40 research outputs found
A multi-center study on the attitudes of Malaysian emergency health care staff towards allowing family presence during resuscitation of adult patients
BACKGROUND
The practice of allowing family members to witness on-going active resuscitation has been gaining ground in many developed countries since it was first introduced in the early 1990s. In many Asian countries, the acceptability of this practice has not been well studied.
AIM
We conducted a multi-center questionnaire study to determine the attitudes of health care professionals in Malaysia towards family presence to witness ongoing medical procedures during resuscitation.
METHODS
Using a bilingual questionnaire (in Malay and English language), we asked our respondents about their attitudes towards allowing family presence (FP) as well as their actual experience of requests from families to be allowed to witness resuscitations. Multiple logistic regression was used to analyze the association between the many variables and a positive attitude towards FP.
RESULTS
Out of 300 health care professionals who received forms, 270 responded (a 90% response rate). Generally only 15.8% of our respondents agreed to allow relatives to witness resuscitations, although more than twice the number (38.5%) agreed that relatives do have a right to be around during resuscitation. Health care providers are significantly more likely to allow FP if the procedures are perceived as likely to be successful (e.g., intravenous cannulation and blood taking as compared to chest tube insertion). Doctors were more than twice as likely as paramedics to agree to FP (p-value = 0.002). This is probably due to the Malaysian work culture in our health care systems in which paramedics usually adopt a 'follow-the-leader' attitude in their daily practice.
CONCLUSION
The concept of allowing FP is not well accepted among our Malaysian health care providers
A cyclic universe with colour fields
The topology of the universe is discussed in relation to the singularity
problem. We explore the possibility that the initial state of the universe
might have had a structure with 3-Klein bottle topology, which would lead to a
model of a nonsingular oscillating (cyclic) universe with a well-defined
boundary condition. The same topology is assumed to be intrinsic to the nature
of the hypothetical primitive constituents of matter (usually called preons)
giving rise to the observed variety of elementary particles. Some
phenomenological implications of this approach are also discussed.Comment: 21 pages, 9 figures; v.4: final versio
Endoluminal Treatment of Barrett's Esophagus: Current and Future Prospects
Endoluminal treatment of Barrett's esophagus has become the preferred
option for initial intervention for advanced neoplasia without invasive
carcinoma. Data from abstracts presented at Digestive Disease Week 2008 provide
greater insight into optimal use of existing techniques and an early look at
potential next generation therapies. Results from the AIM Dysplasia trial
describe a larger study with longer post-treatment surveillance highlighting the
efficacy and tolerability of radiofrequency ablation, while early results from
liquid nitrogen cryotherapy studies suggest a potential to obtain similar
eradication results with very high tolerability. Endoscopic resection, despite
its risks, remains a popular option for focal as well as more widespread
resection of Barrett's mucosa. Additional abstracts highlight novel
approaches to ablation and resection. Enhanced imaging techniques and molecular
marker analysis also appear to improve treatment outcomes. However, time and
further studies of combined approaches to diagnosis and eradication are
necessary to optimize treatment algorithms