). In 29 patients (mean Euroscore: 9), SG was performed under local anesthesia 9±3 days after coronary surgery (simultaneous) and in 13 patients (mean Euroscore: 7) during the same anesthesia (synchronous). In the latter group, 11 out of 13 patients underwent off-pump CABG. All aneurysms were treated by implantation of commercially available self-expanding grafts. Results: CABG was successful in all, but one patient with left internal mammary artery hypoperfusion syndrome, requiring an additional distal saphenous graft to the left anterior descending coronary artery. SG was uneventful in 98% (41/42 patients). Postoperative computerized tomography showed incomplete sealing in seven patients (17%), but only the two attachment endoleaks had to be treated by one proximal and one distal SG extension. Overall hospital stay for the synchronous repair was 12.5±6 days and that of the simultaneous group 17.5±7 days. Thirty-day mortality was 5% (2/42) as one patient of the simultaneous group experienced a lethal cerebral embolism during SG and one patient of the synchronous group developed an untreatable infection. In the follow-up of 4 years, there were two vascular reinterventions but no additional procedure-related morbidity or mortality. Conclusions: This experience shows that combined CABG and SG of thoracic or infrarenal aortic aneurysm is a safe and less-invasive alternative to the open graft repair, especially in the older patients or patients with severe comorbiditie

Recovery oriented mental health nursing: a pilot Intervention study

Based on previous studies that have been focusing on current practices in mental health nursing and the on-going development in mental health practice towards a more recovery-oriented approach this pilot intervention study focuses on improving mental health nursing practice through providing specific training sessions for nurses and the implementation of goal-oriented care in close collaboration with service users. Results are measured within a pre- and post-test design among health professionals and service users. The presentation will contain an introduction of the study protocol, an experience report and hopefully some initial results of the study

Views and experiences of people with intellectual disabilities regarding intimate relationships: a qualitative metasynthesis

The aims of this review were to systematically identify, critically appraise and synthesize the results of existing qualitative literature exploring the views and experiences of intimate relationships amongst people with intellectual disabilities. Fourteen peer-reviewed articles were identified through a systematic search of eight databases, reference lists, citations, and relevant journals. The identified articles were appraised for quality, then synthesized using a metaethnography approach. No study met all quality criteria and references to ethical approval were often lacking. Interpretation of the findings suggested three key themes: the meaning of intimate relationships, external constraints and facilitators, and managing external constraints. Though many people with intellectual disabilities desire and benefit from intimate relationships, they experience restrictions that others do not, which can lead to isolation and loneliness. Intimate relationships are not always necessarily linked with sexual behavior; therefore, intimate relationships warrant their own focus in future research, as well as in education and training for people with intellectual disabilities and their caregivers. Within this, a commitment to transparency over research processes is needed, in particular with reference to how ethical approval was obtained, since this has been a shortcoming of research with this focus to date

From model to radar variables: a new forward polarimetric radar operator for COSMO

In this work, a new forward polarimetric radar operator for the COSMO numerical weather prediction (NWP) model is proposed. This operator is able to simulate measurements of radar reflectivity at horizontal polarization, differential reflectivity as well as specific differential phase shift and Doppler variables for ground based or spaceborne radar scans from atmospheric conditions simulated by COSMO. The operator includes a new Doppler scheme, which allows estimation of the full Doppler spectrum, as well a melting scheme which allows representing the very specific polarimetric signature of melting hydrometeors. In addition, the operator is adapted to both the operational one-moment microphysical scheme of COSMO and its more advanced two-moment scheme. The parameters of the relationships between the microphysical and scattering properties of the various hydrometeors are derived either from the literature or, in the case of graupel and aggregates, from observations collected in Switzerland. The operator is evaluated by comparing the simulated fields of radar observables with observations from the Swiss operational radar network, from a high resolution X-band research radar and from the dual-frequency precipitation radar of the Global Precipitation Measurement satellite (GPM-DPR). This evaluation shows that the operator is able to simulate an accurate Doppler spectrum and accurate radial velocities as well as realistic distributions of polarimetric variables in the liquid phase. In the solid phase, the simulated reflectivities agree relatively well with radar observations, but the simulated differential reflectivity and specific differential phase shift upon propagation tend to be underestimated. This radar operator makes it possible to compare directly radar observations from various sources with COSMO simulations and as such is a valuable tool to evaluate and test the microphysical parameterizations of the model.</p

On the polarimetric backscatter by a still or quasi-still wind turbine

Wind turbines negatively affect the performance of weather radars, especially when located in the proximity of a radar site. In March 2019, MeteoSwiss performed a measurement campaign by deploying a mobile X-band radar in Schaffhausen. It proved to be useful for mapping and characterizing the maximum power returns by three wind turbines observed using standard scanning strategies. In March 2020, the campaign was repeated using a more sophisticated scan strategy: ∼ 100 min special sessions of fixed pointing an antenna towards the nacelle of the closest wind turbine (WT) located within a range of 7766 m from the radar, interleaved every 2 h by a scanning protocol identical to that of the March 2019 campaign. Polarimetric radar signatures were derived every 64 ms using 128 radar pulses transmitted every 0.5 ms (pulse repetition frequency (PRF) = 2000 Hz). A thorough overview of the polarimetric signatures of the WT in still or quasi-still conditions has been obtained based on 30 000 polarimetric measurables acquired over 32 min on the first day of the campaign (4 March 2020). During the first 2 min with zero rotor speed, the co-polar correlation coefficient between the orthogonal polarization states, ρHV, was persistently equal to 1, similarly to the signature of a bright scatterer observed by a non-rotating antenna. The changes between two consecutive values of the differential reflectivity and radar reflectivity factor were either 0 dBz or ±0.5 dBz. Due to the absence of precipitation, one could assume that the standard deviation of the differential phase shift, which was as small as 3.0∘, can be entirely attributed to the variability of the differential backscattering phase shift. There were two 10 min periods during which the rotor moved less than 1 revolution. It is worth noting that this slow movement could be associated with a change in the blade pitch angle and the nacelle orientation, which caused extreme changes in the radar reflectivity factor. For instance, two pairs of 64 ms consecutive values reached 78.5 dBz, which is the absolute maximum reached in the whole campaign (4–21 March 2020).</p

Regional ventilation distribution and dead space in anaesthetized horses treated with and without continuous positive airway pressure: novel insights by electrical impedance tomography and volumetric capnography

Objective: The aim of this study was to evaluate the effect of continuous positive airway pressure (CPAP) on regional distribution of ventilation and dead space in anaesthetized horses. Study design: Randomized, experimental, crossover study. Animals: A total of eight healthy adult horses. Methods: Horses were anaesthetized twice with isoflurane in 50% oxygen and medetomidine as continuous infusion in dorsal recumbency, and administered in random order either CPAP (8 cmH2O) or NO CPAP for 3 hours. Electrical impedance tomography (and volumetric capnography (VCap) measurements were performed every 30 minutes. Lung regions with little ventilation [dependent silent spaces (DSSs) and nondependent silent spaces (NSSs)], centre of ventilation (CoV) and dead space variables, as well as venous admixture were calculated. Statistical analysis was performed using multivariate analysis of variance and Pearson correlation. Results: Data from six horses were statistically analysed. In CPAP, the CoV shifted to dependent parts of the lungs (p < 0.001) and DSSs were significantly smaller (p < 0.001), while no difference was seen in NSSs. Venous admixture was significantly correlated with DSS with the treatment time taken as covariate (p < 0.0001; r = 0.65). No differences were found for any VCap parameters. Conclusions and clinical relevance: In dorsally recumbent anaesthetized horses, CPAP of 8 cmH2O results in redistribution of ventilation towards the dependent lung regions, thereby improving ventilation-perfusion matching. This improvement was not associated with an increase in dead space indicative for a lack in distension of the airways or impairment of alveolar perfusion

Scalable Synthesis of Self‐Disinfecting Polycationic Coatings for Hospital Relevant Surfaces

The prevention of microbial infections is a global challenge. Efficient antimicrobial coatings that rapidly kill microorganisms upon contact can help minimize their transmission. However, their scalable synthesis is challenging. This work demonstrates the scalable synthesis and characterization of self‐disinfecting nanofilms for the postmodification of hospital‐relevant surfaces. Their antimicrobial action is based on charge interactions between a supercharged cationic surface film and the negatively charged bacteria membrane. Photoinitiated bulk polymerization of an air‐dried [2‐(methacryloyloxy)ethyl]trimethylammonium chloride film on cotton (gowns), nitrile rubber (protective gloves), and glass surfaces (tables, screens) is used for their supercharging, and studied with streaming potential measurements. A 6 nm thick coating dominated by cationic quarternary amine groups is shown by a combination of spectroscopic imaging ellipsometry and X‐ray photoelectron spectroscopy. Antimicrobial in vitro evaluation of the coated surfaces demonstrates up to ≈4 log reductions in bacterial populations in less than 5 min. Confocal laser scanning microscopy and live‐dead staining confirm the surface‐induced killing of bacteria. The coating's range of compatible materials and its rapid bactericidal activity can combat the surface transmission of bacteria and may help to contain the spread of infectious diseases. Its synthesis in environmental conditions is promising for integration into industrial processes

Identifying Contact Risks for SARS-CoV-2 Transmission to Healthcare Workers during Outbreak on COVID-19 Ward

We assessed the risk for different exposures to SARS-CoV-2 during a COVID-19 outbreak among healthcare workers on a hospital ward in late 2020. We found working with isolated COVID-19 patients did not increase the risk of COVID-19 among workers, but working shifts with presymptomatic healthcare coworkers did